The first all-out doctors’ strike in the history of the NHS is under way.Thousands of junior doctors walked out of both routine and emergency care at 08:00 BST in protest at the imposition of a new contract from the summer.
It is the first time services such as A&E, maternity and intensive care have been hit in the long-running dispute.
NHS bosses believe plans are in place to ensure safety, but say the situation will be monitored closely during the stoppage which ends at 17:00 BST.
Further all-out strike action is due to take place on Wednesday, between the same hours.
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- What patients need to know
- Full coverage: Junior doctors’ strike
NHS England said “military level” contingency planning had been carried out to protect urgent and emergency care.
Steps taken include:
- The postponement of nearly 13,000 routine operations and more than 100,000 appointments to free up staff
- The cancellation of holidays and study leave
- Redeployment of consultants, middle-grade doctors and nurses into emergency care
- More GP appointments being kept free for last-minute requests
- An increase in 111 staff rostered on to allow the phone service to handle more calls
Patients are being urged to think carefully about how they use the NHS during the strike – a website has been set up giving patients details about what services are available where they live.
NHS England’s Anne Rainsberry said: “Clearly industrial action of this type can put significant pressure on the NHS. We have been working with all hospitals to make sure they have plans in place to provide urgent and emergency care.”
She said those plans were “robust” and hospitals were “confident” they could cope, but the situation would be kept under review.
It comes as a new poll by Ipsos MORI for the BBC showed the majority of the public still backed junior doctors, although support was not as high since it became an all-out stoppage.
Asked whether they supported junior doctors striking while not providing emergency cover, 57% said they would and 26% said they were opposed.
The last time the public was asked was ahead of the 48-hour walkout in March, when emergency cover was maintained. Then 65% supported junior doctors.
The poll of more than 800 adults in England also found a growing number of people blaming both sides for the impasse. Some 35% said the government and junior doctors were at fault. The majority – 54% – still blamed the government.
The dispute is about working hours and pay, but a key sticking point is about payments for working on Saturdays.
Talks between the government and British Medical Association (BMA) broke down in January, prompting the government to announce in February that it would be imposing its contract in the summer.
Currently junior doctors are paid more for working unsocial hours at night or at the weekend, but under the imposed new contract the Saturday day shift will be paid at a normal rate in return for a rise in basic pay.
How the dispute reached stalemate
- Talks at conciliation service Acas broke down in January
- A final take-it-or-leave it offer was made by the government in February but was rejected by the BMA
- Ministers subsequently announced the contract would be imposed from the summer
- It will reduce the amount paid for weekend work, but basic pay is being increased
- The BMA wants a more generous weekend pay allowance and more investment for more seven-day services – the government is not increasing the overall budget for junior doctors’ pay
- Two legal challenges are being pursued by doctors against the imposition
- Hospitals are pushing ahead with the new contract – offers are expected to go out in May
- The government is refusing to reopen talks, arguing it made compromises earlier in the year but the BMA did not
- The first four strikes in 2016 all involved emergency cover being provided, before the all-out stoppages on 26 and 27 April
The strike comes after last-minute pleas from medical leaders, patient groups and opposition MPs for both sides to get back round the negotiating table.
National Voices, a coalition of patient groups and charities, even offered to host talks.
Chief executive Jeremy Taylor said: “It seems wrong that there is a big strike in the offing, more possible strikes to come, no strategy for ending this dispute, no negotiations going on. There is a stand-off.
“Patients and the public are caught in the middle – and the harm is being felt by patients and their families.”
Health Secretary Jeremy Hunt described the strikes as “extreme” and warned they would be “deeply worrying for patients”.
But BMA junior doctor leader Dr Johann Malawana said if Mr Hunt had scrapped his plan to impose the contract the union would not have taken this action.
“No doctor wants to take any action. They want to be in work, treating patients, but by refusing to get back around the negotiating table the government has left them with no choice but to take short-term action to protect patient care in the long term.”