I"m a hospital consultant and I worry about five-day junior doctor strikes

I am worried. Nothing new, you might say, for a consultant working in acute medicine at a busy district general hospital. This time it is not about the acutely unwell patient in front of me but about the announcement by the British Medical Association junior doctor committee (BMA JDC) that junior doctors in England may take part in more industrial strike action. Five days a month of rolling strikes during which there will be withdrawal of all cover from 8am-5pm. These are planned to happen from October onwards unless the government stops the imposition of the junior doctor contract.

As well as being worried I am puzzled. Back in May 2016 the JDC recommended to its members that they accept the new contract, the now leader of the JDC saying at the time it was safe for patients and junior doctors. Despite this the contract was rejected by the membership due to ongoing concerns about weekend pay and people who work part-time. The membership and the rest of us have been waiting to see what would happen next. Junior doctors tell me they do not even know what would need to change within the contract for the BMA JDC to be happy with it. This is surely a damning insight into the BMA’s lack of communication and leadership at such a critical time.

Then the announcement of the longest and most severe set of strikes the NHS has experienced are announced. They appear to be completely out of proportion to the issues that the BMA JDC and its membership still have with the contract. It is not even the whole contract they want rewriting, but elements of it. Despite that, NHS trusts will have to cancel elective procedures, outpatient appointments and draw up emergency rotas if the strikes go ahead. While the BMA has issues with the employer and the employment contract, it will inevitably be the staff and patients caught in the middle of the strikes who will suffer the most.

I am worried about my junior doctor colleagues, many of whom are starting to lose faith in their trade union, the BMA, but fear repercussions if they voice these concerns. They tell me they cannot see how a full strike will help them. They are stressed as they realise the impact of such strike action. They are battling with ethical and moral dilemmas with many not knowing what to do for the best. Some will lose money during the strike making it hard for them and their families financially. Is this really what the BMA JDC intended? There may be a BMA hardship fund for those junior doctors worst affected but there is no hardship fund to support the staff left behind with added stress and work to contend with at an already busy time of year. I feel the BMA JDC have convinced the membership that the issues of NHS under funding, seven-day services etc can be all put together into the justification for the proposed strike.

Many junior doctors tell me they do not want to strike this time – they are in a profession that cares for patients and they fear harm will come to patients during a full and protracted strike. Did any of the voting that junior doctors took part in earlier this year really give the BMA JDC the mandate for these current proposed strikes?

While other NHS staff will provide all the cover and care they can for patients during the strikes, it is clear that patient harm is a real and valid concern. Junior doctors also feel their training could be extended if they miss more than 14 days of work in a year, which is a possibility. What damage is being done to the profession in the public’s eyes? Public support for junior doctors feels as if it is a surrogate for public distrust of the government. The medical profession is one of the most trusted professions but with industrial action planned, the public support will not last forever.

In every strand of this I worry about the patients who will be unduly affected by this strike. They did not ask for this, they have no contract of employment to negotiate; they simply want to be cared for by the NHS.

If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

I"m a hospital consultant and I worry about five-day junior doctor strikes

Junior doctors suspend planned five-day strike in September

Junior doctors have called off the first of their planned series of five-day strikes after growing alarm from senior doctors and NHS leaders that the action could endanger patients.

In a statement on Monday afternoon, Dr Ellen McCourt, the chair of the British Medical association’s junior doctors committee, said that the doctors’ union was “suspending the industrial action planned for the week of 12 September”.

McCourt told Jeremy hunt, the health secretary, that he now had a month to stop the imposition of the new contract that has sparked such anger among trainee medics in England over the last year. It is due to start being implemented from early October.

However, the BMA is still planning to stage three other five-day- walkouts, in October, November and December, if Hunt does not respond positively.

However, it is unclear what will happen next after the Department of Health’s initial reaction to the call-off did not indicate if Hunt would do what the BMA are urging him to do and suspend the planned imposition of the contract.

A DoH spokesman said only that: “The public will be relieved that the BMA has decided to call off the first phase of these unprecedented strikes, so this is welcome news. But if the BMA were really serious about patient safety, they would immediately cancel their remaining plans for industrial action which, as the GMC says, will only cause patients to suffer.”

Hunt may clarify his position later on Monday, though, when he makes a statement in the Commons on the long-running dispute.

Mc Court added that the BMA decided to call off next week’s planned action, which saw the BMA being heavily criticised by many medical groups including the Academy of Medical Royal Colleges, to ensure that safety of care was maintained.

“Patient safety remains doctors’ primary concern. For the first time in this dispute NHS England have told us that a service under such pressure cannot cope with the notice period for industrial action given,” she said. “We have also listened to the concerns of working doctors, patient groups and the public.”

