Junior doctors will begin a four-day strike today as an NHS leader warns up to 350,000 appointments, including operations, could be cancelled.

The walkout by up to 47,600 junior doctors is part of a worsening pay dispute which threatens huge disruption to the NHS.

The strikes centre around a pay row between the British Medical Association (BMA) and the government.

The BMA, the doctors’ union, says junior doctors in England have seen a 26% real-terms pay cut since 2008/09 because pay rises have been below inflation.

The union has asked for a full pay restoration that the government said would amount to a 35% pay rise – which ministers have said is unaffordable.

Junior doctors will mount picket lines outside hospitals from 7am until Saturday morning in the longest walkout since nurses, ambulance crews and other health workers started taking action in 2022.

Matthew Taylor, chief executive of the NHS Confederation, has told Sky News he expects “up to 350,000 appointments” to be cancelled as a result of the four-day action.

Meanwhile, NHS managers have warned that patient care is “on a knife edge” over the next four days because of the strike.

The BMA has released an advert which shows how much doctors with 10, seven and one-years experience would earn for completing an operation where an appendix is removed.

The advert says they would earn £28, £24.46, and £14.09 respectively – a total of £66.55 for a potentially life-saving procedure.

‘My dad is telling me to quit’

Dr Jennifer Barclay, a surgical doctor in the North West, said: “I’ll be working a busy on-call shift; treating unwell patients, assessing new patients, consenting and preparing patients for surgery and answering never ending bleeps, when we have to run to theatre.

“I haven’t had time to eat or nip to the loo and I know I’ll be in theatre for around an hour. An appendicectomy like the one in this advert would be a typical case.

“I want the doctors treating my loved ones to be well rested and able to provide the best care possible.

“I don’t want them to be burnt out, worried about paying the bills or up to £100,000 of debt or thinking about alternative careers whilst making life and death decisions.

“My dad, an electrician, tells me to quit and retrain in his footsteps; I’d be earning more, have less stress, less responsibility, better hours and a better work-life balance after three years.”

Read more:
Why this could be the worst NHS strike yet

Dr Robert Laurenson and Dr Vivek Trivedi, BMA junior doctors committee co-chairs, said: “It is appalling that this government feels that paying three junior doctors as little as £66.55 between them for work of this value, is justified.

“This is highly skilled work requiring years of study and intensive training in a high-pressure environment where the job can be a matter of life and death.”

Pay rise demand is ‘unreasonable’

Health Secretary Steve Barclay said: “It is extremely disappointing the BMA has called strike action for four consecutive days.

“Not only will the walkouts risk patient safety, but they have also been timed to maximise disruption after the Easter break.

“I hoped to begin formal pay negotiations with the BMA last month but its demand for a 35% pay rise is unreasonable – it would result in some junior doctors receiving a pay rise of over £20,000.

“If the BMA is willing to move significantly from this position and cancel strikes we can resume confidential talks and find a way forward, as we have done with other unions.”

Read more:
Emergency and urgent care to be prioritised during junior doctors’ strike
‘Militant’ junior doctors accused of seeking ‘maximum disruption’

Mr Barclay also said people should attend appointments unless told otherwise by the NHS. He added they should also call 999 in a life-threatening emergency and use NHS 111 online services for non-urgent health needs.

Meanwhile, Mr Taylor told Sky News: “These strikes are going to have a catastrophic impact on the capacity of the NHS to recover.

“The health service has to meet high levels of demand at the same time as making inroads into that huge backlog… That’s a tough thing to do at the best of times – it’s impossible to do when strikes are continuing.”

Asked whether everyone who needs urgent care this week will get it, he said: “We hope so.

“There’s no point hiding the fact that there will be risks to patients, risks to patient safety, risks to patient dignity, as we’re not able to provide the kind of care that we want to.”

Patients ‘crying out for leadership’

Shadow health secretary Wes Streeting said : “The junior doctors’ strike this week will cause huge disruption to patient care.

“Where is the Prime Minister and why hasn’t he tried to stop it?

“Rishi Sunak says he ‘wouldn’t want to get in the middle of’ NHS pay disputes.

“Patients are crying out for leadership, but instead they are getting weakness.”