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The Guardian - UK
The Guardian - UK
Politics
Denis Campbell Health policy editor

Fears more doctors’ strikes in England will push NHS ‘close to breaking point’

Striking junior doctors and consultants on a march around the Royal London hospital
Striking junior doctors and consultants on a march around the Royal London hospital on 20 September. Photograph: Guy Smallman/Getty Images

Hospital bosses fear that further strikes by doctors will push the NHS “close to breaking point” as it struggles to cope with its winter crisis in the months ahead.

NHS leaders are concerned that medics’ plans to continue their campaign of stoppages until February will make it even harder for the service to manage what is always its toughest period.

Four days of strikes this week in England have included the first-ever 24-hour joint strike over pay on Wednesday by consultants and junior doctors. This latest series of stoppages – two days by consultants and three days by junior doctors – has forced hospitals to reschedule many thousands of outpatient appointments and non-urgent operations because of the lack of staff.

“Winter pressures, respiratory illness and rising Covid again mean that the next six months will be exceptionally difficult. Winter always is,” said one hospital trust chief executive, who asked not to be named.

“The NHS is effective at absorbing pressure but the industrial action may, at times, take us close to breaking point and often patient harm and the impact on NHS staff is not fully recognised,” he said.

Matthew Taylor, the chief executive of the NHS Confederation, which speaks for trusts, urged ministers and the unions representing doctors to reopen negotiations and agree a settlement of the pay row before the health service heads into the colder months.

“We need to see a resolution to this situation before winter begins to bite,” said Taylor.

“Winter is always a difficult time for the NHS, with seasonal illness and cold weather affecting patients more than the summer months, and further walkouts will just mount more pressure on an under-resourced, understaffed system already straining to cope with huge demand, recovery efforts and waiting lists.”

The sheer number of people who had had their consultation or procedure delayed due to strikes could increase the strain on GP surgeries, A&E units and walk-in centres, he said.

“The growing backlog will have knock-on effects around the health system and we may see heightened pressure on primary care and urgent and emergency care, as patients present with complications from having operations or appointments cancelled.”

Relations between the government and the British Medical Association (BMA), the main doctors’ union, are becoming increasingly acrimonious. The BMA dismissed as “a cheap shot” Rishi Sunak’s claim last week that doctors’ strikes were a “significant” reason why NHS waiting lists were still rising despite his pledge to cut them.

And on Tuesday the union issued a rebuttal of remarks that Steve Barclay, the health secretary, had made on BBC Radio 4’s Today programme. They accused him of “misleading the public about doctors’ pensions and the independence of the pay review process” that helps set medics’ pay.

Consultants have a legal mandate to keep striking until the end of December and junior doctors until late February.

Junior doctors are seeking a 35% pay rise as soon as possible, while consultants are seeking an uplift of about 12% for this year. However, Barclay has already imposed rises averaging 8.8% on juniors and 6% on consultants.

“Sustained industrial action is the most serious pressure facing the NHS this winter, trust leaders tell us”, said Saffron Cordery, deputy chief executive of NHS Providers, which represents ambulance, community, hospital and mental health trusts in England.

“The bleak prospect of a winter of doctors’ discontent and six more months of strikes is daunting for services already stretched to the limit and would make trusts’ efforts to bear down on care backlogs more difficult,” she added.

Meanwhile, data collected by the Department of Health and Social Care (DHSC) showed that trusts have had to declare 22 “critical incidents” as a direct result of strikes since they began last December.

On two occasions some critical care and gynaecology patients had to be moved to other hospitals because there were too few staff to look after them, while some urgent cancer surgery and chemotherapy appointments also had to be rescheduled, the DHSC said.

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