It comes hours after the General Medical Council, which regulates doctors, warned that “harm and suffering to patients” would inevitably result from the action.

The walkouts were due to include even life-or-death areas of care in hospitals such as A&E, surgery, intensive care and maternity services. An estimated 125,000 planned operations were set to be cancelled as another consequence, leading to fears that patients would suffer pain and distress as hospitals would take months to clear the backlog.

The BMA’s move may be a belated attempt to maintain the profession’s year-long unity over the new junior doctors’ contract, which shattered last week with many leading doctors criticising the intended strikes as disproportionate and likely to threaten patient safety. Junior doctors may also be hoping to keep the public on their side in their bitter dispute with Hunt.

They continued to enjoy around 60% public backing despite the eight days of strikes they staged between January and May in pursuit of their claim that the new contract for England’s 54,000 doctors below the level of consultant was unsafe and unfair.

Junior doctors suspend planned five-day strike in September

Senior colleagues condemn junior doctors" plan for five-day strikes

Senior doctors have voiced strong opposition to the series of five-day strikes planned by their junior colleagues, warning that the action will cause real problems for patients, the service and the profession.

In a surprise statement on Thursday evening, the Academy of Medical Royal Colleges – which brings together doctors’ professional bodies – distanced itself from the doctors’ union, the British Medical Association, which has called the strike. The academy was “disappointed at the prospect of further sustained industrial action by junior doctors”, it said in a statement after several agonised hours of deliberation.

“We are acutely aware that the NHS is under extreme pressure at the moment,” it said. “Patient safety and quality of care must be the priority. We know there are genuine concerns about the contract and working arrangements but we do not consider the proposed strikes are proportionate.

“Five days of strike action, particularly at such short notice, will cause real problems for patients, the service and the profession.”

On Wednesday it was announced that junior doctors will go on strike from 12 to 16 September – the longest period of action yet announced by doctors in their protracted dispute over terms and conditions that the health secretary, Jeremy Hunt, would like to introduce. On Thursday the BMA announced additional dates for proposed walkouts, on 5, 6, 7, 10 and 11 October, 14-18 November and 5-9 December

Junior doctors have long been in dispute with health secretary Jeremy Hunt over conditions of a proposed contract. Photograph: Stefan Wermuth/Reuters

However the BMA is split over whether to support the five-day strikes called by junior doctors, with many of its senior members considering the action unethical and fearful that patients will be harmed.

At a special meeting of the ruling council of the BMA on Wednesday some experts argued that the action was unethical because of the risk to patient safety, the Guardian has learned.

Such was the importance of the meeting that some council members changed their holiday plans to be there. Following a highly charged discussion, the BMA council voted by 16 to 12 to support the junior doctors’ industrial action.

The opposition of senior doctors raises questions over whether the industrial action can go ahead as planned. The opposition of the royal colleges may persuade some junior doctors not to take part and they may also lose the support of some senior doctors who were expected to cover for them during the strikes.

The Patients Association’s chief executive, Katherine Murphy, said the organisation was “gravely troubled” at the “catastrophic impact this will have on so many patients and their families” as winter approaches. “Many patients may be very unwell or vulnerable and so we cannot predict the distress or pain this will cause to everyone this will affect,” added Murphy.

Katherine Murphy, chief executive of the Patients Association, said the organisation was concerned about the impact of the strikes, especially during winter. Photograph: Martin Argles for the Guardian

Earlier in the day Hunt said in a series of broadcast interviews that junior doctors would be inflicting “the worst doctors’ strike in NHS history”. The minister told Sky News: “Patients will be asking why it is that the BMA, who only in May said ‘this deal is a good deal for doctors, a good deal for patients, it’s good for the NHS, it’s good for equality’ are now saying it is such a bad deal that they want to inflict the worst doctors’ strike in NHS history.”

Theresa May, accused the BMA of playing politics, reiterating her confidence in Hunt during a visit to the Jaguar Land Rover assembly plant in Solihull.

“Jeremy has been an excellent health secretary, he is an excellent health secretary and this deal is about a deal that is safe for patients and I think it’s crucial if you look at what we’re doing as a government with the NHS,” the prime minister said. “We’ve got record levels of funding into the NHS, we’ve got more doctors now in the NHS than we’ve seen in its history and this is a deal that is safe for patients.

“The government is putting patients first, the BMA should be putting patients first – not playing politics.”

Most senior doctors condemn Hunt for his continuing threat to impose a contract on them that they say does not recompense them for Saturday shifts and will jeopardise patient safety, because of the excessive hours they will be asked to work.

