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Patients are being told to expect disruption as doctors start their five-day strike in England, with NHS bosses saying they are struggling to keep as many services going as they have done in recent walkouts.
With a wave of flu placing pressure on hospitals, NHS England said non-urgent services would be affected by the strike, which began at 07:00 Wednesday.
This is the 14th walkout by resident doctors, the new name for junior doctors, in the long-running pay dispute.
Health Secretary Wes Streeting said the strike had been timed to inflict most damage on the NHS and put patients at risk, but the British Medical Association (BMA) said it would work with NHS bosses to ensure safety.
The strike is being held after the two sides held last-minute talks on Tuesday afternoon.
The meeting was described as “constructive” by the government, but not enough progress had been made to call off the strike.
The BMA wants a plan to increase resident doctors’ pay over a number of years, plus a guarantee of new training places for qualified doctors.
Resident doctors represent nearly half of the doctors working in the NHS. They will walk out of both emergency and non-urgent care with senior doctors drafted in to provide cover.
Speaking from a picket line outside St Thomas’ Hospital in London, BMA resident doctor leader Dr Jack Fletcher said that “we’re here yet again, on a picket line, because we have not yet reached a credible deal to fix this absurd jobs crisis”.
“What we’re not asking for is a huge stonking pay rise in one go,” Dr Fletcher told BBC’s Today programme.
“No-one has ever asked for anything double digit overnight, no-one has ever asked for anything in one go overnight. What we’re asking for is to stop these real-time pay cuts that the government are recommending for doctors.”
Asked about recent polling that suggests public support for the strikes is declining, he said: “I do care what my patients think but I didn’t sign up to give that care in a corridor.”
In the two most recent strikes – in July and November – NHS England said it was able to keep the majority of non-urgent operations and treatments, such as hip and knee replacements, going.
But NHS England said it expected more disruption this time. Concern has also been expressed that hospitals may struggle to discharge patients in time for Christmas as the doctors who are working concentrate on providing strike cover.
Medical director Prof Meghana Pandit said the strikes came “at an immensely challenging time for the NHS”, with record numbers of patients in hospital with flu for this time of year.
She said more patients were likely to feel the impact of this round of strikes than the previous two, adding that staff who are covering for those striking would not get a Christmas break with their families.
Streeting added: “We have been working right up to today to try and avert these strike actions.
“Everyone knows the period leading up to Christmas and into the New Year are always the busiest for the NHS. With super flu, this year is harder.
“And that double whammy of flu plus strikes means that there is an additional burden now on other NHS staff.”
NHS England said GP practices will continue to be open and urgent and emergency care services will be available for those who need them.
But even then there is likely to be some disruption. Cheltenham General Hospital’s emergency department is closing for emergencies during the strike – it will remain open for minor injuries – with patients advised to use nearby Gloucestershire Royal Hospital.
NHS England said the public should use 111 online as the first port of call for urgent, but not life-threatening issues during the strike.
Patients who need emergency medical care should continue to use 999 or come forward to A&E as normal, it added.
The strike is going ahead despite a new offer from the government being made last week, which included increasing the number of speciality training posts and covering out-of-pocket expenses like exam fees.
Daniel Elkeles, chief executive of NHS Providers, which represents hospital and ambulance services, said the strikes are “like having the worst possible Groundhog Day”.
“But unlike the film this is real, so thousands of patients are going to have their operations and procedures postponed or cancelled,” he told BBC Breakfast.
He added that the “increasingly acrimonious dispute” feels like it’s as “far away from being resolved as it ever has been”.
However, he added that patients will still be safe in hospital and that people should attend appointments unless informed otherwise.
The specialty training jobs, which resident doctors start in year three of their training after completing medical school, have become highly competitive.
This year 30,000 applicants went for 10,000 jobs – although some of the applicants were doctors from abroad.
Dr Tom Twentyman is one of those who lost out after trying to secure an emergency medicine post. He says finding a job is an “absolute nightmare”.
Since then he has been struggling to find work, juggling a handful of locum shifts each month at the same time as applying for more than 40 short-term contracts at hospitals across the country – one of which he has now secured.
But this will not count towards his training, so he must now look to reapply next year if he wants to specialise as a doctor.
“Some of the job adverts were coming down within two hours of going up after they received 650 applications, which is clearly an enormous number to shortlist,” he says.
On Monday the BMA announced its members had voted to continue with the strike – effectively rejecting the offer in the process – after the union agreed to hold an online poll of members.
Streeting has maintained he will not discuss pay as doctors have received pay rises totalling nearly 30% over the past three years.
The BMA argues that, despite the pay rises, resident doctors’ pay is still a fifth lower than it was in 2008, once inflation is taken into account.
But it said it was committed to ensuring patient safety.
“We will be in close contact with NHS England throughout the strikes to address safety concerns if they arise,” the union added.
