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Patients ‘not at risk of serious harm from doctors’ strikes’

Doctors’ strikes do not increase the risk of patients dying and may even be linked to a reduction in mortality, a review of past industrial actions has shown.

The findings appear to contradict comments made by health secretary Jeremy Hunt, who claimed that next week’s proposed industrial action by junior doctors ’poses a serious threat’ to patient safety.

The review, published in the BMJ, found that patient mortality stayed the same or even fell during recent strikes in developed health care systems such as the NHS.

And in two strikes by junior doctors, in New Zealand and Spain, senior doctors were able to provide sufficient emergency care during the strike – with indicators of care quality unchanged or even improved during the strike period.

The authors of the BMJ paper – from Harvard Medical School and the Brigham and Women’s Hospital in Boston, USA – concluded that ‘previous strikes have shown that it is possible to disrupt elective services while ensuring that emergencies are treated promptly and effectively’.

They added that ‘doctors in high-income countries can be reassured by the consistent evidence that patients do not come to serious harm during industrial action, provided that provisions are made for emergency care’.

The study comes as junior doctors prepare to go on strike next week in the first of three days of planned industrial action, following a BMA ballot in which an overwhelming 98% of junior doctor members voted in favour of an all-out strike, on a 76% turn-out.

The strike has been called over a protracted dispute with the Government regarding changes to the junior doctors contract, which the BMA says will cut doctors’ pay and put patients at risk from unsafe working hours.

The first planned walk-out – which looks set to go ahead despite the Government’s U-turn on attending conciliation talks – is due next Tuesday, 1 December when junior doctors will provide emergency care only for 24 hours.

After that a full walk-out – with no emergency cover from junior doctor staff – is planned from 8am to 5pm on both Tuesday 8 December and Wednesday 16 December.

Health secretary Jeremy Hunt has said the vote to strike is ‘regrettable’ and will ‘put patients at risk and see operations cancelled or delayed’.

Tory MP and Health Committee chair Dr Sarah Wollaston, a former GP, who has called on the Government to withdraw from its position over the contract, has nonetheless also condemned the BMA’s planned strike action which she said was ‘highly unsafe’ and would inevitably put patients at risk of ‘significant harm’.

NHS England director of urgent care Sir Bruce Keogh has also waded into the row, accusing the BMA of not making clear enough what contingencies were in place to ensure emergency care would not be affected – even raising concerns over a potential terror attack, in the wake of the recent Paris atrocities.

However, BMA leaders say they deliberately gave the Government and NHS chiefs enough notice to sort out emergency plans.

The BMA declined to comment on the BMJ study directly, but cited a previous statement when the plans for strike action were announced in September, in which they said they wanted ‘to give as much notice as possible about the potential action in order to ensure that the necessary cover can be put in place to minimise disruption to other NHS staff and, above all, to patients’.

A DH spokesperson said: ’This research does not show strikes are safe – it is naïve to assume large scale industrial action can be undertaken without causing harm to patients and having a serious impact on the ability of hospitals to run normally. Alongside NHS leaders and Royal Colleges, we urge the BMA to come back to the table to talk and withdraw strike action immediately.’

BMJ 2015; available online 25 November


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