The chief executive of the NHS England has urged doctors to resist strike action, warning of “significant financial consequences”.
Sir Jim Mackey said the health service was planning a “different approach” and would be “much more resistant” to doctors’ demands than in the past.
He added the NHS would be “much more instructive with striking doctors” and told hospital leaders to press ahead with operations, with a junior doctors’ strike on Friday now looking likely to go ahead.
Hopes of a deal have collapsed, meaning that junior doctors will begin five days of industrial action from 7am on Friday.
Between July 2023 and February 2024, more than 500,000 appointments and operations were scheduled and rescheduled during previous strikes, as doctors were told to prioritise emergency care.
However, those on strike were able to do overtime shifts that aimed to clear NHS backlog, but also compensated for their lost pay.
Mackey said past industrial action had been “net positive from a financial point of view”, but warned that this time would not be “consequence free”.
During negotiations, doctors argued that a further pay rise is needed to prevent Friday’s planned strike, adding they are prepared for years of industrial action if the government refuses to compromise.
Junior doctors have rejected a 5.4 per cent pay offer, having already received a 22.3 per cent increase last year as part of a two-year deal.
Mackey said that the British Medical Association’s leadership was acting “in bad faith” during negotiations.
He said: “We’ve been very, very clear we want to have a different approach this time. You have noticed already we are in a different space compared to where we were last time, much more instructive to the BMA, much more resistant to their demands. Frankly we and you make decisions about safety, not the BMA. Do what you do best, make sensible decisions and we’ll stick together.”
Health secretary Wes Streeting said the heads of its junior doctors’ committee were “either stringing us along or, more likely, couldn’t carry their committee and just swam with the tide instead” after they opposed a proposal he thought they supported.
Streeting has refused to negotiate on pay and criticised the BMA resident doctors’ committee or rejecting an offer on working conditions.
However, he has promised to discuss NHS funding for doctors’ meals, equipment, and exam fees. He also admitted that junior doctors had been “systematically undervalued” but urged them to continue talks and postpone strike action.
Streeting added that he had the backs of hospital leaders if they made contentious calls during the strike period. He also apologised and said “we did everything we possibly could” to avoid the strike action.
Melissa Ryan, co-chair of the BMA resident doctors committee called Mackey’s approach to the strikes “unsafe”.
She told The Times: “If you’re already running on a skeleton staff, and then you ask them to stretch themselves even thinner and do elective work at the same time, that is a safety indicator. That is very concerning.”
Ryan added that the BMA did not want to see years of strike action, but that it needed action from the government.
Co-chair Ross Nieuwoudt said the BMA attempted to engage in talks with “good faith”, but the offers made to them were not “substantive” nor “tangible” or “enough”.
In response to threats made by ministers to cut off overtime work, Nieuwoudt said he was “baffled”, arguing that “not hiring doctors to work on the waiting list to achieve their goals seemed counterproductive.”
