The British Medical Association (BMA), the doctors' trade union, has announced that doctors in training ("junior doctors" - who can be any grade below consultant and may be in their mid-thirties) will hold 5-day all-out strikes in October, November and December but the strike announced for
December has been called off.
The strike threats come after the BMA junior doctor membership rejected the official BMA recommendation to accept the proposed new contract as the best available in a ballot and the Health Secretary stated the intention of the NHS employers (he has no power to do this) to impose the proposed contract.
It can be expected that consultants will step in to maintain services but this will mean their abandoning their normal clinics and procedures so that many operations and appointments will be cancelled.
The BMA has issued a statement on the proposed strike in which they describe the main issues as the effects of the proposed new contract on part-time doctors and the effect of the new contract on those junior doctors working the most weekends.
Junior doctors already work shifts and on-call sessions at night and at weekends, but the Health Secretary claims that the new contract, which reduces extra payment for working out of normal hours, is necessary to provide the 7-day NHS which was one of the Government's election promises.
The cancellation will undoubtedly be upsetting and possibly damaging for some patients. But another danger is that the demoralisation of the junior
doctors will result in more junior doctors either leaving the profession altogether or emigrating to a country where conditions are more attractive. As we already have a big shortfall in doctors, with specialisms such as Emergency Medicine, General Practice and Anaesthetics very short of trainees, this is a serious problem which the Government and NHS employers must try to avoid.
One of the aggravating factors in the discussion has been the Health Secretary's manipulative approach to the question of whether people who fall ill at the weekend are at greater risk than those fall ill in the week. His approach has been strongly criticised by several doctor MPs in various parties, including his own. This has contributed to demoralisation of the junior doctors whose training is strongly oriented to evidence-based medicine.
The Health Secretary has proposed a helpful review of issues outside the contract that affect junior doctors training and that could be changed to improve their working lives, but it has not yet come to any conclusion and indeed may not yet have started.