Earlier in the day, the president of the Royal College of Physicians of Edinburgh, which has members across the UK, called on the government to negotiate but made it plain he opposed the strikes. “The safety of our patients and the wider NHS workforce remains paramount and this long-running dispute benefits no one,” said Prof Derek Bell.

“We are concerned that the industrial action proposed will have a significant impact for patients and all healthcare professionals in the NHS. The timing of the proposed industrial action – so soon after the August changeover with many junior doctors new in post and heading towards the winter months – and the sustained nature of the action will heap pressure on a health system that is already struggling to deal with existing pressures and rota gaps. The proposed notice will also make it extremely difficult for hospitals to arrange cover. We hope that this action can be avoided.”

Dr Mark Porter, chair of the BMA council, said the decision to announce five consecutive days of strike from 12 September was taken after “long and difficult debates”. He said Hunt had left junior doctors with no alternative but to strike again. “The reason the strikes have been announced is the continued reluctance of the secretary of state for health to do anything other than impose a new contract on junior doctors, a contract in which junior doctors have demonstrated repeatedly that they do not have confidence.”

Opinion among doctors who responded to a Guardian call for comment was very divided, with some saying the strike action does not go far enough but others against it, even though they support the junior doctors’ cause. “It is the Department of Health, not us, [which is] endangering patient care by trying to impose an unsafe contract that is also unfair. I’m hopeful that the public understands this – I became a doctor to care for people and it is in the interests of protecting my ability to do so that I’m going to be going back out on strike,” said a 32-year-old anaesthetist.

But a 28-year-old junior emergency medicine doctor said: “Appalling. I’m shocked that the new leadership of the BMA is taking such a damaging step. I can see why they may want to strike – and I’d be OK with a one day walk out – but this is insane.”

There is likely to be close scrutiny of the turnout for the first strike, which begins on 12 September. The last walkout, which was the first full withdrawal of labour, saw 78% of junior doctors fail to report for duty on 27 April, although this would have included some absent for other reasons such as illness.

That was down on the previous strike for the period of 6 to 8 April when emergency care was provided while 88% were on strike, according to NHS England.

There was also a drop in public backing for the action as a result of the full withdrawal of labour, according to an Ipsos Mori survey for BBC News. It found 57% of adults supported the strike at the end of April compared with 65% the previous month. The proportion who blamed both sides for the dispute was also up.

The action on 26 and 27 April saw around 13,000 operations and 113,000 outpatient appointments cancelled. Extrapolating those figures over five days and then multiplying by four to account for the strikes planned each month until the end of the year, the Department of Health is predicting that up to 125,000 operations and over 1 million outpatient appointments could be cancelled as a consequence of the latest wave of walkouts.

• This article was amended on 2 September 2016. Professor Derek Bell is president of the Royal College of Physicians of Edinburgh, not the Royal College of Surgeons of Edinburgh as a previous version stated.

Senior colleagues condemn junior doctors" plan for five-day strikes

Junior doctors: are you in favour of the five-day strike?

The latest plan of action for junior doctors in England, who are locked in a longstanding dispute with the government over new contracts, is an unprecedented five-day strike this month.

The British Medical Association (BMA) agreed on a walk-out on Wednesday, the first since its members rejected the government’s final offer on the contract.

It comes amid a year of strikes (the longest lasting for two consecutive days) and meetings, with more than 100,000 operations and outpatient appointments cancelled so far as a result of industrial action.

Junior doctors seemed close to reaching an agreement with the government in May, when a compromise deal was agreed between the BMA and health secretary Jeremy Hunt. However, there was a split among members when it came to accepting it: 58% against, and 42% in favour.

So what is the feeling among junior doctors now? Are you pro a five-day walk-out or did you vote to accept the deal in May? Are you worried five days is a step too far? Or are you at the end of your tether and think this action is absolutely necessary?

Tell us your views via the form below.

Junior doctors: are you in favour of the five-day strike?

Jeremy Hunt says five-day doctors" strike will be "worst in NHS history"

Jeremy Hunt has accused junior doctors of inflicting “the worst doctors’ strike in NHS history” by announcing a five-day walkout later this month.

In a series of broadcast interviews on Thursday, the health secretary also tried to exploit divisions in the BMA, the doctors’ union, after members rejected a deal over new contracts recommended by the body’s leaders.

Speaking to Sky News, Hunt said: “Patients will be asking why it is that the BMA, who only in May said ‘this deal is a good deal for doctors, a good deal for patients, it’s good for the NHS, it’s good for equality’, are now saying it is such a bad deal that they want to inflict the worst doctors’ strike in NHS history.”

Dr Mark Porter, chair of the BMA council, said the decision to announce five consecutive days of strike from 12 September was made after “long and difficult debates”.

