Junior doctor strikes: Leaders urge government to drop preconditions and negotiate

Junior doctors in England began a 72 hour walkout on 13 March in their ongoing dispute over pay and conditions. The strike action went ahead after the government’s 11th hour offer of talks, just before 10 pm on Friday 10 March, led to nothing after ministers agreed to talk only on the condition that junior doctors call off the planned strike action with immediate effect. Other preconditions from the government included limiting discussions only to future pay, with a one-off bonus payment to offset 15 years of pay erosion.

In response, the co-chairs of the BMA’s Junior Doctors Committee, Vivek Trivedi and Robert Laurenson, told the health and social care secretary, Steve Barclay, that until the government put forward a “credible offer” for England’s 75 000 doctors in training they would not be in a position to call off the strikes. “We remain open to entering talks with government any time and anywhere to bring this dispute to a swift resolution and restore the pay that junior doctors have lost,” they said. “If the health secretary is truly committed to this, then he needs to drop these unreasonable preconditions and begin proper negotiations with us.”

Pay restoration

The strike action has arisen against a backdrop of growing discontent among junior doctors, who say they have been underpaid, underappreciated, and overworked for years.

The average salary for a doctor in training has not kept pace with inflation for more than a decade, and junior doctors are demanding “pay restoration” from the government to reverse their estimated 26% real terms cut in pay since 2008-09. The BMA has said this would require a 35.3% pay rise, costing around £1.65bn this financial year.1

In 2019 junior doctors in England agreed a four year pay deal, with an increase of 2% each year to their basic pay. But since then the pandemic, the cost of living crisis, and spiralling inflation have created a different economic and working environment. The strength of feeling is clear from results of the NHS Staff Survey,2 which showed the proportion of junior doctors satisfied with pay halving in a single year from 34.5% to 17.1%, in 2022.

The BMA’s ballot on taking industrial action saw 98% of junior doctors voting to back strike action, with a turnout in excess of 77%. The BMA said this was the largest ever turnout it had seen in a ballot.

Standing together, fighting back

Speaking to The BMJ at the picket line outside University College London Hospital on 13 March, Laurenson said that junior doctors had felt “lost” and “demoralised” for many years, which was why many so strongly believed they needed to turn out to strike.

“It’s been really tough for junior doctors over the last decade,” he said, “Now junior doctors are coming together to stand together, to fight back.”

To consider bringing an end to the action Laurenson said that the government must produce a “credible deal on the table for us to put to our members.”

“We put our case towards them [the government], and they gave us nothing in return,” he said. “They didn’t give us any numbers. They gave us absolutely nothing except for a demand to remove strike action. You can’t negotiate with no numbers to negotiate with.”

Laurenson said that the government’s recent tactics of engaging with other health unions, and the experience of the last junior doctors’ strike in 2016, had led him to the view that it was not negotiating in good faith. “Doctors and junior doctors in particular have been bitten once by this government before, so we’re very cautious when dealing with these kinds of people,” he said, urging the government and Barclay to show some “faith and goodwill” to rebuild trust with the profession.

“If we could get them around the table, let’s just bash out this deal,” he said. “If he doesn’t meet with us and he does dig in, then the only action, of course, has to be more strike action.”

Barclay said, “It is incredibly disappointing the BMA has declined my offer to enter formal pay negotiations on the condition that strikes are paused.

“I hugely value the hard work of junior doctors and urge unions to come to the negotiating table and cancel strikes which risk patient safety and impact efforts to tackle the backlog. I want to find a fair settlement which recognises the crucial role of junior doctors and the wider economic pressures facing the UK.”

Effects on services

Ahead of the strikes, Barclay said that the government had been working closely with NHS England on contingency plans to help protect patients’ safety by prioritising emergency, urgent, and critical care but said “there will inevitably be some disruption for patients.”

Saffron Cordery, deputy chief executive of NHS Providers, which represents NHS trusts, said the dispute was a “major and unwelcome distraction” for NHS leaders, noting that recent industrial action by healthcare staff had already resulted in more than 140 000 planned procedures and appointments being rescheduled.

“It’s important that everyone understands the impact of continuing industrial action on patients, staff, and the NHS,” she said. “We need a rapid resolution.”

Source: Gareth Iacobucci

Picture Credit: BMA Junior Doctors