Tens of thousands of patients in England face surgeries being cancelled this summer with consultants striking for 96 hours, after Steve Barclay ruled out an improved pay offer.
Routine care across the NHS will come to a virtual standstill from 7am on Thursday as consultant doctors and hospital-based dentists begin their first industrial action in a decade for 48 hours until 7am on Saturday.
The British Medical Association (BMA) had threatened to strike for another two days on 24 and 25 August but only if the health secretary refused to back down.
On Thursday Barclay defiantly announced that his offer of a 6% pay rise was “final”, meaning four days of chaos and mass cancellations now look inevitable.
“I am disappointed the BMA is going ahead with this week’s strike, given the average consultant’s NHS earnings are expected to increase to £134,000 a year,” he said.
“My door is always open to discuss non-pay issues, but this pay award is final so I urge the BMA to end their strikes immediately.”
According to the BMA, consultants on a 2003 contract have a starting salary of £88,364 in basic pay, rising to £119,133 after about 19 years.
More than 600,000 appointments, procedures and operations have already been missed, ditched or postponed in eight months of industrial action across the health service.
This week alone brought the longest period of industrial action in the history of the NHS by junior doctors. The five-day strike from last Thursday to Tuesday morning resulted in 101,977 appointments and procedures being cancelled, according to NHS England.
An even bigger impact was anticipated from consultants going on strike for four days, senior health sources said. That is largely down to two factors. First, consultants won’t be performing any operations themselves. But second, any planned care delivered by junior doctors or other healthcare professionals that requires even remote consultant supervision will also need to be rescheduled.
This means a significant amount of planned care involving junior doctors and other health workers, as well as consultants, will be affected, according to people familiar with the matter.
The NHS England medical director, Prof Sir Stephen Powis, warned patients this week that mass disruption was expected across the NHS as consultants move to providing just emergency cover.
For the next two days, the health service will be able to operate at the level of service usually seen on Christmas Day. Most outpatient appointments and elective surgeries such as hip and knee replacements and cataract removals will be cancelled and will have to be rescheduled for later in the year.
The public is still being told to dial 999 in life-threatening emergencies and to use NHS 111 online for other health concerns. GP services and pharmacies will also be running as normal.
Barclay on Thursday criticised consultants for going ahead with the strike despite him last week awarding them a 6% salary increase.
“I hugely value the work of NHS consultants, which is why we have accepted the independent pay review body recommendations in full, giving them a 6% pay rise this year, on top of last year’s 4.5% increase.”
Consultants say they have suffered a 35% drop in the real-terms value of their income since 2008-09 and are seeking “full pay restoration”.
The BMA published a new analysis on Thursday suggesting that consultant pay had fallen behind lawyers, architects and financial advisers over the past 14 years, with cash increases for those professions growing at six times the rate of NHS consultants.
The chair of the BMA consultants committee, Dr Vishal Sharma, said: “This dispute is not just about one year’s pay settlement, it is about the reality of 14 years of consultant pay falling behind, about a loss in our pay in real terms of 35% and the broken pay review system that has allowed this to happen.
“There is absolutely no justification for the wages of some of the country’s most senior doctors to not have kept pace with those of comparable professions.
“Consultants will stand on the picket lines today because we are angry and at rock bottom. This government is failing us, failing patients and failing to see ministers have the ability to stop the crisis unfolding in front of their eyes.”
• This article was amended on 21 July 2023 to add information from the BMA regarding consultants’ basic pay that adds context to remarks by Steve Barclay.
