By developer – Achievements and defeats so far
(Originally published in newsletter no. 31 for November 2024)
[ On the one year anniversary of the Abhaya protests, we are republishing this analysis of the protests we wrote in November of 2024, where we look back at the conclusion of the most active phase of the doctor’s movement, and analyze the results of the protests ]
On the 1st of October the protesting junior doctors withdrew their hunger strike, accepting many of the concessions offered by the State government, and withdrawing the strike completely. Normalcy has returned to the hospitals, even as the protest movement as such has not stopped. Rather than the state government, the focus of the doctor’s ire comes on the CBI which is investigating into the rape and murder of Abhaya.
With this, we have entered what might be the final phase of the doctor’s movement, with many considering the movement to have ended. If so, this would mark the conclusion of one of the most significant mobilizations since the farmer’s uprising in 2020. The doctor’s movement had shaken up the state government to its core, and exposed the corrupt nature of the TMC. The tug of war between the entrenched bourgeois government of the TMC and the junior doctors, who had the support of the vast majority of the masses of urban and rural people of West Bengal, showed us the ways in which the TMC deals with mass mobilizations.
The movement succeeded not only exposing the TMC and rattling its foundations, but also punished the BJP for their opportunistic politics and attempts at communal divisions. Despite support from mainstream bourgeois media, the BJP could not hijack the movement, and today stand utterly discredited as an opposition party in the state.
The CPIM and its youth wings were in support of the movement from the start, but was not leading the movement. Though they had influence, they did not put their banner on the front. The movement remained without political leadership, but it was not apolitical. In this, one can see similarities with the farmer’s movement, which allowed political parties which supported it to come on stage, but did not give up independent leadership. This ‘apolitical’ nature helped legitimize the movement in the eyes of the urban middle class particularly, who could see the junior doctors and their movement being genuine. This was also a source of strength for the movement, as they were free from the political maneuverings and compulsions that mainstream political parties have, whether bourgeois or Stalinist. This independence, together with militant zeal, and organized discipline, allowed the movement to grow and inspire solidarity strikes and mobilizations across India and the Indian diaspora in foreign shores.
Against this, was the massive oppressive political machinery in the hands of the TMC. This includes its lumpen army, the police forces, investigative authorities and sections of the media. Towards the second phase of the movement, even the BJP had withdrawn its support, and the national media had stopped focusing their attention on the movement. The TMC’s strategy of concessions, deflections, and coercion had all been defeated by the movement, but the strategy of exhaustion gave the government more success. Eventually, both sides conceded ground to bring the movement to a conclusion.
Unfortunately, this latest victory, achieved through negotiations with the state government, also proved to be its undoing as the movement lost its momentum, and with it the large solidarity which had emerged also began to dissipate.
Many began to conclude that the doctor’s movement was a failure, abhaya did not get justice, and the state government has managed to reorganize with business as usual. Such a pessimistic conclusion loses sight of the bigger picture. It can be concluded that the doctor’s movement was not a complete success, but neither was it a failure. The TMC has achieved a short term success in weakening the movement, but its foundations have been shaken and the system of institutionalized corruption within public healthcare was given a body blow.
The junior doctor’s hunger strike :
The movement of the junior doctors began with a strike at R.G Kar hospital on the 9th of August. From here, the movement grew to include all of the public hospitals of West Bengal, and inspired solidarity actions from healthcare workers across the country. The state government was put on the backfoot, unable to contain the growing movement. Neither concessions, nor coercions, nor attempts at deception or deflection worked to end the movement.
The strike went on for over forty days, with the government being forced to come to negotiations with the junior doctors and their demands. Several concessions were won, including the transfer of the hated police commissioner, ending the politically controlled ‘patient help committees’, and sanctioning funds for increasing CCTV surveillance in hospitals, steps were to be taken to build restrooms and proper toilets for hospitals, and a centralized referral system to be established. The victory was the first clear cut political defeat for Mamata Bannerji as a Chief Minister and a big setback for the party, which rules through corruption, and acts chiefly as a vehicle for the enrichment of its leadership.
Despite this victory, the movement could not be ended. The government had to be kept in watch, even as the festive season of the Pujas began in October, the doctors continued to protest in the streets. Solidarity from the public was still strong. Public sympathy largely lay with the junior doctors.
