Thousands of junior doctors across England are to strike for a second day on Wednesday as the dispute with the government over a new contract continues.
Four out of five junior doctors took part in the first all-out strike in NHS history on Tuesday, with some hospitals losing up to 90% of junior doctors between 8am and 5pm. The second strike will take place during the same hours.
Despite the high participation rate in the action on Tuesday, most hospitals coped well and did not experience problems, with senior medics taking on duties usually performed by their junior colleagues. A&E units were quieter than usual as patients with minor ailments heeded NHS warnings to stay away.
The health secretary, Jeremy Hunt, admitted his role was likely to be his “last big job in politics” but added the government would not be “blackmailed” into dropping its manifesto pledge of improving seven-day services.
Hunt said “elements” in the British Medical Association (BMA) had refused to compromise over the new contract, which will be imposed on junior doctors – all those below the level of consultant – from August.
He said: “Insofar as it is a political strike, I do think there are some elements – not the majority and certainly not the majority of junior doctors – but there are some elements at the very top of the BMA who are absolutely refusing to compromise.
“This is likely to be my last big job in politics. The one thing that would keep me awake is if I didn’t do the right thing to help make the NHS one of the safest, highest quality healthcare systems in the world.
“Health secretaries are never popular. You are never going to win a contest for being the most liked person when you do this job. But what history judges is: did you take the tough and difficult decisions that enabled the NHS to deliver high-quality care for patients? For me, that’s what it’s about.”
Figures released by NHS England showed that 21,608 junior doctors – 78% of those due to work – joined Tuesday’s industrial action. It said this was down from the 88% who did so on each day during the previous strike on 6-8 April. However, the 88% figure raised questions as NHS England had previously said that almost half of doctors had worked on those days.
Participation was highest at Barts Health, the largest trust in the NHS. The London trust said 88.4% of its 1,000 junior doctors had joined the walkout.
After four previous strikes, Tuesday was the first one to affect areas of life-or-death treatment, such as A&E, maternity and intensive care. At the two hospitals run by King’s College hospital trust in south London, none of the 13 trainee obstetricians and gynaecologists were on duty and nor were any of the 26 junior doctors in its critical care unit. However, 16 of the 22 junior doctors in its emergency department did work as normal.
At the South London and Maudsley NHS foundation trust, only 40 out of 246 trainees worked – 84% took part in the strike. Participation elsewhere was 81% in Ipswich, 74% at the Royal Free in London, 64% in Blackpool and Stoke and 63% in Bournemouth.
None of England’s 156 acute hospital trusts reported any patient safety incidents or sudden inability to cope with demand that might have led them to ask striking doctors to return to work, although 13,000 operations and 113,000 outpatient appointments had been cancelled as a direct result of this week’s strikes.
Dr Johann Malawana, chair of the BMA’s junior doctors committee, said: “The overwhelming turnout at almost 150 picket lines across England shows the strength of feeling amongst junior doctors against the government’s plans. Tens of thousands protested against a contract they believe is unfair and damaging to patient care in the long term.”
Dr Anne Rainsberry, national incident director for NHS England, said the all-out strike was an “unprecedented situation” and staff across the NHS had made “herculean efforts” to ensure continued safe services for patients. “However, the escalation of this action does bring heightened risk and we are continuing to vigilantly monitor the picture across the whole of the country,” she said.
The prime minister maintained that the strike was unjustified because junior doctors had been promised a 13.5% rise in their basic pay to make up for having to work more antisocial shifts.
He defended Hunt’s robust handling of the eight-month-old dispute, which has caused disquiet in the medical profession. “There is a good contract on the table, with a 13.5% increase in basic pay – 75% of doctors will be better off with this contract,” Cameron told ITN.
“It’s the wrong thing to do to go ahead with this strike, and particularly to go ahead with the withdrawal of emergency care – that is not right.”
A new opinion poll shows that 59% of people across the UK support the junior doctors, even though they have resorted to all-out strikes to try to thwart Hunt. However, the survey by OnePulse, a mobile app, found that support had fallen by six percentage points from the 65% backing recorded last month.
