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Junior doctors to withdraw emergency care in escalation of action

Junior doctors will fully withdraw their labour, including emergency care, in an escalation of their industrial action, the BMA has announced – the first instance of this ever happening in the NHS.

A statement from the BMA said that the 48-hour industrial action planned for 26 April will now change to full withdrawal of labour between 8am and 5pm on 26 and 27 April.

This will follow earlier action – a 48-hour walkout on 6 April – which will continue as planned.

The chair of the BMA’s junior doctor committee Dr Johann Malawana said the Government had left them with ‘no choice’.

The committee had planned earlier this year to withdraw all emergency cover, but did not go through with the action as talks with the Government were progressing.

Junior doctors have already held a 48-hour strike since the imposition of the junior doctor contract, with two more planned for early and late April.

The BMA is also taking the Government to judicial review over the ‘embarrassing’ revelation that the Government failed to carry out an equality impact assessment before imposing a new contract on junior doctors in England.

Dr Malawana said today: ’No junior doctor wants to take this action but the Government has left us with no choice. In refusing to lift imposition and listen to junior doctors’ outstanding concerns, the Government will bear direct responsibility for the first full walkout of doctors in this country.

’The Government is refusing to get back around the table and is ploughing ahead with plans to impose a contract junior doctors have no confidence in and have roundly rejected.

’We want to end this dispute through talks but the Government is making this impossible, it is flatly refusing to engage with junior doctors, has done nothing to halt industrial action and is wilfully ignoring the mounting chorus of concerns over its plans to impose coming from doctors, patients and senior NHS managers. Faced with this reality what else can junior doctors do?’

Health secretary Jeremy Hunt last month announced that he was imposing a contract on junior doctors after talks broke down over the issue of evening and weekend pay, with the Government refusing to step back from its decision to remove ‘unsociable hours’ pay premiums from Saturdays and weekday evenings.

A Department of Health spokesperson said: ’This escalation of industrial action by the BMA is both desperate and irresponsible – and will inevitably put patients in harm’s way.

’If the BMA had agreed to negotiate on Saturday pay, as they promised to do through ACAS in November, we’d have a negotiated agreement by now – instead, we had no choice but to proceed with proposals recommended and supported by NHS leaders.’

What the imposed contract includes

The junior doctor contract imposed by health secretary Jeremy Hunt includes:

  • An increase in basic pay of 13.5%;
  • Redefining the definition of ‘plain time’ to include Saturday from 7am to 5pm;
  • Paying a premium of 30% for Saturday ‘plain time’ working, if the doctor works one in four weekends;
  • Reduce the definition of ‘safe hours’ from 91 to 72 hours a week;
  • Doctors will not work more than four consecutive nights – down from seven currently;
  • The maximum number of consecutive ‘long days’ will be reduced from seven to five;
  • A new ‘Guardian’ role will be introduced, with the authority to impose fines for breaches to agreed working hours, which will be invested in educational resources and facilities for trainees.

Read more here

Readers' comments (75)

  • Vinci Ho

    Freedom from fear
    Freedom from regret....

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  • This is wrong. Nothing justifies this. Brings the whole profession into disrepute and terminally breaks bond with the public. This is so wrong.

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  • Good.This is the only thing that will make this government listen. I hope they extend it to a further 48 hour complete walk out with no emergency cover. If the junior doctors lose public support then so what?

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  • 02:47 pm- If nothing justifies this, then how do you justify what the Government and Hunt is doing with the Junior doctors, the consultants and Gps. How do you justify the long term suffering of not only doctors, but patients and NHS as well due to the imposition of contracts.
    Think about it- Hunt tried to target the supposedly weakest link in the NHS- with Consultants/ GPs/ Nurses to follow suit.
    Its because of GPs like yourself, the government gets away with any and everything.
    I salute the junior docs to have a pair, about time the rest of us follow suit and some out there, grow a pair.

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  • I fully support the junior doctors but there must be another way. If anyone dies as a result of their withdrawal from emergency care they will soon lose public support.

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  • 252 This is not a battle The BMA have backed into a corner by being belligerent and now are ruining the professions reputation with the public. This will all end in tears and it could have been so different - witness the 2016/7 GP settlement which was achieved by negotiation

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  • 02:47pm - there is no bond with the public for GPs and junior doctors any more. They elected this government. This government is running an unsustainable and workforce destroying system. The juniors have nowhere else to go - you could argue that even this is too timid. Perheps even a longer but harsher withdrawal would bring the government to some realism in a shorter period of time, saving patients and doctors in the medium term.

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  • Time to stop fretting about public support.

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  • Its about time this happened. For all those people that think doctors should not strike should go into work!

    I can not see how the government is willing to pay for bail outs of banks and willing to keep the banking industry in the UK (which is good for the economy) but will not invest in the future of health care!

