Senior colleagues condemn junior doctors' plan for five-day strikes

Experts say that sustained action over contracts would ‘cause real problems’ for patients, profession and NHS

Senior doctors have voiced strong opposition to the series of five-day strikes planned by their junior colleagues, warning that the action will cause real problems for patients, the service and the profession.

In a surprise statement on Thursday evening, the Academy of Medical Royal Colleges – which brings together doctors’ professional bodies – distanced itself from the doctors’ union, the British Medical Association, which has called the strike. The academy was “disappointed at the prospect of further sustained industrial action by junior doctors”, it said in a statement after several agonised hours of deliberation.

“We are acutely aware that the NHS is under extreme pressure at the moment,” it said. “Patient safety and quality of care must be the priority. We know there are genuine concerns about the contract and working arrangements but we do not consider the proposed strikes are proportionate.

“Five days of strike action, particularly at such short notice, will cause real problems for patients, the service and the profession.”

On Wednesday it was announced that junior doctors will go on strike from 12 to 16 September – the longest period of action yet announced by doctors in their protracted dispute over terms and conditions that the health secretary, Jeremy Hunt, would like to introduce. On Thursday the BMA announced additional dates for proposed walkouts, on 5, 6, 7, 10 and 11 October, 14-18 November and 5-9 December

Health secretary Jeremy Hunt
Junior doctors have long been in dispute with health secretary Jeremy Hunt over conditions of a proposed contract. Photograph: Stefan Wermuth/Reuters

However the BMA is split over whether to support the five-day strikes called by junior doctors, with many of its senior members considering the action unethical and fearful that patients will be harmed.

At a special meeting of the ruling council of the BMA on Wednesday some experts argued that the action was unethical because of the risk to patient safety, the Guardian has learned.

Such was the importance of the meeting that some council members changed their holiday plans to be there. Following a highly charged discussion, the BMA council voted by 16 to 12 to support the junior doctors’ industrial action.

The opposition of senior doctors raises questions over whether the industrial action can go ahead as planned. The opposition of the royal colleges may persuade some junior doctors not to take part and they may also lose the support of some senior doctors who were expected to cover for them during the strikes.

The Patients Association’s chief executive, Katherine Murphy, said the organisation was “gravely troubled” at the “catastrophic impact this will have on so many patients and their families” as winter approaches. “Many patients may be very unwell or vulnerable and so we cannot predict the distress or pain this will cause to everyone this will affect,” added Murphy.

Katherine Murphy
Katherine Murphy, chief executive of the Patients Association, said the organisation was concerned about the impact of the strikes, especially during winter. Photograph: Martin Argles/The Guardian

Earlier in the day Hunt said in a series of broadcast interviews that junior doctors would be inflicting “the worst doctors’ strike in NHS history”. The minister told Sky News: “Patients will be asking why it is that the BMA, who only in May said ‘this deal is a good deal for doctors, a good deal for patients, it’s good for the NHS, it’s good for equality’ are now saying it is such a bad deal that they want to inflict the worst doctors’ strike in NHS history.”

Theresa May, accused the BMA of playing politics, reiterating her confidence in Hunt during a visit to the Jaguar Land Rover assembly plant in Solihull.

“Jeremy has been an excellent health secretary, he is an excellent health secretary and this deal is about a deal that is safe for patients and I think it’s crucial if you look at what we’re doing as a government with the NHS,” the prime minister said. “We’ve got record levels of funding into the NHS, we’ve got more doctors now in the NHS than we’ve seen in its history and this is a deal that is safe for patients.

“The government is putting patients first, the BMA should be putting patients first – not playing politics.”

Most senior doctors condemn Hunt for his continuing threat to impose a contract on them that they say does not recompense them for Saturday shifts and will jeopardise patient safety, because of the excessive hours they will be asked to work.

Earlier in the day, the president of the Royal College of Physicians of Edinburgh, which has members across the UK, called on the government to negotiate but made it plain he opposed the strikes. “The safety of our patients and the wider NHS workforce remains paramount and this long-running dispute benefits no one,” said Prof Derek Bell.

“We are concerned that the industrial action proposed will have a significant impact for patients and all healthcare professionals in the NHS. The timing of the proposed industrial action – so soon after the August changeover with many junior doctors new in post and heading towards the winter months – and the sustained nature of the action will heap pressure on a health system that is already struggling to deal with existing pressures and rota gaps. The proposed notice will also make it extremely difficult for hospitals to arrange cover. We hope that this action can be avoided.”

Dr Mark Porter, chair of the BMA council, said the decision to announce five consecutive days of strike from 12 September was taken after “long and difficult debates”. He said Hunt had left junior doctors with no alternative but to strike again. “The reason the strikes have been announced is the continued reluctance of the secretary of state for health to do anything other than impose a new contract on junior doctors, a contract in which junior doctors have demonstrated repeatedly that they do not have confidence.”

Opinion among doctors who responded to a Guardian call for comment was very divided, with some saying the strike action does not go far enough but others against it, even though they support the junior doctors’ cause. “It is the Department of Health, not us, [which is] endangering patient care by trying to impose an unsafe contract that is also unfair. I’m hopeful that the public understands this – I became a doctor to care for people and it is in the interests of protecting my ability to do so that I’m going to be going back out on strike,” said a 32-year-old anaesthetist.

But a 28-year-old junior emergency medicine doctor said: “Appalling. I’m shocked that the new leadership of the BMA is taking such a damaging step. I can see why they may want to strike – and I’d be OK with a one day walk out – but this is insane.”

There is likely to be close scrutiny of the turnout for the first strike, which begins on 12 September. The last walkout, which was the first full withdrawal of labour, saw 78% of junior doctors fail to report for duty on 27 April, although this would have included some absent for other reasons such as illness.

That was down on the previous strike for the period of 6 to 8 April when emergency care was provided while 88% were on strike, according to NHS England.

There was also a drop in public backing for the action as a result of the full withdrawal of labour, according to an Ipsos Mori survey for BBC News. It found 57% of adults supported the strike at the end of April compared with 65% the previous month. The proportion who blamed both sides for the dispute was also up.

The action on 26 and 27 April saw around 13,000 operations and 113,000 outpatient appointments cancelled. Extrapolating those figures over five days and then multiplying by four to account for the strikes planned each month until the end of the year, the Department of Health is predicting that up to 125,000 operations and over 1 million outpatient appointments could be cancelled as a consequence of the latest wave of walkouts.

• This article was amended on 2 September 2016. Professor Derek Bell is president of the Royal College of Physicians of Edinburgh, not the Royal College of Surgeons of Edinburgh as a previous version stated.


Sarah Boseley and Haroon Siddique

The GuardianTramp

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