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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)

  • I think withdrawing emergency care is wrong personally. There could be many people dying as a result of this...

    I understand that hunt negotiating with hunt is never going to achieve anything but prior to this JDs had a measure of sympathy from the public....... be warned that the media will have a field day if deaths result from this

    Hopefully in this game of chicken the government will blink first

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  • I would have suggested longer (indefinite?) emergency-only strike, rather then this, very risky.

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  • Junior doctors are doing the right thing and as a GP - I fully support our juniors.

    They have to do this. Why? when the NHS collapses after they leave - no one can say they didn't do their best to warn everyone. So rather than trying to leverage emotional blackmail and bully the juniors listen to what they are saying and lean on your local politician to support them. Juniors have a choice - come August they can locum, emigrate, change career, study etc. But once the NHS is gone - it's gone. There are only 4 months to save the NHS.

    Many assume come August it will be business as usual - I don't think so. How many need to leave to cause a collapse ?5% ?10%.

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  • Other healthcare professional23 Mar 2016 8:55pm
    What evidence do you have to base your remarks on?

    The strike will be a consultant led emergency strike. Who would you rather see as a patient a Consultant or a junior doctor? It is completely baseless to say it will be unsafe for patients. The emergency units, and wards will be staffed by senior consultants with many years of experience.

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  • Sessional/Locum GP23 Mar 2016 9:32pm

    Many thanks for your support and comments. It is also time for the GP'S and Consultants to stick up for the NHS and negotiate a better deal with their own contracts.

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  • You all need to listen to Dr Hamed Khan a GP who is standing up for junior doctor's and the NHS:

    http://www.lbc.co.uk/watch-passionate-iain-takes-on-doctor-over-strike-127431

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  • I had another hell-ish day at work. We have no choice to do this. Our current situation is unsustainable and unsafe. We have to use force, if we give-in, expect things to get worse and patients suffer as a result. I fully support the juniors.

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  • I think the public will support the junior doctors. I worked in NZ in the 1990s and there were 3 strikes over a few weeks when I was there. No emergency cover was provided. The nz govt was trying to bring in UMT style payments like the uk to replace the treble time payments nz doctors got after midnight. The govt capitulated with each strike being called off after an hour or so. It was weird watching ambulances arrive at a and e with one consultant running around trying to cope whilst the juniors watched from the picket line. The press at all times supported the doctors....

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  • @0.41 today

    The problem is that the world is now a different place. We have a very determined Govt that has support from right wing media that will not support JDs. Joe Public is fickle. They have been very supportive of JDs so far, but judging by the comments in the DM today, they have switched allegiance. The question is does this matter?

    My view is that JDs have to win. If they capitulate JDs will increasingly walk away and then it will be the same onerous contracts that will be forced on GPs, Consultants, Nurses, Porters.. Quite frankly all of us are already being forced to work far harder than at any time in the past. If this deteriorates no doctor will be able to mentally cope with full time work in the NHS. Many already can't and only work part-time.

    So despite possibly losing public support This is the only way to go.

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  • Our biggest problem is that Doctors have little support from any Politicians, and that includes the Labour Party. Osborne had to rapidly back down from proposed cuts to the disabled because many Politicians, including Tories, opposed them. Few Politicians support Doctors. They want us to have huge reductions in income. If everyone gets a 30% reduction it is expected that 30% more activity will be achieved.

    So will you accept a 30% reduction in income or are you mentally able to carry out 30% more work as will be forced on us all?

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  • I protested about junior doctors hours in the late 80's. I have been forced out of medicine by revalidation, as I dont now fit into any neat category. I will be there supporting my former collegues.
    It can be done as the new contract will end it all anyway. Few doctors could work that new schedule and survive let alone thrive.
    Why should we be martyres and throw our lives and those of our families on bonfires?
    For what good reason?
    We need to protect the doctors of the future. I protested and chained myself to the front of Westminster with my collegues to show my anger at the hours back then.
    I had no idea of the living hell I was letting myself in for as being a doctor because of the hours.
    As soon as I discovered, I tried to back out of hospital medicine asap.
    So if anyone wants to be looked after themselves in their dotage, the juniors need to strike NOW and we ALL need to fully support them.
    Otherwise there will be NO free NHS in the future.
    Public opinion should not stop doctors from protecting themselves. You will be pleasantly surprised to see the level of support on some newspaper sites, like the Guardian. I know most news papers are negative about doctors but headlines will be easily and quickly forgotten, while contracts remain......

