Hospitals have cancelled tens of thousands of outpatient appointments and operations this week as they prepare for a junior doctors’ strike that will severely disrupt NHS care.
NHS trusts in England have postponed many more procedures than for any of the recent walkouts by nurses and ambulance staff.
As many as 61,000 junior – or trainee – doctors will stage a 72-hour stoppage from 7am on Monday in pursuit of a 26% pay rise.
The British Medical Association (BMA) and Hospital Consultants and Specialists Association (HCSA) are pressing ahead with their coordinated action after the health secretary, Steve Barclay, asked them to call it off but only committed to discussing a potential one-off payment for 2022/23, and an unspecified payrise for 2023/24. He refused to commit to discussing their demand for 26% full pay restoration, the unions say.
In a move designed to maximise the impact of their action, junior doctors will refuse to work in areas offering life-or-death care, including A&E, critical care and maternity services.
Hospital bosses are deeply concerned that patients could come to harm because consultants – senior doctors – are unable to provide the same level of medical supervision as when hospitals are fully-staffed, despite working longer hours to try to cover the workloads of juniors, who carry out much day-to-day patient management.
One hospital chief executive said: “What worries me most is that there’ll be fewer medical rounds on the wards than usual and that one or two consultants will have a lot of beds to look after, and may also have to keep an eye on people in A&E, and so may not be able to see every patient every day the way we expect these days.
“Therefore patients whose health is deteriorating could get missed. There is a risk of us missing opportunities to intervene with people and prevent them coming to harm, because we just won’t have the number of bodies on the ground from a medical perspective that we usually do.”
The same source said they were particularly concerned about the degree of medical cover available in their hospital overnight and also that they had had to cancel more than 1,000 outpatient appointments and hundreds of surgical procedures, all of which will have to be rescheduled.
“But do I think the strike is to any degree irresponsible? No, I fully support them striking. Junior doctors should be paid more because they do bloody hard jobs and do it under a lot of stress and pressure. They’re making a point. I do want to see the government pay them more.”
The BMA and HCSA are seeking a 26% increase in junior doctors’ salaries as “full pay restoration” for the real-terms loss in their income they say has occurred since 2008/09. In a column in the Sunday Telegraph, however, Barclay insisted that such demands were “simply unaffordable” and would cost the taxpayer an extra £2bn, threatening the government’s efforts to cut inflation.
He also said the refusal to keep working in services such as A&E and children’s and cancer care during the stoppage “should pose difficult ethical dilemmas for our hardworking junior doctors”.
He attacked the BMA for advising consultants to charge NHS trusts “eye-wateringly high rates” of up to £262 an hour to cover for junior doctors during their strike.
Many NHS trust bosses share that concern. “The level of greed displayed by some of our highest-paid colleagues is sickening,” one told the Health Service Journal last week.
Rishi Sunak said it was “very disappointing” the union was “not engaging with the government”.
Speaking on a plane to San Diego on Sunday night, the prime minister pointed to the “constructive dialogue” with other union leaders that had led to an offer for rail workers being proposed and progress being made in the dispute with nurses.
“I would urge the junior doctors to follow suit, and accept the government’s offer to come in and have talks,” Sunak said. “The other unions have done that and we are making progress.”
He also dismissed suggestions the industrial action could add to already-long NHS waiting lists.
“We are actually making good progress,” he said, insisting the health service was on track to eliminate the one-and-a-half-year wait this spring. “We have a clear set of plans in place, he said.
• This article was amended on 13 March 2023. An earlier version said that Steve Barclay asked the BMA and HCSA to call off the strike action, but refused to commit to start pay negotiations in return. In fact the health secretary offered to talk to them about junior doctors’ pay but, not about their claim of 26% pay restoration.
