What’s happening with the Junior Doctor’s NHS strike?

David Kinane for Distilled Post

Stories have broken across the media of patients resorting to seeking private medical treatment abroad at huge personal cost or in some extreme examples, or ripping their own teeth out due the NHS backlog preventing them from getting a timely appointment. 

Although this is not caused by the industrial action taken by NHS workers, strikes are bound to make it worse as it occurs at a time when the NHS is already under immense pressure in recent years from the pandemic and lockdown. The NHS backlog for non-emergency care has reached an all time high with a backlog of 7.2 million cases. Prior to Covid that number was at 4.4. million cases. 

Strikes have been affecting the NHS in the last months and that may continue over the next few weeks. The strikes were first organised in December by the Royal College of Nursing. Later in the same month, ambulance workers also agreed to go on strike after the health secretary, Steve Barclay refused to discuss pay and accused NHS workers of consciously inflicting harm on patients. 

In January of this year, junior doctors represented by the British Medical Association (BMA), the Hospital Consultant and Specialists Association (HCSA) and some dentists who are on junior doctor contracts and represented by the British Dental Association (BDA) had all agreed to take strike action. It was also revealed that 86 per cent of Senior doctors have voted in an indicative ballot that they too are willing to strike next month. 

As a result of strikes thousands of operations that were scheduled in advanced have been cancelled and many more appointments postponed. More than two thirds of those were reported to outpatient appointments which are minor, over 7,000 were elective procedures like hip and knee replacements and the rest were community service, mental health and support for patients with learning difficulties. 

Reason for the strike 

The British Medical Association are asking for a pay rise above RPI inflation to keep salaries in line or equivalent to what they were in 2008/09. Other unions that represent non-medical staff in the NHS such as Unite, Unison, the Royal College of Nurses and the GMB have a structure in place that governs all pay called the “Agenda for Change”. According to this framework agreement in place since 2004, all pay scales among these workers are harmonised so that any pay rise applies to each of them together. These unions are also seeking a pay rise above inflation. 

An independent pay review body for NHS workers recommended at least a 4 - 5 per cent pay rise, however previously the government had been unwilling to accept even this and set a maximum at 3 per cent. These offers are still far below the ask of, for example, the Royal college of Nursing who want a 14 per cent pay rise. They’ve suggested that a 4 per cent pay rise would amount to a real terms cut of around £1,400 a year.

The reason for the government’s fiscal propriety and its reluctance to increase the pay of NHS workers has been what it regards as an unreasonable increase in spending, that pay rises above inflation would require. This would entail several billions in additional funding (between £5.7 and £8 billion depending on which measure of inflation is used). 

Negotiations taking place 

Three unions from the NHS staff council representing junior doctors and nurses called off strikes last week and entered into talks with the government hoping to reach an agreement over their pay award for both the 2022-23 and 2023-24 years. A fourth, Unite, which represents ambulance workers has also agreed to do the same this week. This is occurring after the government has already held talks individually with the Royal College of Nursing. 

A junior doctor, who would like to remain anonymous, working at the Royal London Hospital, expressed her ‘support for the strike’ when asked to comment, and stressed she and others would support them, showing the strikes have support from many branches within the NHS.

Steve Barclay entered into talks last week, offering a one-off cost of living payment for this year and a discussion on a potential pay rise. This included a promise to pay for any increased spending with additional money being put into the NHS and not just a relocation of already existing funding. 

If the government is unable to reach an agreement with the health unions then the industrial action that they’ve called off over then next few weeks may continue.