As part of a national week of action, there are daily protest rallies against the genocide in Gaza in front of the BRI at 12 noon. The rally is held in front of a hospital to show solidarity with health workers in Gaza who have been<a href="https://www.vitalsignsmag.org/posts/against-the-militarisation-of-the-health-sector-a-vital-signs-position"> systematically and fatally targeted by the Israeli army. </a>
Unfortunately not many workers from the BRI participated in the protest. I haven’t seen any posters or leaflets inside the hospital that would invite fellow workers to the rally. Based on individual conversations at work, in particular with younger nurses and HCAs, I have the impression that many would join an anti-war protest during their lunch break.
From a political perspective it was rather painful to demonstrate under the Iranian flag &#8211; or actually under any national flag. Workers and poor peasants gained little during the various wars of ‘national liberation’ during the 20th century &#8211; they were mainly used as cannon fodder to establish a new national elite. Even during the struggle against the Apartheid system in South Africa, <a href="https://www.angryworkers.org/2021/06/17/the-national-liberation-struggle-some-personal-experiences-from-southern-africa/">the working class and poor were sold out by the new ANC-led regime. </a>
We have to fight against war and state repression, as part of a wider internationalist struggle for a society without exploitation and nation states. Currently we have to undermine the war machine by all means necessary &#8211; for example in France,<a href="https://en.labournet.tv/en/videos/grenoble"> fellow workers at ST Microelectronics</a> went on strike against the use of their microchips in weapons systems of the Israeli army. 
Down with all war regimes, whether in Russia or Ukraine, whether in Iran or Israel &#8211; and first of all the one<a href="https://www.angryworkers.org/2025/07/16/short-overview-on-the-process-of-militarisation-in-the-uk/"> here in the UK!</a>
<a href="https://www.vitalsignsmag.org/posts/thoughts-for-a-working-class-revolution">For international working class solidarity and revolution </a>

Protest in front of the BRI against the genocide in Gaza

The picket in front of the Bristol Royal Infirmary was sunny and lively, with about 40 resident doctors and supporters present. Like during the last BMA strike it was decided by the union where pickets would be held, in order to bring a bigger mass of people together. This meant that there were resident doctors from Yeovil, Southmead hospital and smaller local clinics present. You can read an interview and an analysis of<a href="https://www.vitalsignsmag.org/posts/conversation-with-a-junior-doctor-about-the-recent-strikes"> the last round of BMA strikes here.</a>
A rushed strike?
A resident doctor friend felt that the BMA might have rushed into the strike, that the government has withdrawn the promise of pay restoration and that this time round the strike will be tougher. It’s a shame that the BMA strike comes at a point where we don’t know yet whether other NHS workers who are members of other unions will vote to strike, or not. Currently it looks unlikely that the unions will encourage enough of their members<a href="https://www.vitalsignsmag.org/posts/wheres-our-pay-increase-its-our-power-vs-the-power-of-the-state-and-the-rich"> to vote for industrial action</a>, which means that with current inflation levels we look at another real wage cut for the wider NHS workforce.
Deserving more than others?
The question is if the resident doctors feel that they have a better chance of getting a pay increase if they link their struggle with the struggle of the general NHS workforce &#8211; or, as it often seems, if they emphasise that they, as doctors, deserve more than others (see the picture of a sign of one of the strikers). In general, the union seems to have told members to push the slogan that resident doctors deserve “more than their assistants”, meaning,<a href="https://www.vitalsignsmag.org/posts/physician-associates-vs-advanced-practitioner-vs-doctors-cooperation-or-bare-knuckle-fight"> physician assistants.</a> We reckon that this will undermine the future unity of health workers and it will make it easy for the government and the media to portray the resident doctors as a “greedy and privileged profession”. At the same time, resident doctors have disadvantages compared to other NHS workers, e.g. there is no automatic pay progression through seniority. <a href="https://www.vitalsignsmag.org/posts/the-mysterious-world-of-nhs-bands-or-how-we-re-grade-health-care-assistants-to-a-band-8">We have to question the wage divisions from below.</a>
<img loading="lazy" decoding="async" class="alignnone size-medium wp-image-658" src="https://vitalsignscontenteditor.co.uk/wp-content/uploads/2025/07/WhatsApp-Image-2025-07-25-at-13.10.19_9b272952-300x225.jpg" alt="" width="300" height="225" srcset="https://vitalsignscontenteditor.co.uk/wp-content/uploads/2025/07/WhatsApp-Image-2025-07-25-at-13.10.19_9b272952-300x225.jpg 300w, https://vitalsignscontenteditor.co.uk/wp-content/uploads/2025/07/WhatsApp-Image-2025-07-25-at-13.10.19_9b272952-1024x768.jpg 1024w, https://vitalsignscontenteditor.co.uk/wp-content/uploads/2025/07/WhatsApp-Image-2025-07-25-at-13.10.19_9b272952-768x576.jpg 768w, https://vitalsignscontenteditor.co.uk/wp-content/uploads/2025/07/WhatsApp-Image-2025-07-25-at-13.10.19_9b272952-1536x1152.jpg 1536w, https://vitalsignscontenteditor.co.uk/wp-content/uploads/2025/07/WhatsApp-Image-2025-07-25-at-13.10.19_9b272952.jpg 2040w" sizes="auto, (max-width: 300px) 100vw, 300px" />
The impact of the strike
At Southmead hospital elective surgeries have largely been cancelled and some people have been sent to work in trauma. Management also encourages workers to take annual leave, as they only need so many people to do some extra cleaning or restocking. During the last round of strikes we, as the wider health workforce, only noticed the strike through cancellations. The strikers themselves remained invisible within the hospital, there were no direct conversations about the strike. It would be good to change that and do ‘ward rounds’ to inform everyone about the strike and its aims.

