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Industrial action: junior doctors provide emergency-only care

Tens of thousands of junior doctors are today taking industrial action over their contract dispute with the Government.

Trainees in England are providing emergency care-only cover — similar to a Christmas Day service — in the first of three planned periods of industrial action.

Doctors are taking the action over the Government’s failure to address junior doctors leaders’ concerns about contractual safeguards on safe working, and proper recognition for those working unsocial hours.

Conciliation talks paused last week with both sides saying, while discussions had been ‘constructive’, they were not enough to call off today’s planned action by the BMA.

BMA junior doctors committee chair Johann Malawana said: ‘Junior doctors feel they have been left with no option but to take this action.

'We have been clear throughout this process that we want to negotiate a contract that is safe and fair, and delivers for junior doctors, patients and the NHS as whole.

‘This remains our goal and our door is open to talks, but the Government must address our concerns around safe working patterns and ensure the contract recognises the long, intense and unsocial hours which junior doctors do.’

 

Solidarity

GP trainee John Sykes attended the picket line at the Royal United Hospital in Bath where around 100 people, including doctors, nurses and NHS supporters, gathered.

Dr Sykes said as a GP trainee he would receive pay protection under Government proposals but he was taking action to support his colleagues who face working longer hours.

‘I have had more conversations this week with my colleagues about wanting to quit their jobs than I have ever had in my career,’ he said.

Dr Sykes added: ‘Where I am working at the moment [in a GP practice], I am a different person compared to the [hospital] job I was doing where I was working really long hours.’

He said that he was concerned that the Government proposals would put many people off pursuing medical careers.

The Government could have prevented today’s industrial action by listening to doctors’ concerns when they were first raised, he added.

‘It should have had proper negotiations in the summer before this came about.

'We have had a month in which it could have developed a deal but it has just stuck to its guns ... we are telling it our concerns about safeguards and the increased number of hours doctors are working,' he said.

 

First leg

Talks facilitated via ACAS between the BMA, NHS Employers and the Department of Health will resume on Thursday. If these do not succeed, the association is planning two further days of action as follows:

  • 8am, Tuesday 26 January to 8am Thursday 28 January — emergency care only
  • 8am to 5pm, Wednesday 10 February — full withdrawal of labour

In December, three days of industrial action were suspended at the 11th hour following conciliatory talks between the BMA, NHS Employers and the Department of Health.

Talks have continued since then and the timeframe for the BMA to begin any industrial action was extended to 5pm on 13 January to allow negotiations to take place.

In November, 98 per cent of junior doctors balloted by the BMA voted for industrial action in response to the Government’s attempt to introduce an unsafe and unfair contract.

Amongst the many messages of support received by junior doctors was one from the World Medical Association.

Its president Sir Michael Marmot said: ‘In this case it is clear that patient care would suffer in the long term if the Government's proposals to change the working hours of junior doctors goes ahead.

‘We note the widespread support given to junior doctors among the public and across the National Health Service and we would urge the British Government to establish a new working relationship with junior doctors. It is essential that trust is restored on both sides for the sake of patient care.’

For updates on the industrial action, follow the BMA on Twitter @theBMA and email your experiences and pictures from the day.

Read guidance on the action and FAQs

 

Membership surge

The industrial action dominate social media conversation – the #juniordoctorsstrike hashtag had 100,000 tweets as of Tuesday lunchtime.

Meanwhile, BMA membership figures are at their highest level ever as doctors join the association in droves in support of the juniors’ action.

Highest number of members the BMA have ever had — 170,042

Highest number of working doctor members in the UK — 134,750

Highest number of junior doctor members — 52,245

Highest number of joiners in a 12-month period — 31,338

 

Live from the picket lines

BMA News reporters speak to junior doctors on strike outside hospitals across England:

Paediatricians Najette Ayadi O’Donnell and Alex Perkins say they have been left with no other option but to take industrial action. They would normally be tending to children with cancer, who are in today in the care of their consultants, in University College Hospital London but are outside the hospital where there is a picket line.

Specialty trainee 3 in paediatrics Ayadi O’Donnell said: ‘It’s about having children who are looked after by not exhausted doctors who make good clinical decisions without feeling like they can’t think.’

Fellow ST3 in paediatrics Alex Perkins said she does not understand the Government rhetoric about using the juniors’ contract to assist a seven-day service.

‘We already provide a 24-7 service for the children and young people in our care. Certainly, I have just come from a job where there was exactly the same staffing weekends, nights, Christmas day — I’m sure there’s exactly the same staffing on strike day today because [a neonatal unit is] the kind of environment where babies are born all times of the day and night … I don’t see why we’re expected to be in, in some cases, having a pay cut, having the protection for working unsafe and dangerous hours taken away.’

Both trainees thanked their consultants for their support.

Dr O’Donnell added: ‘Our consultants have been amazing. They are currently on the shop floor looking after our children with oncology. Not once have they made us feel pressurized to work. They have completely supported us as a department.’