The government took no concrete steps to implement the agreement with the doctors, by the first week of October only 6% of the infrastructural work had been completed, all the while key officials responsible for the institutionalization of corruption in healthcare remained in power, such as the Health Secretary. The system of extortion in public hospitals, more commonly known as ‘threat culture’, remained unchanged. It was the government’s lackadaisical attitude which prompted the doctors to return to strike, this time embarking on an indefinite hunger strike.
This move came at a time when apathy was beginning to creep into the minds of the people. Solidarity actions were dissipating, and the state appeared to regain confidence to use coercion and violence against the protestors. The hunger strike re-electrified the movement, and put the spotlight back on the junior doctor’s movement. The timing could not have been worse for the government, as it took place right in the midst of the Durga puja festivities. This was a deliberate act of defiance, aimed against the Chief Minister’s call to ‘return to festivities’.
The hunger strike was accompanied by massive solidarity protests, joined in by large numbers of Calcutta’s citizenry. There were solidarity protests in Delhi and support from the Indian medical Association as well. The durga pujas happened with the protests casting a large shadow over it. The government’s efforts at coercion and deflection, using the festivals to distract and pacify the masses, failed in the face of such solidarity.
The hunger strike went on for more than two weeks, and the momentum only grew with each passing day, even as the health of the striking doctors deteriorated. Six of the doctors had to be admitted to intensive care, and there was a very real possibility that any of the doctors on strike could have died. Before such an eventuality came to pass, the government succumbed to pressure and agreed once more to negotiations with the doctors.
This time however, the state had the upper hand in the sense. The hunger strike had exhausted the best of the doctors, and the festive season had at least partially, dampened the militant mood of the people. The protests in the second phase was smaller than in September and August. This time, the Central government and its agencies had also worked against the doctor’s movement, the Supreme Court did its part to pacify the public, the CBI as usual continued to act as agents of the ruling party of India.
The exhaustion in the minds of the doctors and the waning strength of the movement was clear in the negotiations with the Chief Minister which was livestreamed, unlike the first negotiations in September.
The second round of negotiations with the Chief Minister :
The hunger strike lasted from 5th of October to the 27th of October. Before it was withdrawn, the striking doctors accepted offers for negotiations with the Chief Minister, just as the IMA had announced plans for a big solidarity strike in support of the striking junior doctors in West Bengal.
By this time six doctors had fallen critically ill, and been admitted into intensive care unit. Solidarity with the doctor’s strike which had begun to wane after the agreement reached in September, began to grow, foiling the strategy of the state government to use exhaustion as a strategy to end the movement. Once more, they would resort to concessions.
The second round of negotiations with the state took place on the 22nd of October. This time the government conceded to live streaming of discussions, perhaps hoping that with the doctors exhausted by the protests and hunger strike, the Chief Minister would hold the upper hand. This proved to be a bad calculation, as the Chief Minister’s bias and ignorance was put on full display over the course of the discussion, recorded and shared publicly for all to see.
At the same time, the Chief Minister had managed to successfully steer the course of the discussions away from the question of justice for Abhaya, and neither did she entertain the most pressing demands of the doctors for the resignation of the health secretary, and answer any questions relating to the botched investigation by the police or the cover up. The focus of the discussions was the administration of public hospitals, the systematic intimidation of doctors, and holding elections within medical colleges which had been stalled for a long time now.
On these points the government conceded without committing to any hard deadline. The government sought one month to implement the agreed reforms, including improvements to hospital facilities, and holding elections in medical colleges by March of 2025. A task force led by four junior doctors, a female medical student, and presided by a senior government official would be formed to look into all complaints regarding government medical colleges.
All in all, the results of the meeting itself was disappointing, in exchange for the government’s assurances, the junior doctors withdrew their hunger strike. The protest movement was not called off however, but changed focus. Rather than the state government, it was the central investigating agencies who became the focus of the doctor’s anger.
In the aftermath of these negotiations, the leading organization of junior doctors the West Bengal Junior Doctor’s front split. Now there are two organizations heading the protests. No doubt this split has caused much relief in the minds of the beleaguered state government which hopes this would be a sign of weakness.
