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The Guardian - UK
The Guardian - UK
Politics
Haroon Siddique

Junior doctors strike for fourth time over new contract - as it happened

The cast of medical comedy Green Wing reunite to support the junior doctors strike

Summary

Thanks for reading and for all your comments. We’re going to wrap up the blog now as most pickets finish at lunchtime. Here is a summary of the latest developments:

  • Junior doctors have been back on the picket line at the beginning of their fourth strike over the terms of their new contract.
  • Supporters of the industrial action, including the actor, Vanessa Redgrave, gathered for a rally on Whitehall where a petition with 120,000 signatures backing the junior doctors was delivered to the Department of Health.
  • Redgrave said the doctors were “being treated like dirt” and called the government “mad” for imposing the contract. Protesters staged a die-in of doctors on Whitehall.
  • There was more celebrity support for the junior doctors from some of the cast of hospital comedy Green Wing, including Stephen Mangan and Tamsin Greig. They turned up at the picket line outside Northwick Park hospital, in Harrow, west London, where the series was filmed.
  • NHS England said that more than 5,000 operations have been cancelled over the 48 hours of the walkout, warning that the second day would be particularly difficult.
  • Dr Johann Malawana, chair of the BMA’s junior doctor committee chair blamed the government for the ongoing dispute, warning it risked “alienating a generation of doctors”.

Junior doctors in Manchester are marching from Manchester Royal Infirmary to Piccadilly Gardens.

Rebecca Pinnington sends this update from Whitehall.

Sophia Koumi is a mental health nurse, and Daniel Langley is training to be a mental health nurse at King’s College London. They are at the DoH today in solidarity with junior doctors from the #BursaryOrBust campaign, in protest of the government’s removal of NHS bursaries for trainee nurses.

Langley says:

If the government goes ahead with removing bursaries, nursing students like me will essentially be paying, in some cases upwards of £65,000, to work 48 hours a week.

Neither is put off working for the NHS by the DoH’s policies.

Koumi says:

The reason we became doctors, nurses, mental health professionals, is because we want to help people, we want to work for the NHS. This is why we have to fight for it - it’s so important.

She is worried however that the introduction of tuition fees will negatively impact the nursing profession.

At the moment, nursing is such a diverse course with lots of older students, carers, people from minority backgrounds - my fear is that we’ll massively lose that diversity. It’s difficult to become a nurse, it’s hard work, and I do worry people will see it as too much to take on with a debt as well.

A fire engine has turned up on Whitehall in support of the junior doctors.

Annie Gouk has been speaking to Victoria McCormack, 38, an anaesthetic and intensive care registrar and mother of two outside Wythenshawe hospital. McCormack said:

I’ve been a junior doctor since 2003, and I’ll be becoming a consultant in the next couple of years. It’s taken me a long time because I’ve had children, so couldn’t always work full time. That’s part of why I find the new contract massively disappointing - it’s really going to hit people in my situation. We’re already outnumbered in my department, it’s very male dominated, and the new contract is really going to put smart women off. It’s terrifying, and a slap in the face for women who have worked so hard to get here.

Supporters of the doctors strike, including Vanessa Redgrave, have gathered at Whitehall, with colourful banners. A doctors choir joined the crowd as well as activists who chanted: “We don’t want your sexist racist cuts”.

Vanessa Redgrave addressed supporters of the doctors strike in Whitehall and said “the doctors are being treated like dirt” and said the government was “mad” for imposing the contract.

Aisling Leyden a campaigner for Care2, which organised the petition, said, outside the Department of Health, before handing in a petition signed by 120,000 people:

I started the petition for Care2. My younger sister is a junior doctor, and I care about the working conditionS but the concern I have is that I think this an obvious attempt to dismantle the NHS. It’s not okay the way the government is spinning and it’s an enforced contract which is medieval.

Beth Granter also campaigner at Care 2 said:

The petition has 120,000 and nobody wants to be treated by an exhausted doctor and this increase in working hours and the public knows this and why they are striking.

Rebecca Pinnington, for the Guardian, is outside the Department of Health in Whitehall, where protesters will present a petition against the new contract with over 100,000 signatures.

Kiah Hamm has Ehlers Danlos Syndrome, which affects the connective tissues in her joints and can be disabling for some. The NHS, she says, has saved the life of her and members of her family on multiple occasions, starting with a spell in intensive paediatric care as soon as she was born, when her chances of survival were very low.

Members of Plan C, Free Education Manchester, and Action for Trans Health have picketed the private Spire hospital in Manchester “in solidarity with the junior doctors and to broaden the conversation to include the wider sell off of the NHS”.