 

Public support

In Liverpool, GP trainee Heather Ryan would ordinarily be seeing patients at an open-access clinic in the GP practice where she is training.

This morning, however, she was on a picket line outside the Royal Liverpool Hospital. ‘There are between 50 and 100 of us, and the support we’re getting from our colleagues and from the public is just amazing,’ she says.

‘Obviously none of us wants to be here — we’d all rather be at work, looking after patients. But if the proposals for this new junior contract were to go through, we’d be practising unsafely, and none of us wants to do that. So that’s why we’re taking action today.’

As an ST3 in general practice, Dr Ryan has received great support from her training practice, Mather Avenue Surgery. ‘This morning I’d be seeing on-the-day patients, and this afternoon I’d be helping my trainer with on-call,’ she says.

‘But my GP colleagues have been extremely supportive. They’ve put a sign up in the waiting room saying that Dr Ryan isn’t here today because she’s striking as a junior doctor, and saying that the practice supports junior doctors wholeheartedly, which is great.’

Back on the picket line, the atmosphere is hugely positive.

‘Of course we’d rather not be here, but I hope the Government is watching and listening to what’s going on across the country,’ she said.

London GP trainee Ben Brazier was among dozens of doctors standing in the cold outside St Thomas’s Hospital.
 
He said that juniors were taking action owing to the unsafe working conditions likely to be imposed under the Government’s proposed contract.
 
Dr Brazier said: ‘My main concern is that it [the proposed contract] is not safe for doctors. Juniors want to work in the NHS — they just want to do it safely.’
 
He added that the support received from consultants and other medical colleagues, as well as patients, had proved hugely welcome and inspiring, adding that he hoped health secretary Jeremy Hunt would return to meaningful debate with doctors.

He said: ‘Come back to the negotiating table, work with the BMA on bringing about a safe contract for patients and doctors’.

 

Patient concern

It was comments from patients and members of the general public brought home to Melody Redman just why she and her junior doctor colleagues were taking industrial action.

‘There was one middle aged lady and a couple of older people who said to me: “We want you to be safe to look after us.' The support from the public has been fantastic.’

 

Dr Redman, a foundation doctor 2 in York, spent part of the day picketing outside York Hospital, but also at a ‘meet the doctors’ event on the city’s Parliament Street.

‘We’ve been asking people to sign a petition in support and have more than 250 signatures already,’ she said, speaking before lunchtime.

‘We’ve made sure we’re visible, wearing scrubs and bright jackets, and we’re finding that people are coming up to us, rather than us having to approach them.

‘Most people have been really supportive, but there have been a few myths out there that we’ve had to bust.

'One man I was talking to was speaking about the media headlines and spin, and saying that if you only looked at the headlines, you only got one part of the picture.

'I feel that it’s really important that people realise that the proposed contract is unfair to doctors, unsafe for patients, and unsustainable for the health service.’

Back at the picket line, Dr Redman has been hugely touched by the support the striking juniors are getting from other healthcare staff and passers by.

She added: ‘Consultants have been popping out to tell us they support us, and we’ve had BBC York, Look North, and the newspapers here.

 

'Sad to strike'

Foundation doctor 1 Alexandra Thompson was one of six junior doctors at the Sunderland Royal Hospital picket today.

She said that up to 40 people including other unions, consultants and public and patients had been in attendance to show their support.

‘People on the picket line are sad that we have had to strike, but the public support has been really important and buoyed us up,’ she said.

‘Consultants have been broadly supportive and the hospital has behaved very well [regarding the day of action]’

She said that the day of action had been necessary as it still did not appear that the Government were truly listening to the concerns of doctors during its contract negotiations with the BMA.

Dr Thompson said: ‘The essential sticking points are still the same … we all want a safe NHS, they [the Government] are just not listening.’

 

Petition

London specialty trainee 4 in general surgery Jasmine Winter Beatty attended a meet the doctors which just under 500 people attended.

‘People wanted to sign the petition [a letter to the prime minster expressing public support for junior doctors] and they were really well-informed,’ she said.

‘There were 10 of us working and we got 494 signatures on the petition in three hours.’

Dr Winter Beatty said patients had been extremely supportive.

‘Yesterday when I was telling them I wouldn’t be there because of the strike they understood because they see what long hours we work. They were saying that we need to fight the contract,’ she said.

‘Already we’re seeing lots of doctors leaving and leaving specialty training. We’re scared that if this contract goes ahead we’re going to be left with a demoralised workforce,’ she said.

 

Life savers

Doctors in Sheffield taking part in Tuesday’s day of action were among those helping out with a life-savings skills workshop for families.

The event was one of four organised by doctors to coincide with the day of action, which saw around 180 parents attending to learn first aid skills.

Sheffield specialty trainee 3 in public health Amrita Jesurasa, who works in academia and therefore took annual leave in order to take part, said that colleagues who were taking part in industrial action, had been keen to use the day constructively.

She added that members of the public taking part in the sessions had been overwhelmingly supportive of the national day of action.

She said: ‘This was not just a day off, we wanted to do something constructive.’

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