It can be said without a doubt that the momentum and intensity of the protest movement has waned. The daily protests, the spontaneous torch marches, and rallies no longer happen. While public sympathy remains with the junior doctors, the solidarity seen on the streets is no longer visible. However, the doctors have not stopped protesting, a gallery focusing on the protest has been placed at R.G Kar hospital, and SSKM hospital, called ‘droher gallery’ (gallery of rebellion) as a permanent mark of protest. On the 31st of October the doctors took out a protest march against the CBI for the slowness of its investigation.
Though the protest movement has not officially ended, there is a feeling that it is no longer alive. From this, many have made the pessimistic conclusion that the junior doctor’s movement was a failure in totality.
Victories and defeats :
The junior doctor’s movement is likely entering its final phase with the end of the hunger strike, cease work and the split of the WBJDF. It is worth looking over the struggle and understand what was achieved and what was lost.
Undoubtedly the greatest victories were achieved at the initial stages of the movement. The principal of R.G Kar hospital, Sandip Ghosh, was disgraced and isolated by the student protesters. Attempts by the government to protect him and the hospital administration was foiled by the protesting resident doctors and medical students. It was protesting doctors who compelled the hospital administration to conduct the autopsy of Abhaya, when the administration was all set to hide away and burn the body, much like how the UP police had done in Hathras.
The efforts at cover up were hasty and rushed, and would have succeeded were it not for the steadfast actions by the junior doctors. The fact that a proper autopsy had to be done, and investigation had to be conducted against the Principal of R.G Kar was one of the first great victories of the doctor’s movement.
Later revelations emerged of Sandip Ghosh’s network of corruption, one which he built through political patronage. He had been using R.G Kar to conduct illegal scams, selling corpses for money, taking bribes for favourable placements, and running the public hospital like his private business. He was busy enriching himself at the expense of the public, and the doctors.
It was later revealed that the principal would often punish junior doctors and students with bad placements or impossible schedules. Abhaya had suffered such a punishment, for defying the overtures of the principal.
The doctor’s first demand was to remove the principal. The government was forced to comply with this, but soon turned to protect one of their favorite money makers, by placing him in an even more prestigious hospital, the Calcutta Medical College Hospital. Once more, the students intervened to prevent his appointment. It was at this point, that Sandip Ghosh’s reign of corruption and terror was ended.
In their fight against the principal, the students also exposed the despicable way in which the TMC was administering the state’s public hospitals. Rather than centers for treatment, public hospitals were turned into tools of influence and money for the party. The case with R.G Kar hospital was the most brazen and horrifying, but a system of intimidation under ‘threat culture’ and scamming government funds for private enrichment.
The protests at R.G Kar resonated loudly and instantly across public hospitals in West Bengal, beginning with Calcutta and spreading to other cities and towns in the state. The reason it resonated so much, was because the issues resonated. The misrule of R.G Kar hospital was not isolated, it was part of a systematic problem in healthcare in West Bengal, which in turn is a microcosm of the problem of public healthcare in India.
Indian healthcare remains heavily privatized, greatly underfunded and overburdened. While elite private hospitals behave unethically towards patients, making healthcare inaccessible for most, public healthcare is kept underfunded and in a ramshackle state. The poor are left to get their healthcare needs fulfilled from hospitals where infrastructure is falling apart, doctors are hard to find, and if one is lucky enough to get a bed and treatment, it is likely that the doctor is an overworked and underpaid junior resident.
The eruption of the protests gave a moment where this system could be challenged and destroyed. The doctors who came out on the streets were joined by thousands of people from all walks of life. Other healthcare workers had also supported their protests but did not strike work. This challenge was a victory in itself, the ability to pose a united mass popular challenge to the rule of the TMC. This had not happened in the history of the party’s 13 year rule in West Bengal.
As the protests continued, the demand was raised for a CBI probe into the death. The Supreme Court intervened in the matter and directed the security at R.G Kar be handed over to the Central government paramilitary force, of the Central Industrial Security Force (CISF). The investigation of the case was taken away from the Kolkata Police and handed over to the Central Bureau of Investigation (CBI).
One of the first fallouts from the CBI investigation was to highlight the role of the police in the cover up of the crime committed at R.G Kar, and the arrest of the disgraced ex principal Sandip Ghosh. His criminality was finally brought to book, and a valuable tool for the plunder of public hospitals was broken. This was undoubtedly a first great victory of the doctor’s movement.