They have plans to expand pickets on the next set of strike days to Manchester, Birmingham, Brighton, Leicester, and London.

Petition supporting junior doctors being handed in to Department of Health

A rally is being held on Whitehall, where a petition of 120,000 signatures supporting the junior doctors is being delivered to the department of health.

Updated

Jenny Higgs, 38, a junior doctor at Manchester Royal Infirmary has been on all four strikes and says her morale is low.

Speaking personally, I’m getting a bit depressed with the whole thing. It doesn’t feel like we’re changing anyone’s minds.

She plans to join her colleagues in the all-out strike planned for the end of this month.

I hope something will change before then because nobody wants to go ahead with that. But I’ve just been reading the summary of the new contract and there are so many things in it that are completely appalling.

Higgs argues that the contract will result in doctors working unsafe hours and having nobody to go to complain about it. She said:

A lot [the public] are very supportive. But I think there are a lot of people who don’t understand what it’s all about and it’s quite hard when some of the reports in the papers aren’t very helpful.

https://twitter.com/fperraudin/status/717657367761043456

The former Labour minister, Ben Bradshaw, tweets that he had a run in with the controversial newspaper columnist Katie Hopkins (who is unsurprisingly unsympathetic to the junior doctors) at a picket line outside the Royal Devon and Exeter hospital.

Here is video of the Green Wing stars, including Stephen Mangan and Tamsin Greig, at the Northwick Park hospital picket line, in Harrow, north-west London.

Annie Gouk sends this update from Wythenshawe hospital, in south Manchester:

Mike Nesbitt, 28, has been working in A&E, but from today he’ll be starting as a junior GP.

He said:

The situation is pretty bleak to be honest. The night before last, every single bed in A&E and the whole hospital was full so patients coming in had no bed to go into. It’s been demoralising - there aren’t enough staff and the staff that are there are overworked. The shifts are difficult enough and when it becomes busier it becomes very difficult. That’s part of why I’m striking - currently the number of staff are struggling to maintain a five day service, so how can they expect the same number of staff to provide that service over seven days without extra funding? I think that unfortunately we’ve been left without a choice but to escalate the strikes, and hopefully the public will continue to support us.

Cast from the medical comedy Green Wing have shown up at the picket line at Northwick Park hospital (where the series was filmed) in Harrow, north-west London, to show their support for the striking junior doctors.

Updated

This image of the Kent and Canterbury hospital picket line was emailed to the Guardian.

Junior doctors picket line at Kent and Canterbury hospital
Junior doctors picket line at Kent and Canterbury hospital Photograph: Dr Gyula Petranyi

Fardad Soltani, 25, came straight out to join the picket line outside Manchester Royal Infirmary after finishing a night shift in A&E. It’s the first time he’s joined his junior doctor colleagues on strike because he works in emergency care, which is still being fully staffed. He said:

I’m glad to be here. Even though I haven’t been striking, you can still see what’s going on around you and it does have a knock on effect. You’re already working a really tiring shift, especially in A& E, and it does affect your morale and make you reconsider your career options.

Soltani says the dispute has persuaded him to try and get work as a doctor abroad.

I want to be a doctor and I will always want to be a doctor, but it’s made me want to move abroad.

Ideally he wants to move to Canada, where he says junior doctors are offered better training opportunities and work conditions.

It’s very, very, very competitive for international graduates, but I’d rather try hard to get there than have to deal with what’s going on here.

He says he doesn’t know how much junior doctors get paid in Canada, but that his salary isn’t his primary concern.

Mary Gee, 27, has helped organise the picket line at the last three strikes. She said:

There was a poor turn out at the last picket. I think morale was really low. The contract had just been imposed, everybody had given up. And now, particularly because of the equalities report, people have kicked back against it.

The Department of Health last week published an equalities analysis into the new junior doctor contract, which concluded that “any indirect adverse effect on women is a proportionate means of achieving a legitimate aim”. The new contract was also published on the same day.

Gee said:

Prior to that there was a summary of the recommendations for the contract, which I think a lot of junior doctors looked at and thought ‘this doesn’t actually look that awful’. But when the contract was finally released they realised it actually looks horrific.

“The thing that’s really angered me is that, regardless of whether you are a man or a woman, [the equalities report] singles out that actually it’s terrible for a single working parent. This is a government that has said they are committed to families. They say they want people to be in work, whether you’ve got kids or not.

