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'Credible Offer' Needed to Avert Junior Doctors' Strike

Junior doctors in England have given the Health Secretary, Steve Barclay, an ultimatum to put forth a "credible offer" on pay if he wishes to avert next week's threatened 4-day strike, which could see junior doctors walk out from 11-16 April.

Junior doctors in England are asking for a 35% pay rise to compensate for what they say is 15 years of effective pay erosion, but Mr Barclay has described this as "unaffordable".

Dr Vivek Trivedi and Dr Robert Laurenson, co-chairs of the British Medical Association (BMA) Junior Doctors' committee, expressed frustration at what they said was the Minister's refusal to meet with them, the fact it had taken him almost a week to reply to them, and that he appeared to have laid down "yet another pre-condition" to the negotiations. 

Trust leaders have warned that if the strike goes ahead it would affect both emergency and planned care and could cause harm to patients.

Dr Trivedi and Dr Laurenson accused Mr Barclay of misrepresenting their opening position as a precondition to talks and of asking them to give up their negotiating position and to call off the strike action – for which the committee had "an overwhelming mandate from nearly 50,000 junior doctors in England", they said.

BMA: 'Credible Offer' Needed to Call Off Strikes

In their latest volley in the dispute, Dr Trivedi and Dr Laurenson said: "Today we are making a serious and substantial offer to Steve Barclay, which means it is within his gift to see next week's strike action suspended. If he puts a credible offer on the table that shows he is serious about addressing doctors losing more than 26% of their pay in real terms, and which we believe can form the basis of negotiation, we will suspend next week's action.

"The ball is now very much in the Secretary of State's court. Is he willing to table a serious offer we can consider? Or does he want to sit in his office and continue to claim we have set preconditions, which we have not."

The planned 4-day strike is set to begin Tuesday, 11th April. Details of its picket line locations would be available on Strike Map, which describes itself as "a 'worker-powered' attempt to map the industrial action taking place in the UK".

The last walk out by junior doctors lasted 3 days in March and reportedly led to about 175,000 hospital appointments and operations being postponed.

Mitigating Risks Requires 'Phenomenal Effort'

NHS England (NHSE) issued a system letter to NHS bosses at the end of March warning that this month's strike would take the form of "a full stoppage of work, including night shifts, on-call shifts, and non-resident work". 

It cautioned that next week's strike would present an "additional challenge" due to its duration and timing, and said that previous strikes had "required colleagues across the NHS to make a phenomenal effort to mitigate risks industrial action has presented".

NHSE emphasised that safety must be prioritised, whilst accepting that "rescheduling activity is going to be essential to minimise risks to patients", but this should happen only when "absolutely necessary, proportionate and clinically appropriate". Clinically urgent, cancer care, and long waiters should be the last cohorts to be rescheduled.

"We wish to be clear that we trust system leaders to make decisions to ensure we maintain a safe urgent and emergency care pathway – and that critical care, maternity, neonatal care, and trauma sites are resilient," the NHSE said.

'Real Concerns' About Patient Safety

NHS Providers said trusts would work to mitigate the impact of the strike, but that its 4-day duration and timing – immediately after the Easter bank holiday weekend, when many colleagues would anyway be on annual leave – made it "harder to assure patient safety".

If the strike goes ahead, "the NHS will focus resources on emergency treatment, critical care, maternity, neonatal care, and trauma", it said. "But even in these areas, there are real concerns of a raised risk to safety."

The organisation issued a press release quoting worry from several trust leaders:

  • "This is less about what planned routine work gets pulled down, and everything about maintenance of safety in emergency departments, acute medicine and surgery... Concerned doesn’t begin to describe it"
  • "I am not confident this time that we can maintain patient safety as we will not be able to provide the cover"
  • "Many of the consultants who stepped up to do nights last time are not available or are more reluctant this time"... "Those with families almost certainly won't as [they] can't rearrange out of school holidays."

'Uncharted Territory'

Sir Julian Hartley, chief executive of NHS Providers, said: "It's clear from our extensive dialogue with trust leaders that we are in uncharted territory. Yet again, we are seeing colleagues pull out all the stops to minimise disruption and ensure patient safety. But the challenges here are unprecedented."

He said that while "no effort will be spared" to provide needed emergency care during the strike, for less urgent cases, people should look first to 111 online if they can.

"Even now it's not too late for the two sides in this dispute, the Government and the unions, to recognise the gravity of the situation and step back from the brink.

"We need a solution to prevent further strikes, and we need it now."