Picket of striking resident doctors in July 2025

On the 4th of July 2025, health workers and supporters met in Gloucester town centre to celebrate 100 days of strike. The 37 phlebotomists in the hospital want to pressure trust management to re-grade them from Band 2 to Band 3. Currently phlebotomists, who take blood samples from hospital and GP patients, earn 17p more than the minimum wage. At the BRI in Bristol, the trust used to offer vacancies for phlebotomists on bank &#8211; this means that the samples on which most medical diagnosis is based are gathered by minimum wage workers on zero-hour contracts.
The issue of re-banding workers is peculiar. There are national job profiles, which local trusts should use in order to write their<a href="https://www.vitalsignsmag.org/posts/the-mysterious-world-of-nhs-bands-or-how-we-re-grade-health-care-assistants-to-a-band-8"> job descriptions and band their workers</a>. In the case of health care assistants (HCAs) the national job profile said that anyone who is doing medical tasks (taking blood pressure, performing blood sugar tests or taking blood samples) should be paid Band 3. Most trusts regraded their HCAs themselves, in other trusts the trade unions used the opportunity <a href="https://www.vitalsignsmag.org/posts/a-hot-winter-a-series-of-local-strikes-within-the-nhs">to stage strikes</a>, which in the case of HCAs were often successful. Unison was able to present these disputes as victories, although the strikes just enforced what workers were entitled to anyway. In the long run, <a href="https://www.vitalsignsmag.org/posts/issue-no-1-re-banding-or-banding-together">the trade union strategy</a> to justify the fight for higher wages by referring to skill levels and job categories will only contribute to the deepening of divisions within the workforce &#8211; and thereby weaken everyone. 
It seems that with the phlebotomists the union miscalculated slightly, which could explain the fact that the strike is dragging out that long. The work of phlebotomists is even more reduced to single tasks than the work of health care assistants. This means that it is easier for the trust to replace the striking workers by forcing nurses and health care assistants to perform more venepunctures for blood samples than they normally do. Over the course of the strike, the phlebotomists have been able to win over the lower level Band 4 supervisors who joined them in strike in the 5th to 6th week. This is an impressive, and necessary step. It can help us to question the function of managment in future: which of the tasks are necessary and which are only there to justify hierarchies and discipline workers.
Unfortunately there were no nurses or health care assistants at the strike rally and from short conversations with the phlebotomists, I gathered that there aren’t any strong links between striking workers and their nurses colleagues &#8211; not even with those nurses who are members of the same trade union. For the strike to hit home,  the nurses and HCAs would have to refuse to do the extra work. This lack of practical solidarity between professional groups is a major problem, which undermines the strength of the strike.
This lack of strength cannot be compensated for by well-meaning speeches of leftists and trade union supporters, who promise that ‘the entire trade union movement’ is behind the strikers. What we need is more analysis of the strength and weaknesses of our struggles &#8211; and less trade union stage-shows of symbolic unity.