As the movement grew and continued over the months, efforts by the government to break up the protests without having to concede any ground seemed to fail. The tensions culminated in a dramatic meeting between the Chief Minister and the leadership of the striking doctors where the doctors won a series of concessions from the government. The meeting at the end of September represented the end of the first phase of the protests and the culmination of their victories.
By this point, the doctors had achieved the ending of Sandip Ghosh’s tenure, his medical license revoked, and the transfer of the Police Commissioner of Kolkata Police Vineet Goyal, forced the government to break up the politically controlled ‘sasthya sathi committees’ (patient help committees), and a series of concessions including a commitment to build restrooms in hospitals, providing CCTV cameras for hospitals, and creating a centralized referral system.
These concessions were important, and would not have happened without a movement forcing the government’s hand.
After reaching this pinnacle, the movement started to lose its energy and much public support. The central focus of protests shifted from the state government to the central investigating agencies, chiefly the CBI which was investigating into angles of cover up by the police, and the role of Sandip Ghosh in the rape and murder of Abhaya. During the period after the meeting and the start of the protests in October, it was found that the government had barely started implementing the agreed changes. The doctors found no alternative but to embark on the path of protest once more.
Over the period of October, public mood started to turn away from protests and towards the durga puja festival. The government’s plan of exhaustion and using concessions to pacify the movement appeared to be working. However, here we see the determination and creativity of the junior doctors, who withdrew the strike but continued the protests embarking on a hunger strike instead.
The hunger strike energized the movement once more, and put the possibility of any of the protesting doctors dying before the government. The TMC government remained steadfast in its position to safeguard its power and interests even as doctors were being admitted to intensive care. The protests showed no signs of dying down, and even in the midst of festivities, protests were growing. Once more, it seemed that the national wave would erupt again with the Indian Medical Association expressing solidarity with striking doctors in West Bengal.
The government was once more forced to bow down before the protests and come to the negotiating table. However, the doctors were stymied here, with the government giving no concrete assurances to their demands, no time tables for implementation of agreed concessions, and a firm position on the matter of removing the health secretary, one of the key demands of the protesters. The only concrete concession that was won by the doctors was the deadline of holding student body elections in medical colleges by March of 2025.
The end result of the negotiation was a pyrrhic victory for the state government, which had managed to get away with giving nothing of consequence to the doctors. However, neither did it regain what ground they had given up in the first phase of the movement.
Today, there is neither a hunger strike nor a strike in place, but protests continue in other forms at regular intervals. The central focus of the protests is now the CBI, while medical student bodies prepare for elections which are to be held in March of next year.
The leading body of the protests, the West Bengal Junior Doctors Front split in the aftermath of these negotiations, however both conduct protests parallel.
Conclusions and the way forward :
The events during the end of October culminating in the split of the WBJDF created the impression of a movement that had ended in defeat. This sees the developments at the end of the second phase of the doctor’s movement in isolation, losing focus of the victories that they had secured thus far. Till the very end, the only winning strategy that the TMC government could levy against the doctors was the strategy of concessions.
There was an expectation among many that this movement would spell the end of the TMC government, much like the Singur and Nandigram farmer’s agitation had spelled the end of the CPIM led Left Front government. However, that was never an agenda of the striking doctors, nor was there any political movement which directed the movement that way. While the CPIM was present in support of the movement, they did not lead the movement, which remained independent of any political leadership, much like the farmer’s protest.
It is undeniable that the initial energy which erupted in the aftermath of the junior doctor’s strike has died down. The movement had grown to become much larger than its immediate aims. The discontent and the fight of the junior doctors against the TMC government became a channel to express wider public dissatisfaction with the TMC government. This was sharpest in the cities among the urban working class, youth and middle class.
The doctor’s strike went parallel with and coincided with the strike of the tea plantation workers in Darjeeling and the disastrous floods in the western districts of the state. The failure of the state government to solve the repeated damage from floods in West Midnapore district led to great dissatisfaction and anger of the people against the government. It was poignant that the striking doctors organized relief measures for the flood affected villages.
It can be concluded that this period could see a rise of militancy and consciousness among the people of West Bengal, at a time when there is a change at the national level as well. It would not be entirely correct to say that the government defeated the doctor’s movement in entirety, but the government has succeeded to contain the victory of the doctors. The fight for systematic change would go on until a final victory.