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  • I hear talk of patients dying because of the strike. But the public need to realise people are dying now due to gross underinvestment (outdated equipment, trolleys instead of beds, poor standards in cancer treatments, no mental health services, etc. etc.) And understaffing (poor recruitment and retention, zero morale which means poor quality workmanships) in the NHS. But nobody is blaming the Manager – Mr Hunt of these deaths. Mid Staff is the evidence of these deaths – Yes it was under Mr Hunt’s watch and yes he has not been accountable. Mr Hunt is accountable for many deaths that seem to have fallen under the radar. It is sad the junior doctors are blamed for failings of the NHS.

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  • There isn't "underinvestment".There is more money going into the NHS than ever before: fact.From my experience as GP Exec Finance Lead on my CCG dealing with a bankrupt Trust I can assure you that the NHS is utterly incompetent in planning how to spend money.Additionally of course, demand, driven by demographics and inappropriate lifestlye choices, is rising exponentially.The "NHS" model is terminally broken.We need to look at other European countries to learn how to do it better.

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  • The NHS is suffering from under investment and wasteful commercialisation, Dr Paul Hobday in Guardian letters- I agree with this letter.. The NHS is failing but only because of the lack of investment by this government – the lowest in the G7 – and the wasteful commercialisation.

    The issue here is from today' media and newspapers- even there is a expected death from an illness, the media is going blame the strike - as from lack of doctors on that day of strike. CRAZY!

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  • I can't understand why the juniors don't just refuse to accept the new contract and give notice to leave on the day it is imposed, but agree to stay under the old one until an agreement is reached. The public would find it difficult to argue with such a stance, and the blame for loss of staff would lie squarely with the government.

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  • Just been listening to LBC. Very interesting. There was a representative from a government think tank who obviously opposed the proposed junior doctors all-out strike. He sympathised with the junior doctors stating that their job was low-paid and agreed that they all had debts as a result of their training and had to look at their fellow peers in higher paid jobs working less hours. He blamed the BMA for not agreeing to modern work practices. He did not saywhat this meant, but stated that the modern NHS is no longer fit for purpose. 'The original purpose of the NHS was to provide medical cover for industrial accidents and patients with TB'. He did not categorically state that there needed to be some form of personal payment from patients, but implied that the BMA should be 'more open to modern working practices as exists everywhere else in modern service delivery'.

    My belief is that the government wants the BMA to back some form of direct payment from patients. The implication is that they want to bring in personal health budgets, as has already commenced. Once the limit is reached patients would presumably need to top up with personal payment.

    It is inevitable that some form of personal payment will be brought in. The BMA should be seriously considering this rather than completely rejecting it.

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  • I salute my colleagues in training. Anyone condemning them simply doesn't understand how downtrodden, miserable and energy sapped they are. Unlike previous generations they have the guts and the unity to make a stand. Undoubtedly, social media has helped to keep them together and galvanise them. Whatever it takes, I hope they stay resolute.
    Unlike a number of their older colleagues they have no interest in behaving like good little boys and girls and toeing the line. The cockroaches in government are no doubt hoping they will prove to be timid like their predecessors.

    Public support is a difficult issue. As with all groups, Joe Publics interests are vested. Either toe the line and convince yourselves that the public support your cause or make a stand to try and improve our working lives. I'm delighted that so many consultants and GPs are on the same team. I hope the consultants consider the doctors-in-training problems during their contract negotiations and don't do anything to undermine their struggle.

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  • Not one mention of this on the news this morning

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  • It is increasingly impossible for the government to provide NHS care for all things. All countries are facing the same problem. The BMA needs to address this and realise that some form of copayment will be required.

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  • Rip the plaster off quickly, don't let the wound fester underneath!

    Junior doctors are entirely correct.
    As to public opinion this isn't a popularity contest - people will keep attending hospital even if they dislike the doctors!

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