Junior doctors across England have begun a four-day strike as the pay dispute between the British Medical Association (BMA) and the Government continues.
An estimated 350,000 appointments, including operations, are expected to be cancelled, causing significant disruption to the NHS.
The action is only taking place in England, meaning services in Scotland should run as normal. Here’s what you need to know.
Why aren’t junior doctors striking in Scotland?
Junior doctors in Scotland are currently voting on strike action amid their own pay dispute with the Scottish Government. The ballot is set to close on 5 May.
Depending on the results of this ballot, junior doctors in Scotland, who are also represented by the BMA, could hold a 72-hour walkout.
The BMA said junior doctors in Scotland have faced a real-terms pay cut of 23.5 per cent since 2008. The union said it was “calling for full pay restoration for junior doctors to 2008 levels to make up for this long term, demoralising and undermining deterioration in pay”.
The Scottish Government has called these demands unaffordable.
When is the junior doctors’ strike in England?
The strike in England started at 7am on Tuesday 11 April and will run until 7am on Saturday 15 April. Almost 37,000 out of 47,692 eligible BMA members took part in the strike ballot, with 98 per cent voting in favour of walkouts.
Junior doctors who are members of the Hospital Consultants and Specialists Association will strike on the same days. This union, which represents about 600 junior doctors, accused the Government of refusing to drop pre-conditions for talks to resolve the dispute.
How will the NHS be affected?
Senior health figures have warned that patients face 10 days of “distress and disruption” as a result of the walkouts. Consultants said the effects of the action will be felt for much longer as it takes place after the Easter bank holiday and runs into the following weekend.
Dr Nick Scriven, a Yorkshire-based consultant and former president of the Society for Acute Medicine, told i: “It is going to be really challenging maintaining flow through the hospitals as it will be, in reality, 10 consecutive days on reduced workforce with the bank holiday, the strike and then a weekend.
“From what I know, the consultants are ready and willing to roll up their collective sleeves again, but there will be an ongoing risk of fatigue accumulating that will need to be factored in in the rush to try to get all those missed appointments/operations back in process.
“The service will be stretched, but a lot depends on if and how many [operations] are to be cancelled and if those consultants are then released to help out in the wards to give the rest of the senior team a hand.”
The Health Secretary advised: “People should attend appointments unless told otherwise by the NHS, continue to call 999 in a life-threatening emergency, and use NHS 111 online services for non-urgent health needs.”
NHS Confederation chief executive Matthew Taylor said on Monday: “We say to the public: obviously if you have a medical emergency you need to call 999, but if you have a concern then there’s 111, there’s the NHS website – try to use the NHS in the most responsible way you can.
“And I have to say this as well – try to avoid risky behaviour, because the NHS is not going to be able to provide the level of care that we want to provide.”
A safety net is in place to manage the risk to patients from junior doctors’ strike action, a BMA official has said.
Dr Sumi Manirajan, deputy co-chair of the BMA’s junior doctor committee, told Sky News: “What we’ve got in place with NHS England is a system where they can flag to us four times a day if there are any concerns at all.”
She added: “We had this system in place in the 72-hour strikes, where they were able to communicate with us and not a single safety concern was raised. We have this safety net but we know our colleagues – our senior SAS [specialist, associate specialist and specialty] doctors and consultants – these other expert clinicians can safely provide care.”
Why are junior doctors striking?
Junior doctors are campaigning for pay restoration. The BMA said their real-terms pay had been cut by 26.1 per cent since 2008, which would require a 35.3 per cent pay rise.
The BMA claimed that the Health Secretary, Steve Barclay, had failed to make any “credible offer”. It accused the Government of not being serious about resolving the dispute.
Dr Vivek Trivedi and Dr Robert Laurenson, co-chairmen of the BMA junior doctor committee, said: “It is with disappointment and great frustration that we must announce this new industrial action.
“The Government has dragged its feet at every opportunity. It has not presented any credible offer and is refusing to accept that there is any case for pay restoration, describing our central ask as ‘unrealistic’ and ‘unreasonable’.
“We therefore have no confidence that without further action these negotiations can be successful. This situation is entirely of the Government’s own making. We want to spend our time looking after patients, not on strike.”
Saffron Cordery, deputy chief executive of NHS Providers, said: “The prospect of a 96-hour strike by junior doctors will ring alarm bells for trust leaders up and down the country.
“It would immediately follow a four-day bank holiday weekend, meaning demand will have piled up before the strike even begins on 11 April. There will also be no exemptions.
“This threatens the biggest disruption from NHS walkouts so far. There should be no doubt about the scale of the impact on patients, staff and the NHS. No one wants this.”
The Health Secretary called the strikes “extremely disappointing” and said the BMA’s pay demands were unreasonable.
“Not only will the walkouts risk patient safety, but they have also been timed to maximise disruption after the Easter break,” he said over the weekend.
“I hoped to begin formal pay negotiations with the BMA last month but its demand for a 35 per cent pay rise is unreasonable – it would result in some junior doctors receiving a pay rise of over £20,000.
“If the BMA is willing to move significantly from this position and cancel strikes we can resume confidential talks and find a way forward, as we have done with other unions.”