    The DDRB has suggest pay rise for the medical profession of years but the government has rejected them. Their own parliamentary pay review board has suggested a pay increase for themselves and they have accepted that as "it is an independent body" isn't the DDRB?

    Doctors should not have to work longer hours for less pay with their profession being put through the mud by other doctors and the media!
    The NHS was set up for a 7 day emergency service. We have that. We do not have a 7 day routine health care. No country does. It is unsafe and not good for patient care to work shift patterns that will be expected of doctors with the new contract.

    We should stand shoulder to shoulder with everyone that helps run the NHS! From nurses to porters. As well as the teachers and firemen and other public bodies who are being drowned of resources and working harder and harder.

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  • Supported. Self respect, dignity and pride in the work clinicians do and the years of sacrifice for an unvomparable cause. The real public will support the only lasting clean profession out there. The rest will appreciate you one day.

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  • To GP who are worried about loosing public support.
    Stop worrying about public support. Public is not worried about your loss of income. They don't care whether you have worked 12/14/16 hrs. All they care about is free health care and don't want to contribute to it. Our job is to see that they get safe/ good health care and we should get appropriately paid for doing that job. How funding is arranged is government's problem not ours. If they can't fund it properly then be ready to compromise.
    Lets fully support our Junior doctors. I hope all GP call in sick one day to show our support to JD , lets see what the ---- NHSE does.

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  • I would stop fretting about losing public support - be really honest - how many patients really, really care....and how fickle they are and how short their memories anyway.
    Let's not kid anyone - patients are only happy when they get what they want - I recall complaint after complaint after complaint because Dr wouldn't give antibiotics / Dr wouldn't refer for ??? / Dr didn't do this or that or the other - 99.99% of which our complaints review shows were not clinically indicated - and the other minority is one opinion versus another and far from clear cut.
    This is the only game in town and the stakes are high - the NHS as we know it is very broken after career politician after career politician pushing through idealogical policies that are not working.
    If one branch of medicine (in this primary care) in all its form does not support another (2nd care JDs) then there is no voice of the NHS - only factions. Please don't let Hunt see cracks in the professional support the JDs have.

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  • Hopefully the threat of withdrawing emergency care will be enough to force the Government to be fair to doctors and they won't have to actually do it.
    In fact, long term ,many more lives will be lost by losing the workforce than a 48 hour strike, so overall it may still be in the patients interests for doctors to strike. When you are very ill and waiting to be seen, with reduced numbers of doctors your likelihood of dying increases, obviously.
    As the poor conditions in the NHS become more obvious, the intelligent children will no longer want to do medicine .This will mean the doctors of the future may not be as bright, and this will also affect the death rate . It is not so black and white.

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  • good

    the NHS is everyone's

    the consumer / public / taxpayer has to decide if they want the service they say they want then they have to pay for it.

    staff have already taken yearly pay cuts and absorbed increased expenses to prop the system up. the suggested contract is bad news for doctors and will lead to such a demoralized work force that the quality of care will plummet.

    it is common sense that if you are not increasing the work force numbers and want to increase availability of services - the same staff are going to have to work longer hours. The CQC is a puppet and will pay lip service to breaches in hours. We have all been there with 100 hour weeks. In our time if something happened it would raise an eyebrow and then we'd move on. Now if something happens it will end a juniors career. It is not fair on them.

    the BMA are doing this to bang the drum to make sure the public heeds their warnings.

    sadly the public don't care enough and feel this is a drs vs state argument. it is not - the NHS is the public and if they don't fight for it - come August it will be gone as juniors will walk. those talking about don't do this and stick it out are deluded - think about it - this is the most extreme strike action ever. Juniors are not mildly upset they are fuming and come August I can see a lot leaving. You may choke on your cornflakes on the thought of strikes but how about having no doctors after August or no hospitals.

    If the public abandon juniors then doctors can feel they did their best to warn the public and can leave knowing they did the right thing.

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  • All health staff, nurses and doctors should give three months notice of a complete walk out.

    Desperate times, desperate measures.

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  • Malawana has what Nagpaul hasn't

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  • Public opinion may not bother some of you, but it does bother the government very much. We'll see, but I suspect the government will hold their line and allow the junior docs to be the first ever to behave so unprofessionally as to completely abandon their posts and their bond of trust with their patients. That's how it will be presented.

    So now, it is not only the relatively few who will suffer longer waits for routine care but, potentially, everyone in the country will personally feel at risk when emergency care is compromised. They will not blame the government, but those idly standing around on the picket line, as they now see it, just wanting a bigger salary.

    I personally think this escalation is wrong and is very likely to completely backfire. Just because the government has badly mishandled the affair, it does not give license to the profession to stoop even lower. The battle is lost.

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  • Enough is enough. We should all walk out.

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  • We can only fight to the same rules that this health secretary employs. I wholly support this escalation in industrial action. I fear this government more than I fear the actions of our young doctors. Heads up ladies & gentleman & apply pressure the likes of which this government will understand.

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  • Fight the power!

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