A pay disagreement involving junior physicians in England has sparked a four-day walkout that could severely disrupt the NHS.
A projected 350,000 appointments, including surgeries, would be canceled as a result of the British Medical Association members’ strike (BMA).
Beginning at 7 a.m. today, doctors set up picket lines outside of hospitals, where they plan to remain on strike until Saturday morning.
Downing Street has also insisted there would be no talks with the BMA unless junior doctors abandoned their starting position of a 35% rise and called off the strikes.
Striking Junior Doctors march through central London
Number 10 said the 35% demand was ‘completely out of step with pay settlements in other parts of the public sector’ and would cost £2 billion.
Managers have said patient care is ‘on a knife edge’ because of the strike and the suggested number of cancelled appointments could rise by 100,000.
National medical director of NHS England Professor Sir Stephen Powis said he expects the figures to be ‘considerably more than the 175,000’.
He told BBC Radio 4’s Today programme: ‘When we had the last period of industrial action a few weeks ago, that was three days, we saw over 175,000 operations and procedures having to be rescheduled.
‘We won’t get the exact number this week until the strike is over but our expectation is that we will see considerably more than that.’
He added: ‘I think it will be considerably more than the 175,000 – it’s four days this time, not three days, and of course it comes after the Easter holidays and a lot of staff are on leave this week.’
The strikes centre around a pay row between the BMA and Government, with the union claiming junior doctors in England have seen a 26% real-term pay cut since 2008/09 because pay rises have been below inflation.
The union has asked for a full pay restoration that the Government said would amount to a 35% pay rise – which ministers have said is unaffordable.
The Prime Minister is said to have been kept up to date with the latest on the strikes, and a spokesman said today unless the strikes were called off no further talks would take place.
A spokesman said: ‘A spokesman said: ‘It continues to be the case that we call on the BMA junior doctors to cease their strikes and revise their starting point for negotiations, which is 35%, which we continue to believe is unreasonable and is not affordable for the British taxpayer.
‘We know that the strike action will have an impact on patient care. The last set of strikes saw around 180,000 operations cancelled and that was a three-day strike, so we’d expect to see higher numbers this week.’
BMA officials said the pay issue is making it harder to recruit and retain junior doctors, with members previously walking out for three days in March.
The co-chairman of the BMA junior doctors’ committee said the pay rise the union has asked for is ‘not a tall ask’.
Dr Vivek Trivedi told BBC Breakfast: ‘This uplift that we’re asking for is only to reverse the pay cuts that we’ve had, doctors have had more than a 26% real-terms pay cut over the last 15 years.
‘All we’re asking is for a doctor who’s paid £14 an hour to be paid £19 an hour, so it’s not a tall ask.’
Dr Trivedi added that the 96-hour walkout by junior doctors could be stopped if Health Secretary Steve Barclay would approach negotiations with a ‘credible offer’.
‘We’ve offered multiple dates to Mr Barclay to try and meet and he’s only met us twice, he didn’t have a mandate to negotiate once, and didn’t even give us an offer the second time,’ he said.
NHS England said staff will be asked to prioritise emergency and urgent care over some routine appointments and procedures to ensure safe care for those in life-threatening situations.
The health body said appointments and operations will only be cancelled ‘where unavoidable’ and patients will be offered alternative dates as soon as possible.
Health and Social Care Secretary Steve Barclay said: ‘It is extremely disappointing the BMA has called strike action for four consecutive days.
‘Not only will the walkouts risk patient safety, but they have also been timed to maximise disruption after the Easter break.
‘I hoped to begin formal pay negotiations with the BMA last month but its demand for a 35% 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.
‘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.’
The BMA has previously said it was willing to enter talks with Mr Barclay and suspend strikes if members were presented with a ‘credible’ pay offer ‘to resolve 15 years of pay erosion’.
Mr Taylor, head of the NHS Confederation which is a membership organisation that represents healthcare bodies in the UK, said the likely impact of the strike is ‘heartbreaking’ and called on both sides to end their ‘battle of rhetoric’.
Speaking about pay negotiations which would avoid the action, Mr Taylor told BBC Breakfast on Monday: ‘It’s depressing that there seems to be no movement at all from the two sides of this dispute over the last few days.
‘We should consider asking the Government and the trade unions to call in Acas, the conciliation service, to provide some basis for negotiations, because if anything the positions seem to have hardened over the last couple of days.’
Shadow health secretary Wes Streeting said: ‘The junior doctors’ strike this week will cause huge disruption to patient care.
‘Where is the Prime Minister and why hasn’t he tried to stop it?
‘Rishi Sunak says he ‘wouldn’t want to get in the middle of’ NHS pay disputes.
‘Patients are crying out for leadership, but instead they are getting weakness.’