100 days strike of phlebotomists in Gloucester

This article will be circulated in <a href="https://www.vitalsignsmag.org/posts/vital-signs-no-4">Vital Signs Mag no.4</a>, of which we distribute 1,000 copies within our two local hospitals. Feel free to help us with the <a href="https://www.angryworkers.org/contact/">print cost</a>.
In Vital Signs no.3 we wrote about outsourcing of orthopedics theatres to private companies on weekends. Things have moved on since then. At weekends the Trust rents out theatres to the private health agency KPI. Instead of asking the Trust&#8217;s own staff they bring in a private company to operate on NHS patients. For the Trust this looks good on paper: income from the rent payment and additional surgeries to reduce the waiting list. But from a social perspective it doesn’t make sense at all. The private company gets the money back from the NHS, plus a big profit,   
The surgeons, scrubs nurses, ODPs and health care assistants often don’t know each other at all and haven’t worked together before. In one case scrub nurses came all the way from Liverpool, in order to work for a weekend in Bristol. It’s not only that they don’t know each other, they also don’t know the local theatres. This is why the Trust employs a so-called link nurse, normally a local Band 6 nurse who is paid extra to be around on weekends to support the private team. Still, it is not unlikely that in emergency situations a team that is not familiar with local infrastructure would struggle to be as effective. 
The employment of a link nurse at premium pay was also a way for the Trust to undermine the resistance to privatisation. It was the Band 6 nurses in particular, who had initially questioned the move to open the theatres for private business. The deal with management was that the link nurses would also prepare everything for the weekend sessions, for example the boxes with necessary disposables, such as sutures or drapes. However, because the Band 6 nurses are very busy during the week with normal NHS surgeries, it ended up being the NHS health care assistants who were actually asked to prepare things for the private business, which caused confusion and tension. Another problem is the lack of instrument sets. The Trust might decide to use disposable instruments, instead of more costly sterilised sets, which causes large amounts of extra waste. Carting nurses all the way down from Liverpool to work with one-time-use instruments just in order to show off some superficially good-looking waiting list figures &#8211; that’s what you call green sustainable hospital management. Not!
The dispute about employing private companies on weekends is not only about it being disadvantageous to local NHS staff. The bigger picture is that they want us to get used to the idea that profit is acceptable in healthcare, and that you might have to pay extra (beyond the tax that you already pay!) for health services. This basically means a significant pay cut for all workers and a money transfer to the corporations and their owners. 
The private sector currently receives £12.3bn a year for treating NHS patients, according to the Department of Health and Social Care (DHSC) annual report from December 2024. The NHS payments account for nearly a third of the private health companies revenues, compared with 10% two decades ago. In 2023, private operators carried out 1.7m NHS procedures – 10% of all planned operations. Under current Labour government plans this figure is supposed to increase to 20%. Once the private sector has a certain market share it uses the fact that patients depend on it by increasing prices, e.g. the cost of undergoing a hysterectomy privately has soared by 19% from £7,385 in 2021 to £8,795 in 2023. Rich patients will be able to pay, working class patients will be made to suffer. The state is acting according to a short-term calculation: instead of investing in the NHS, they are trying to make use of already existing capacities of the private sector. Actually, the state ends up paying more and also loses experienced workers to the private sector. In the long-term this is disastrous for all of us who either work in the NHS or depend on its services.
The problem is that the state and the private companies are able to bribe NHS staff to cooperate with the process of privatisation. What, for example, about the so-called Glanso lists, which are popular both at NBT and UHBW? Glanso UK Ltd. was founded by two consultant anesthetists in Bristol in 2019. The anesthetists consultants made use of their relative monopoly and told Trusts that they would only perform extra shifts in order to cut waiting lists if they would be paid extra as a private company, rather than as NHS employees. The Trusts agreed to that blackmail and not only gave them infrastructure, but also NHS staff. In order to sweeten things with NHS scrub nurses, health care assistants and porters, these get paid on a ‘per case’ basis when working weekend Glanso lists, which often means a much higher wage compared to a normal NHS shift. These higher payments are just an initial carrot in order to get a foot in the door &#8211; in the long-run wages will be more difficult to defend once we work in a more fragmented corporate sector, compared to being employed by a large-scale employer &#8211; unless you have the privilege of having a rare qualification like a consultant anesthetist, of course.
We have to oppose the blackmail and refuse to cooperate with the process of privatisation, it will mess things up for us in the future, both as workers and as patients.

Protest in front of the BRI against the genocide in Gaza

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