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Beginning on Wednesday January 3rd, junior doctors from across the UK's NHS (National Health Service) will engage in a week-long set of protests that are being defined as the longest set of NHS strikes in history. So, we at EPM HQ are aiming to answer the key question, why are junior doctors on strike in one of the busiest weeks of the year throughout the NHS?
2023 was a year defined by turbulence and instability. Continual political disturbances throughout Westminster have had far reaching implications for the health of the UK as a nation, not to mention the remaining Brexit hangover and the seemingly daily demands to call for a general election following what has been now fourteen years of Conservative Party leadership. You would be forgiven, therefore, for hoping – or even believing – that 2024 would be quieter. This is likely not to be the case.
The junior doctor’s strike comes almost a year after the first round of strikes which, much like the strikes kicking off 2024, were centred around a desire to increase pay in-line with inflation. It is worth a mention at this point that pay deals have already been agreed between the UK Government and junior doctors in Scotland, whilst junior doctors in Wales are likely to strike later in January and those in Northern Ireland currently being balloted.
The British Medical Association position
In a recent BMA statement, BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi stated that: “Morale across the health service is at an all-time low. Fifteen years of pay erosion have meant 26% real terms pay cut for an increasingly undervalued workforce who are overstretched and left yet again to carry the burden of years of neglect and decline this Government has overseen. Many will be wondering if their chosen career is still worth pursuing – the Government has the chance to show those doctors they still have a future working in this country.
“This strike marks another unhappy record for the NHS – the longest single walkout in its history. But as we have said all along, there is no need for any records to fall: we can call off this strike now if we get an offer from the Government that we can put to members. Doctors want 2024 to be the start of a renewed workforce which can finally provide high quality care for patients again – it is for the Government to put forward a credible offer and facilitate that journey.”
The BMA is asking for 35%, to restore pay to where they say it was 15 years ago, citing the relative 26% wage decrease since 2008 as their impetus, although they may be willing to receive this pay rise over a few years rather than as a direct one-time increase now: "We're not asking for any uplift or pay restoration to happen overnight. What we need to do is to start a way towards that and especially not further the pay erosion, and that average 3% uplift would have still amounted to pay cuts for many doctors this year” explained Dr Vivek Trivedi to BBC Radio 4.
UK Government Position
On the morning of first round of 2024 strikes beginning, A statement from Health and Social Care Secretary Victoria Atkins said that: “Over 1.2 million appointments have already been rescheduled since industrial action began, including 88,000 during last month’s strikes. The NHS has again put in place robust contingency plans to protect patient safety and it is vital anyone who needs medical help continues to come forward. I urge the BMA Junior Doctor’s Committee to call off their strikes and come back to the negotiating table so we can find a fair and reasonable solution to end the strikes once and for all.”
In what is typical fashion for any minister when under strike pressures, influencing the public against the strike action by highlighting the extent of the disruption is understandable, especially in arguably the most important sector of society within the UK public consciousness. That said, the BMA have been overtly clear that these planned strikes are aimed at poor government fiscal management of the NHS, particularly during the period of austerity instigated by the David Cameron Conservative Government.
Impact on NHS Services and Patients
In inevitable, yet undesirable fashion, strike action will have wide-reaching impacts on those in need of NHS treatment and services. Emergency care will still be provided, yet those who need less directly urgent services, including cancer treatments, must be rescheduled for the strikes to be completed.
The Patients Association released a statement on December 6th 2023 in response to planned junior doctor’s strikes highlighting that: “News that the junior doctors will strike before and after Christmas is dreadful news for all patients, but especially the millions waiting for treatment. Winter is always tough for the NHS, the people who work in it, and patients. We have raised concerns recently that this winter could be worse than last year’s.
Now, we are profoundly concerned for patients’ safety and long-term well-being. We know from calls to our helpline, and research the Care Quality Commission has done, that the health of thousands of patients is deteriorating as they wait to be seen. Strikes have the potential to push back their appointments and treatment even further. We are disappointed that talks between the BMA and the Government broke down. We say to both the BMA and Government – whatever it takes to reopen negotiations, do it.”
Due to this strike action, services are now being limited or completely cancelled altogether, best exemplified by the fact that Cheltenham A&E will not be opening at all throughout the striking period meaning potentially thousands of patients will need to go elsewhere to receive treatment.
Continuing from 28 days' worth of protests and strikes throughout 2023, these initial and most dramatic junior doctor’s strikes are likely to be an ever-present motif throughout 2024 should a deal between the Uk Government and the BMA not reach a helpful consensus.
Public opinion often swings in support of NHS staff, and rightly so. The NHS, like many key British institutions have seen a decrease in their ability to run successfully over the last decade, thanks to government mismanagement and the COVID-19 Pandemic.
The public are being encouraged to contact 999 for an emergency, or to use 111 should their issue not be of the utmost urgency. The strikes are likely to influence GP appointments too, with increased waiting times and rescheduling of appointments ready to impact thousands across the country.
Danny Mortimer, Deputy Chief Executive of the NHS Confederation, in his attempts to quell public concern, has stated that: “There is a well-established process for requesting derogations, which includes the recall of staff in a mass casualty event, and we take account for alternative sources of staffing. But derogations should be a last resort. We will continue to work with trusts to ensure the process of derogation requests is fair and properly followed, whilst also protecting doctors’ ability to strike.”
What Now?
2024 is going to be a year of political change and instability, with a record number of elections taking place in 60 countries across the world representing nearly half of the world’s population – including (well, potentially) a UK General Election.
In a year of anticipated turbulence, striking doctors may not be an ideal way to start things off, however, they are the key workers who have worked tirelessly throughout the pandemic years and after to ensure that as many patients as possible receive proper treatment. Let us hope a resolution is found urgently that helps craft a process of NHS rejuvenation and revival, rather than increased tension between those working within the NHS and Westminster.