A walkout by the NHS’s most senior clinicians is expected to lead to even more care postponements than the 49,000 a day caused by the junior doctors’ strike, NHS bosses fear.
Strikes this week by hospital consultants are expected to further imperil Rishi Sunak’s vow to bring down waiting lists. Senior NHS figures are also concerned that the prime minister’s refusal to hold further pay talks with consultants could poison relations for years to come, leading to a crisis in morale and further disputes.
Consultants are striking for two days from 20 July, soon after a walkout by junior doctors ends, despite Sunak’s insistence that he will not increase the 6% pay offer revealed last week. The British Medical Association (BMA) says consultants in England have seen their take-home pay cut by 35% since 2008-09.
Miriam Deakin, director of policy and strategy at NHS Providers, said that the nature of a consultant’s work meant that their impact on waiting lists could be significant. “There’s also a lot that other staff can’t do without consultants’ supervision,” she said. “It’s likely we’ll see a significant amount of postponed care as a result of the consultants’ strike. On average, 49,000 appointments and procedures had to be rescheduled per day during the junior doctors’ strike.
“They were doing a full walkout, whereas consultants will provide Christmas Day cover [for emergency treatment], but I think we could still reasonably expect to see more care rescheduled when the consultants strike because of the work they do. This puts the government’s pledge to cut the waiting list at risk.”
There are already concerns over the funding of the pay increases. While ministers said the money would come from an increase in the surcharge placed on migrants for NHS care and “reprioritisation” from within existing budgets, there are concerns that it could have an impact on recruitment.
There are similar concerns within schools. While teaching unions are recommending the 6.5% pay deal offered to their members, some heads are concerned that their schools will not be able to afford to pay it in practice. Specialist schools are said to be struggling to fund the increase, because extra funding is linked to pupil numbers, which tend to be lower in such schools.
Deakin also warned that imposing a settlement on doctors could have lasting effects. “Trust leaders also worry about the long-term impact on relationships with their staff,” she said. “In 2016, we saw the impact on junior doctors when the government implemented a contract the relevant union hadn’t agreed to. They’ve come into this dispute with that history fresh in their minds.
“If we see something similar play out for consultants, it will be a challenging situation to navigate long term. It’s a real worry in terms of future morale, ensuring the NHS remains an attractive place to work and sustaining those key relationships between staff and employers, and between unions and government.”
The government says the pay offer means that starting basic full-time pay for consultants will increase from more than £88,300 to £93,600, with more experienced doctors receiving far more. Junior doctors have been offered a 6% pay rise, as well as a one-off £1,250 payment. Steve Barclay, the health secretary, has repeatedly said that the BMA is being “unreasonable” in seeking a 35% pay rise.
Reducing waiting lists has been earmarked as one of Sunak’s “five priorities” as he attempts to restore confidence in the government. The prime minister has already warned that the pledge will be difficult to deliver if walkouts continue into the autumn.
The current strike by junior doctors in England, conducted over five days, is the longest stoppage in NHS history. It is also the fourth bout of action from them since March. The hospital treatment backlog has now risen from 7.2 million when Sunak first made his pledge to almost 7.4 million.
The higher pay offer to doctors has also angered nurses, who were offered only 5%. The Royal College of Nursing has written to Barclay, stating that his approach has been “cavalier and reckless at a time of the greatest industrial unrest the NHS has ever seen”.
