Hundreds of thousands of appointments cancelled as junior doctors begin four-day strike

The health secretary has said that the 35% pay rise being sought by the BMA is neither 'fair or reasonable'. ITV News' Martin Stew reports.

Junior doctors across England have launched a fresh four-day strike in a deepening dispute over pay, which threatens to cause huge disruption "for weeks" across the NHS.

An estimated 350,000 appointments, including operations, will be cancelled as a result of the walkout, which has been dubbed the most disruptive in the health service's history.

Doctors from the British Medical Association (BMA) mounted picket lines outside hospitals from 7am Tuesday morning and will strike until 7am Saturday morning. It's the longest stoppage since the wave of strike action began last year.

Professor Sir Stephen Powis, national medical director for the NHS in England, said the walkout will cause "unparalleled" upheaval, while Health Secretary Steve Barclay said it is deeply "regrettable" they are taking place.

Why are junior doctors still striking?

The BMA claims junior doctors in England have shouldered a 26% real-terms pay cut since 2008/09 because pay rises have been below inflation.

The union has asked for a full pay restoration which the government said would amount to a 35% pay rise. Speaking on Tuesday morning, the health secretary said this "would amount to more than £20,000 for some junior doctors," which is "not fair or reasonable."

"But we want to engage," he insisted.

Speaking to ITV News from the picket lines, Dr Arjan Singh said: "We've been trained to a really high standard in medical school and we can't offer you that care anymore because there's not enough of us."

Another said: "We're doctors, we care about our patients, we care about the NHS. It's a very difficult decision but we're all aware that this is the only way to actually improve conditions for both doctors and patients."

Junior doctors will be "reserving the right for further industrial action", added Dr Vivek Trivedi, co-chair of the BMA's junior doctors committee.

He added that "a credible" offer from Mr Barclay would result in doctors calling off action.

A 35% pay rise is not 'fair or reasonable', the health secretary maintains

'I feel like my life is being put on the line for money'

NHS Confederation Chief Executive Matthew Taylor said the number of appointments and operations cancelled is likely to be 350,000.

Bowel cancer patient, Nick Gladwell, was supposed to have a medical appointment ahead of an operation, but it was cancelled due to the strike action on Tuesday.

He told ITV News: "Whether you stand on the side of the government or the doctors, it's people's lives at risk."

He added: "Having two young children and being a single father, I've got to be there for them. I've got people who rely on me, so I've got to get well as soon as possible,"

"I feel like my life is being put on the line for money."

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 over the next four days.

Senior doctors and medics who are not on strike have been diverted to cover these emergency services, such as A&E and maternity care, while it's expected that disruption will continue for weeks as cancelled appointments and operations will need to be rescheduled.

'People's lives are at risk', says bowel cancer patient Nick Gladwell who had an appointment cancelled due to junior doctor walkouts

Do junior doctors get paid while on strike?

Junior doctors are not paid while they are on strike. The BMA warns its members to "plan ahead" and "save" for industrial action, especially during "repeated or long periods" of disruption.

"By planning ahead and saving, you can help to minimise the negative impact of losing pay," it says on the BMA website.

Striking junior doctors who head to a picket line on a non-working day or during their annual leave should still be paid.

NHS Employers has published advice to health trusts on pay deduction for members of staff who go on strike, encouraging them to calculate 1/365th of annual salary for each day on strike.

For a newly-qualified junior doctor on a salary of £29,384, they would be set to lose around £80.50 gross for every day they strike while on a rostered shift. If they were missing four days of work this week due to strike action, they would miss out on more than £300 before tax and other deductions.

According to the BMA, this salary equates to £14.09 per hour when split across a 40-hour week - a figure they argue is less than a barista working at coffee chain Pret A Manger.

However, there are several scales to junior doctor pay, and many earn extra or overtime pay by working during anti-social hours, being on-call, and working towards further academic qualifications.

Strikers outside Bristol Royal Infirmary on the first day of a four-day walkout Credit: PA

On Tuesday morning, Shadow Chancellor Rachel Reeves accused the Conservative government of running the health service "into the ground" when asked about junior doctors strikes, while shadow Health Secretary Wes Streeting accused Rishi Sunak of failing to resolve the pay dispute.

“Rishi Sunak says he ‘wouldn’t want to get in the middle of’ NHS pay disputes," said Mr Streeting.

“Patients are crying out for leadership, but instead they are getting weakness," he added.

Meanwhile, Liberal Democrat Deputy Leader and Health and Social Care Spokesperson Daisy Cooper MP said: “By refusing to talk to junior doctors, Steve Barclay is putting our NHS and thousands of patients at unnecessary risk. We need to recall Parliament so Conservative ministers can be held to account.

“The government needs to get round the table immediately to resolve this impending crisis facing our NHS."

Striking NHS junior doctors on the picket line outside Leicester Royal Infirmary Credit: PA

BMA junior doctor committee co-chairman Dr Vivek Trivedi said: “We were knocking on the health secretary’s door, asking to meet with him to negotiate a settlement to this dispute, long before the current strike got underway.

“We have been in a formal dispute since October. He refused to respond and meet us until we had a strike ballot result. He has had months to put a credible offer on the table and avert industrial action, so for him to say, ‘It’s disappointing,’ is at best disingenuous.

“We have always maintained our aim is for full pay restoration – to reverse the more than 26% real-terms pay cuts Mr Barclay’s Government have imposed on us over the past 15 years, putting starting salaries up by just £5 per hour to £19.

“We have always maintained we are willing to negotiate on how to achieve pay restoration, so for Mr Barclay to suggest we had any preconditions is yet again disingenuous.

“The reality is that the health secretary has had every opportunity to bring an end to the dispute. His decision to refuse to table a credible offer – indeed he has not tabled a single offer so far – means that this action is solely due to this Government’s repeated inaction.

“We would still be willing to suspend strike action this week if the secretary of state makes a credible offer that can be the basis of negotiation.”

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