Hospitals across England reschedule non-urgent operations with first walkout by junior doctors for 40 years set to go ahead on Tuesday

Thousands of patients will have planned operations or check-ups in hospital cancelled on Tuesday as junior doctors strike for the first time in 40 years in the start of a concerted series of protests against plans to impose a new contract on them.

The show of strength has forced hospitals in England to reschedule about 4,000 non-urgent operations while thousands of other patients will have to see their doctor on another day because hundreds of outpatient clinics have also been called off.

The walkout by junior doctors on Tuesday is the first since November 1975. It will see many of the NHS’s 45,000 junior doctors – medics below the level of consultant – picketing hospitals across England from 8am after last-ditch talks last week to find a solution ended in deadlock.

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Their action will force many consultants to work longer hours, overnight or in a different department for 24 hours until 8am on Wednesday as hospitals seek to ensure that emergency services such as A&E, emergency surgery and intensive care remain fully operational.

The postponed operations amount to about 13% of the normal daily total of 30,000. Some of those called off were due to take place on Monday and Wednesday.

David Cameron criticised the junior doctors’ action, lamenting the disruption and inconvenience it would cause. “This strike is not necessary; it will be damaging,” the prime minister said. “You cannot have a strike on this scale in our NHS without real difficulties for patients and potentially worse.”

The British Medical Association (BMA), which represents about 38,000 of the 45,000 trainee medics, said it had been forced to act after ministers refused to heed its concerns that a new contract Jeremy Hunt, the health secretary, has proposed would be unfair on doctors and reduce patient safety. Approximately 98% of its members backed strike action in a ballot in November.

The BMA’s junior doctors committee is opposed to Hunt’s plan to classify Saturday as part of a junior doctor’s normal working week for which they are paid at only the basic rate. He also wants to see the portion of weekday evenings classified as normal time extend from 7pm to 10pm, but junior doctors fear this will lead to cuts in their pay.

Hunt has offered to raise junior doctors’ basic pay by 11% to offset the loss of overtime they currently earn for working in the evening and on Saturday , and has promised that no junior will be worse off under the new contract, which is due to start in August.

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A fresh opinion poll suggests that despite Hunt’s efforts to portray the walkout as politically motivated and based on misinformation from the BMA, the public are largely behind the strike. An Ipsos Mori poll for the health service journal found that 66% of 869 people polled support them taking action like they plan to on Tuesday – where juniors due to be on duty in emergency care areas still turn up to work – with only 16% completely against.

Katherine Murphy, chief executive of the Patients Association, said that while she sympathised with junior doctors, industrial action would cause “a great deal of distress for many patients, who continue to be caught in the middle of this dispute”. She urged the BMA and ministers to resume talks as soon as possible to agree a deal before the second of three planned strikes, from 26-28 January.

The NHS trust that runs King’s College hospital in London and the Princess Royal University hospital in Orpington, Kent, emerged as one of the trusts facing the most disruption. It said the junior doctors’ action had forced it to call off most of its planned operations and clinics, affecting 485 patients.

Portsmouth hospitals NHS trust has also rescheduled 45 elective operations and 450 outpatient appointments. Ipswich hospital has not cancelled any operations but has postponed 60 patients’ appointments at outpatient clinics.



Elsewhere, West Herfordshire NHS trust, which runs hospitals in Watford, Hemel Hempstead and St Albans, has had to cancel less than ten operations. But, a spokeswoman added: “We are asking patients to bear with us if their care and treatment takes us more time than usual.”

Both the main opposition parties accused the government of mishandling the junior doctors’ dispute from when it started back in September with Hunt’s threat to impose the new contract. But while Labour and the Liberal Democrats both voiced sympathy for the striking medics, and said they had been forced into the walkout, neither offered their unequivocal support.

It is understood that neither Jeremy Corbyn, the Labour leader, nor Heidi Alexander, the shadow health secretary, will attend a picket line at any stage during the 24-hour walkout.

Justin Madders, one of the party’s shadow health ministers, said that Hunt “chose to pick a fight with the very people who keep our NHS running, and he has left them with no choice but to take this action. Junior doctors don’t want to become embroiled in a political dispute but the government’s refusal to listen to their concerns has led to this point.

“Any patient who has had their operation cancelled or appointment postponed today should be clear – don’t blame the junior doctors, blame Jeremy Hunt.”

A new row erupted on Tuesday night when it emerged that Professor Sir Bruce Keogh, NHS England’s national medical director, had written to hospitals suggesting that they could call junior doctors back into work if departments get too busy. Keogh advised medical directors – the most senior doctor in NHS trusts – that they should be ready to make such a request if they experienced an “exceptional and sustained deterioration in performance as indicated by Ambulance Handover Delays and 4-hour A&E”.

His intervention, in a letter sent last Thursday, angered the BMA, the doctors’ union. In his reply, Dr Mark Porter, the BMA’s chair of council (leader), said: “Your letter to medical directors has been interpreted by many doctors as a further attempt to thwart lawful industrial action in favour of which junior doctors voted almost unanimously.”



Tim Farron, the Liberal Democrat leader, accused ministers of using “megaphone diplomacy” with the BMA and claimed the walkout was the result of the government’s mismanagement of negotiations with junior doctors. “Throughout this process, the government seems to have focused more on political point scoring than engaging with junior doctors in a respectful way which recognises that they are dedicated public servants, who work extremely hard, caring for people in need,” he said.

Why I’m striking

Today, instead of going into the hospital to work, I will be taking part in the first withdrawal of labour by junior doctors in 40 years.

Doctors do not have a mass media machine. We do not have the powers of spin at the disposal of the Department of Health. What we do have is years of training in the evaluation of evidence and communication with people. Today, I will use these skills in a new way.

I will be outside my local tube station taking part in a nationwide campaign called Meet the Doctors. I will offer, to anyone who wishes to listen, to explain all of the issues that have led us to this situation.

No spin, just facts. I will explain how the removal of safeguards on doctors’ working hours will put patients at risk, how we already have a seven-day NHS, how I already work weekends and nights, and that the new contract will not change this. I will explain that doctors are working at the very limit of what is possible and that a move to stretch them further is dangerous.

I will say that we have tried to explain all of this to the government, that we tried negotiating and they did not listen, that 20,000 of us marched in the streets of London and they did not listen, that 98% of us voted for the strike because this contract is so unsafe and unfair, and still they will not listen. I will explain we are left with no choice but to take industrial action.

Finally, I will ask members of the public for their support. The NHS belongs to all of us. If we want to keep it then we need doctors to be able to work safely and feel valued by the NHS.

Dagan Lonsdale, 32, is a specialist registrar in intensive care medicine, based at St George’s hospital in south London.