A ballot is due to close at 5pm on Wednesday that is expected to lead to thousands of junior doctors in England going on strike for three days next month.
The result of the ballot of the 30,000 juniors represented by the British Medical Association (BMA) will be announced on Thursday.
But after 20,000 trainee doctors marched through London in protest at the proposed new contract last month, the expectation is that there will be a convincing vote for industrial action. That raises the prospect of further pressure on the NHS over the busy winter period, when there are already fears about its capacity to cope.
A vote to strike would see junior doctors provide only emergency care for 24 hours from 8am on Tuesday 1 December, reducing hospitals to a minimal level of service usually seen on Christmas Day.
They intend to follow that with two all-out stoppages, on Tuesday 8 December and Wednesday 16 December, in which all junior doctors will refuse to work.
The NHS has 45,000 trainee doctors in England. The action would lead to the cancellation of most planned operations and outpatient clinics, with consultant doctors prioritising more urgent and emergency cases.
Junior doctors are furious the proposed new contract will greatly extend the hours in any week for which they are paid basic rates of pay – from the current finish time of 7pm on weekdays to 10pm – and, crucially, will also include Saturday up until 7pm for the first time.
They are also worried that safeguards that stop hospitals forcing them to work dangerously long hours, and the current banding system, which dictates how much they are paid, especially in overtime, will disappear.
Both sides have accused each other of being unwilling to enter genuine negotiations and of putting patient safety at risk. The BMA says the health secretary, Jeremy Hunt, must drop his his threat to impose the contract before talks resume.
Dr Mark Porter, chair of the BMA’s ruling council, said the ballot was a “last resort in the face of their continued threat to impose a new contract”. Hunt, meanwhile, has described the proposed industrial action as “extreme” and “unwarranted”.
He insists no junior doctor will lose out financially under the new system and that it will reduce the maximum number of hours they can be expected to work in any week. The new contract will ensure that more doctors are on duty at weekends to help deliver the promised seven-day NHS by 2020, he says.