Hunt claimed he was ready to continue negotiations. Photograph: Neil Hall/PA

Repeatedly challenged on BBC Radio 4’s Today programme about the level of support for the strike, Porter did not dispute a claim that the council backed five-day strike action by only 16 votes to 14. But he denied that there had been block voting by consultants and GPs to reject the strike.

The latest planned strike action is the first since BMA members rejected the government’s final offer on the contract in a 58% to 42% vote in July, despite a recommendation to accept by the BMA’s leadership.

At the heart of the contract dispute is Hunt’s proposal to change what constitutes “unsocial” hours for which junior doctors can claim extra pay, turning 7am to 5pm on Saturday into a normal working day as part of a Tory manifesto pledge to create a “seven-day NHS”.

There have been five previous walkouts in the dispute, all this year. The longest lasted two consecutive days, and the first all-out strike – including junior doctors working in emergency departments – was held in April. More than 100,000 operations and outpatient appointments have been cancelled so far as a result of industrial action.

Porter said Hunt had left junior doctors with no alternative but to strike again.

He said: “The reason the strikes have been announced is the continued reluctance of the secretary of state for health to do anything other than impose a new contract on junior doctors, a contract in which junior doctors have demonstrated repeatedly that they do not have confidence.”

He also dismissed a claim by Chris Hopson, chief executive of NHS Providers, that the government and employers side had made 73 concessions in the negotiations.

Porter said: “Anyone could count up the number of commas changed and words inserted into a negotiated document containing tens of thousands of words and come up with a number like 73. That number is completely meaningless.”

He added: “It is time to give up the incremental approach of changing a word here or there. That is not going to work as the doctors have comprehensively shown in the latest referendum.”

“The only alternative that junior doctors have been left with is protracted strike action. The reason this dispute has become protracted … is the insistence of the government on moving ahead without agreement.”

Hunt claimed he was ready to continue negotiations.

“The way to solve the honest disagreement is to sit round the table and talk,” he said. “It is cooperation and dialogue and not confrontation and strikes, which is going to cause absolute misery to hundreds of thousands of families up and down this country.”

Hunt claimed there were only two outstanding issues to resolve. “In July they wrote to us and said there were just four outstanding issues of concerns – we have solved two of those four issues to their satisfaction.

“The main sticking point are two issues around pay: Saturday pay and automatic pay rises for part-time workers. Weekend pay rates for doctors are higher than for nurses, police officers, and fire officers. In the 24/7 society that we live in it is very fair and reasonable deal.”

Jeremy Hunt says five-day doctors" strike will be "worst in NHS history"

Junior doctors "push for monthly five-day strikes"

Junior doctors are pushing for monthly five-day strikes to be held between now and the end of the year in an escalation of the dispute over their new contract, according to leaked documents.

Senior members of the British Medical Association (BMA) are meeting on Wednesday to decide what industrial action – if any – should take place after a compromise deal on the contract agreed with the government was rejected by its members last month.

The Mail reported that it had seen a 13-page document marked “confidential” which states that the BMA’s junior doctors committee (JDC) is proposing a full withdrawal of labour between 8am and 5pm for five consecutive weekdays in September and then further walkouts of the same duration in each of the remaining months of the year.

The BMA refused to comment on the specifics of the industrial action being considered but a source said “anything is up for discussion”.

Last month, the JDC chair, Ellen McCourt, wrote to members informing them that the committee was planning “a rolling programme of escalated industrial action beginning in early September”.

The decision will ultimately taken by the BMA council, effectively the union’s board of directors, which usually has 34 voting members.

There have been five walkouts by junior doctors to date, the longest lasting for two consecutive days. The first all-out strike, including junior doctors working in emergency departments, took place in April. More than 100,000 operations and outpatient appointments have been cancelled in total as a result of all industrial action to date.

A breakthrough in the dispute appeared to have occurred in May, when the JDC and health secretary, Jeremy Hunt, agreed a revised contract. However, almost six in 10 junior doctors – all doctors below consultant level – and medical students (58%) who belong to the British Medical Association refused to accept the compromise deal, with only 42% endorsing it.

About 37,000 BMA members, or 68% of the 54,000 trainee doctors and final and penultimate-year medical students who were eligible to vote, took part in the ballot.

After the vote, the JDC chair, Dr Johann Malawana, who had recommended the revised terms and conditions as the best settlement junior doctors could get, resigned from his position. He was replaced by McCourt.

A BMA spokeswoman said: “Junior doctors have been clear in their rejection of Jeremy Hunt’s imposed contract. It should come as no surprise that BMA council are discussing the issue of further industrial action. But at this stage, no decisions have been made.”

Junior doctors "push for monthly five-day strikes"