Annie Gouk, for the Guardian, has been speaking to Joe Cohen, 28, a junior anaesthetic doctor and BMA representative, outside Wythenshawe hospital in south Manchester. He said:

In the operating theatres, we are definitely having issues with available beds for patients, but I’m mainly shielded from the high stress they experience on the ward. The lack of beds is thanks to the government massively slashing social care funding and the shortage of nursing homes - it’s nothing to do with staffing or junior doctors working at weekends. The hospital have been totally upfront about the major incident announcement, and I don’t think it was deliberately timed for the strike. None of us want to be on strike, I’d much rather be in the hospital - I really enjoy my work, but we feel like we have no choice. This is really the last resort for us, but I think everyone agrees that we have to keep fighting.

There are now around 30 doctors on the picket line, two hours into strike action.

Eoin Dore, an F2 doctor (in the second foundation year between medical school and specialist/GP training), said:

Today, it’s been nice to come down and see so much public support. There are lots of people worried and it’s already a mixed and private service.

When asked what he had to say to the government and people who disagreed with strike action, Dore said:

I would ask people who don’t agree with the strike to let us debate on TV

Lot of stats are being handed about, being misused and misinterpreted, so give us a platform and let people make up their own mind

I have a real fear that in ten years time we won’t have an NHS.

George Lawson, his colleague in paediatrics, told the Guardian it was a “sexist contract” and said “in this day and age it is outrageous that the government is putting out a contract not promoting equality, when historically the NHS has done so much in terms of equality”.

Rebecca Pinnington, for the Guardian, writes:

Maureen Cooper, from Wandsworth Momentum, is at the St George’s picket line in solidarity with the junior doctors. Maureen was born before the creation of the NHS, and has seen the positive impacts it has had on her children and grandchildren.

It’s just not on that people should be conned into devoting their lives to a career and suddenly have it tipped up in the air. You need to have changes, you really do need to have changes in health provision, but you don’t impose them. You consult, you negotiate, and you use evidence to back up your plans, not ideology.

Thomas Ofori, on crutches, has been to St George’s hospital this morning for an appointment following a leg injury in February. Although he was seen by a consultant today, he said he does not support the strike.

“When doctors aren’t in the hospitals, it’s not fair,” he said. When asked if he was concerned patients would not be looked after, Thomas agreed he felt this was a problem.

Here are some more pictures of strikers across the country:

Annie Gouk, is at Wythenshawe hospital, in south Manchester, for the Guardian. She writes:

A major internal incident was announced yesterday due to “huge pressures” on the A&E department. More than 20 junior doctors have gathered despite the grim weather , playing cheesy pop, sharing around chocolate and waving banners. Cars and buses have been beeping support as they pass.

Junior doctors picket line at Wythenshawe hospital
Junior doctors picket line at Wythenshawe hospital Photograph: Annie Gouk for the Guardian

A petition of 120,000 signatures organised by the Care2 community website is to be delivered to the Department of Health, on Whitehall, in central London, at 11.30am.

There will be a rally from 11am with speeches. There will be a fire engine there as well as junior doctors, nurses, teachers and members of the fire brigade union. Vanessa Redgrave will also reportedly be there.

The rallying cry says:

Join us to show your support in person.

The government will not budge despite all of the evidence which proves they are in the wrong.

The 7 day NHS rhetoric we know is an uncosted, not funded, dangerous policy for the NHS and patients and the workforce will be left to deal with the inevitable harm to patients.

Stephen Mangan and other stars of the medical comedy Green Wing, are going to be showing their support for the junior doctors at Northwick Park hospital in north-west London today.

Junior doctor Cheryl Battersby told Rebecca Pinnington, who is at St George’s for the Guardian, that hospitals could benefit from more doctors on the weekend but it needs to be done “in the right way which is extra resources, extra funding, more doctors and it’s not making the doctors who are already there work more weekends”.

Here are some more images from picket lines:

Updated

Imogen Clarke, a junior doctor of 11 years is handing out badges and stickers at St George’s hospital, in south London. She said she was here “because the government has imposed a contract the BMA said is unfair. It’s untried and untested but the government are pushing through soundbite policy without saying what it means.”

Something doesn’t add up I think the big problem is that we are thin on the ground already but do cover for goodwill. We already feel burdened with the gaps in the rota.”

If they push through this contract we will have good hard look at why we are in this career and then they’ll be left with even more gaps.

Carrie Thomas, junior doctor of eight years has just come off a nightshift in A&E at St George’s. Although she can’t strike as she is on emergency cover, she is supporting her colleagues. She has another nightshift this evening. She said:

I think the contract will drive people out and it will impact me greater as I will be on training for longer. We are particular lucky here as we have 24 hour cover.

But I know a lot of us have applied abroad - I’ve applied to a hospital in Wales.

