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Hospital Leaders Worry About Upcoming Junior Doctors Strike

Editor's note: This story has been updated with a comment from the Royal College of Emergency Medicine

Strikes by junior doctors will have a "significant impact" on NHS waiting times, a hospital leader has said. Nick Hulme, chief executive of East Suffolk and North Essex NHS Foundation Trust, warned that the majority of pre-planned care would be cancelled on strike days, which are yet to be announced. Meanwhile, Health Minister Maria Caulfield said junior doctors' pay demands are "unrealistic" and claimed that their strike action will "put patients at risk".

On Monday the British Medical Association (BMA) announced that its junior doctor members had voted overwhelmingly in favour of taking industrial action. The action, which will include all doctors under consultant level, will last for 72 hours and the BMA said that it could possibly coincide with action taken by other health unions. It is expected that the walkout will take place on the 15th of March.

Resources Expected to be 'Significantly Reduced'

Mr Hulme told LBC radio: "Clearly this is a significant shift in the industrial action now involving doctors, previously obviously nurses and paramedics.

"So it will mean that we will be in a position of cancelling an awful lot of our elective (planned) care."

He added: "We won’t know exactly which doctors will come in on the day, they’re not mandated to inform us whether or not they’re going to strike so it’ll be an hour-by-hour assessment of risk, placing those doctors who come in into our highest risk areas, which will probably be those sort of 24/7 services of maternity, ICU, A&E, critical care, and others.

"But that will mean that we won't be able to provide most of our outpatients and our planned or elective operations.

"So the challenges that we face in terms of the care backlog and the extraordinary long waits that people are now having for diagnosis and treatment of cancer and for other elective care, this will have a significant impact on already worryingly high waiting times."

Mr Hulme added: "We will be asking our consultant staff who are not on strike to act down effectively into those junior doctors roles and negotiating with them the best way that we can support them to do that.

"And again (we will be) imploring the public to stay away from A&E unless you have a life-threatening condition because clearly the resources that we will have to care for you in A&E will be significantly reduced on the days of the industrial action."

Some Junior Doctors Earning £14/Hour: BMA

Meanwhile, the BMA's deputy chair of council, Dr Emma Runswick, told BBC "Breakfast": “Junior doctors in this country have faced a cumulative 26% pay cut since 2008 in real terms.

"We've got junior doctors earning as little as £14 an hour and we would like to reverse those pay cuts to prevent staff leaving the NHS and to make sure that we can provide the care that patients deserve.

"There is going to be disruption through strike action.

"The system we are using will allow senior colleagues – consultants and specialists and GPs – to cover urgent emergency and critical care.

"But hospitals will have to plan to cancel a variety of different non-urgent appointments and procedures in order to make sure that care remains safe during strike action.

"Unfortunately, that's the only option we've got.

"We’ve been warning this government since July that we were keen to see action on pay – we told them we were balloting in October and they've known that this was coming for a long time – [there has been] every opportunity to prevent strike action by doctors and yet they've chosen not to."

Worry Over A&E Cover During 72-Hour Strike

She said that it was "possible" that action might be co-ordinated with strikes by other health unions, adding: "We will always co-ordinate with other unions to make sure that our action is safe, always. And we're never going to put patients at risk.

"But co-ordinated action is useful for a number of other reasons as well. It makes action more effective. And we’re hopeful that that will bring the Government to the table far quicker than we might otherwise see.”

But Ms Caulfield told BBC "Breakfast": "We are absolutely concerned about the announcement that junior doctors won't necessarily protect A&E and intensive care units. That's a real worry because they're the really sickest patients who need urgent care and help.

"My understanding from the BMA is their current demands in terms of why they're striking is a demand of a 26% pay increase, but that's unrealistic and not achievable.

"Striking with those demands on the table is unfair on patients, let's get around the table, let's talk about future pay settlements and get this resolved, but striking and particularly not being able to guarantee cover for A&E, and emergency, and ITU cover is very, very difficult and will put patients at risk."

Sunak Pledged to Negotiate with Unions

On Monday, NHS leaders pleaded with Rishi Sunak's Government to negotiate on pay with unions.

Health Secretary Steve Barclay said he was "deeply disappointed" with the BMA announcement, but NHS Providers – which represents health trusts – said the Government could resolve the dispute by opening talks on current pay rates.

More than 140,000 appointments have already been postponed due to industrial action and this will rise "significantly", NHS Providers said.

Some 47,600 junior doctors in England were eligible to vote in the BMA's ballot. Almost 37,000 votes were cast and 98% of those were cast in favour of strike action, meaning this was the largest ever turnout for a ballot of doctors by the BMA and a record number of junior doctors voting for strike action.

The BMA's action is the latest industrial dispute to hit the NHS as workers face a squeeze on living standards driven by soaring inflation. A smaller number of junior doctors in the Hospital Consultants and Specialists Association (HCSA) have already said they will strike for the first time in the union's history next month in a dispute over pay.

More strikes are set to be announced by ambulance workers and nurses are due to stage their biggest walkout to date as they strike continuously for 48 hours from 6 am on March 1.

For the first time, the Royal College of Nursing action will involve nursing staff working in emergency departments, intensive care units, cancer care, and other services that were previously exempted.

RCEM: 'Staff Deserves Better'

Commenting on the announcement of industrial action by junior doctors, President of the Royal College of Emergency Medicine, Dr Adrian Boyle, said: "Our members and colleagues have an individual right to take industrial action as appropriate. Political leaders must recognise the challenges and difficult conditions facing staff. We hope that a resolution can be found quickly without the need for this industrial action by junior doctors to take place. We also urge the government to include doctors in training and SAS doctors in any negotiations, resolution or deal that is made. They are an equally crucial part of the workforce and must be valued as such.

"While strikes may disrupt emergency care and pose a risk for patient safety, patient safety has long been at risk as a result of years of under-resourcing, under-funding, lack of staff, lack of beds, and inadequate and insufficient community and social care. Staff deserve better and so do patients. Every effort must be made to retain our competent and valuable staff in the health service, working on the frontline and delivering for patients.

Dr Boyle added that patients should continue to seek help in "the usual way" if they have a medical emergency but should expect longer waits and a disrupted service that the strikes may cause.

This story contains information from PA Media