We’re worries we are spread so thin and if we can’t get patients out [of hospital] then we can’t keep patient flow moving.

Rebecca Pinnington, also at St George’s for the Guardian writes:

St Georges has typically seen a walkout rate of over 90% during the strike, and doctors here today anticipate more of the same.

Asked whether he felt optimistic in light of the Department of Health’s insistence that the new contract will be imposed, junior doctor George Lawson said:

I do think better media PR from the BMA would be useful and would help us get our message out there. I think it does make a difference, people do notice when doctors strike for the first time in over forty years, but I think the problem is that the message behind the strike might have not got through so it doesn’t resonate. I think it’s embarrassing for the Department of Health, but I don’t think there’s enough pressure being put on.

The Equality Assessment that came out last week effectively says this is a sexist contract which disproportionately disadvantages women and other sole providers of care. [...] Then in the next paragraph it says that it is a proportionate means of achieving a legitimate aim, effectively saying that women are collateral damage and okay to be disadvantaged in order to push the contract through.

Here is NHS England’s advice to patients during the industrial action. Although emergency care is excluded from the current strike, A&E departments are likely to be under increased pressure. Most of the advice is common sense and applies equally on a normal day.

Here are some updates from our northern reporter Frances Perraudin:

On a drizzly spring day, junior doctors in hi-vis jackets have set up a stall outside St George’s hospital, in Tooting, south-west London, and are handing out stickers to passers by.

Speaking to the Guardian, Niall Durrant, who has been a junior doctor for 20 months, said:

I’m here because I’m a junior doctor and work at the hospital and can’t imagine where else I’d be working.

It’s incredibly disappointing in my first few years to have the government turn on us.

I have friends who will be impacted. I’m a young male but I have a little sister who wants to be a doctor and don’t know what to tell her [about entering the profession].

It’s difficult to strike, I don’t even like to be a ward away but I know my consultants [who are covering] and they have been fantastic and supportive.

Here are some early pictures from today’s strike.

Actor and comedian David Schneider has posted an imaginary conversation about the Jeremy Hunt ordering a sandwich, which he says is a metaphor for the health secretary’s handling of the junior doctors’ contract.

The latest YouGov poll found that 45% of people blame the Department of Health for the contract dispute, compared with 12% pointing the finger at the BMA. A significant minority - 30% - said the blame was equally shared.

Support for industrial action is at 59% when junior doctors in emergency care do not take part (as in all strikes to date including the one beginning today), according to the poll. Just under a quarter (23%) oppose such action.

When asked about backing for a full withdrawal of labour, including junior doctors working in emergency care, support fell to 45%, compared with 38% against such action. The first full strike by junior doctors is scheduled to take place on 26 and 27 April.

The strike has begun.

The Evening Standard’s health editor says the junior doctors have the backing of the Patients Association.

Summary

At 8am, junior doctors will launch their fourth strike in four months.

NHS England says 5,165 operations have been cancelled as a result of the latest walkout. There are usually 31,000 operations in the NHS on any given day, so the total cancelled represents about 8.3% of the total that would usually be carried out over the 48-hour period (62,000).

NHS England national incident director Dr Anne Rainsberry warned that “this will be a difficult period especially over the course of the second day”.

The first two strikes lasted for 24 hours each but the BMA ramped up action after the health secretary Jeremy Hunt announced, following months of fruitless negotiation, that he was imposing the unpopular contract on junior doctors.

This is the second 48 hour strike and a third two day strike on 26 and 27 April will, for the first time, see a full withdrawal of labour, including from emergency care. All action up to and including the strike beginning today has excluded junior doctors working in life-or-death areas such as A&E and intensive care.

Hunt said he imposed the contract - which extends the hours of the junior doctors’ standard working week to include Saturdays and later weekday nights - to deliver the government’s pledge of a seven day NHS and improve patient safety.

Dr Johann Malawana, BMA junior doctor committee chair, said today:

We deeply regret any disruption this action will cause to patients, but it is because we believe this contract would be bad for the delivery of patient care in the long term that we are taking this action.

By imposing a contract that junior doctors have no confidence in and refusing to re-enter talks with the BMA, the government has left us with no choice.

He urged the government to get back round the negotiating table.

A Department of Health spokeswoman denounced the strikes as “irresponsible and disproportionate”. She added

With almost 25,000 operations cancelled so far, it is patients who are suffering.

If the BMA had agreed to negotiate on Saturday pay, as they promised to do through Acas in November, we’d have a negotiated agreement by now.

We will be providing live updates, including from colleagues on the picket lines.

You can send me pictures etc to haroon(dot)siddique@theguardian.com or tweet me @Haroon_Siddique

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