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.
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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.”
Image: Junior doctors at a picket line outside St Thomas’ Hospital in Westminster in March. Pic: AP
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.”
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.”
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‘Strikes going to have catastrophic impact’
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.”
Warning: This article contains graphic descriptions of murders.
Image: (L-R) Yostin Mosquera murdered Albert Alfonso and Paul Longworth
Mosquera’s victims were 62-year-old Albert Alfonso and his civil partner, 71-year-old Paul Longworth. It is believed that Mosquera, a 35-year-old who worked in the adult film industry, first met Mr Alfonso online.
Image: Paul Longworth and Albert Alfonso walk with Mosquera from their house. Pic: Met Police
The three men struck up a friendship, the couple visited Mosquera in Colombia, and they repeatedly flew Mosquera to the UK to stay with them at their flat in London.
While the men would take day-trips to tourist attractions, like Madame Tussauds, Mr Alfonso and Mosquera would engage in extreme sex together.
But in the weeks leading up to their murders, Mosquera was clearly planning his attacks.
He looked online for a freezer and, on the day of the killings, searched for: “Where on the head is a knock fatal?”
The prosecution argued he was financially motivated.
Image: Mosquera has been convicted of two murders. Pic: Met Police
Mosquera repeatedly tried to find the price of the couple’s property in Scotts Road, Shepherd’s Bush, and stole money from Mr Alfonso after murdering him.
On 8 July 2024, Mosquera killed Mr Longworth by hitting him with a hammer, shattering his skull, before hiding his body in a divan bed.
That evening, during sex with Mr Alfonso, Mosquera stabbed him with a knife. A postmortem revealed 22 stab wounds.
Image: Paul Longworth and Albert Alfonso. Pic: Met Police
All of this was recorded on cameras, which had been placed in the room by Mr Alfonso.
Mosquera then decapitated the bodies, the heads stored in a freezer which he had delivered on 9 July.
Image: A handyman hired by Mosquera loads the victims’ bodies into a van in suitcases. Pic: Met Police
The other remains were put in suitcases and on 10 July, Mosquera hired a van with a driver to transport him and the bags to Clifton Suspension Bridge.
The prosecution argued Mosquera went to Bristol with the intention of throwing the bags off the bridge.
But, struggling with their weight, Mosquera caught the attention of passers-by, telling them the cases contained car parts.
But people noticed liquid leaking from the bags – blood.
Image: Yostin Mosquera ran off after passers-by noticed the suitcases were leaking blood. Pic: Met Police
Image: Mosquera was later arrested just after 2am on 13 July. Pic: Met Police
Mosquera ran off and was later arrested at Bristol Temple Meads station on 13 July 2024 and charged with both murders.
When the case came to trial, initially at the Old Bailey and then at Woolwich Crown Court, the gruesome footage of Mr Alfonso’s murder was repeatedly played to the jury.
‘It was the worst video I have ever seen’
It is not often a murder is caught on camera.
It is even rarer when they are filmed from multiple angles, with sound.
I was at the Old Bailey for the first trial, where the recording of Mosquera killing Albert Alfonso was repeatedly played to the jury.
The two men are naked, taking part in consensual sex, which was filmed by Mr Alfonso on several cameras, a normal practice for the pair.
Unwittingly, Mr Alfonso recorded his own murder.
We see Mosquera hide the knife.
Then, when Mr Alfonso is at his most vulnerable, Mosquera calmly stabs him in the neck.
Mr Alfonso struggles against Mosquera, screaming, but is overpowered.
Mosquera cruelly taunts him, asking, “Do you like it?”
As Alfonso lay dying, Mosquera bizarrely sings and dances before going to Alfonso’s computer.
The judge warned the jury about the graphic video, reassuring them that, if they felt unable to proceed due to its content, they would be excused.
One jury member did not come back the next day and I could completely understand their discomfort.
The sound of screaming was hard to forget.
A murder is always upsetting to watch, but this felt intrusive.
While many aspects of their sexual relationship could be disturbing to an outsider, Albert Alfonso could never have predicted that his private recordings would be so publicly analysed at a trial into his own murder.
Miranda Jollie, Senior Crown Prosecutor at the CPS, said she found the video “horrific”, but maintained that it was necessary to show the video because of Mosquera’s claims.
Mosquera denied the murders, but admitted killing Mr Alfonso – his defence team argued it was manslaughter by loss of control.
However, the video evidence contradicts this claim.
It shows Mosquera had hidden the knife before sex, showing the attack was premeditated.
He was also calm as he attacked Mr Alfonso, who was taken off guard, and went to Mr Alfonso’s computer to try and steal from him as he lay dying.
In court, Mosquera argued, through a Spanish interpreter, that Mr Alfonso had repeatedly “raped him” and that Mr Longworth had been killed by Mr Alfonso.
But the prosecution argued there was no evidence to support these claims, while the couple’s relationship was unconventional, it was also “loving”, and Mr Alfonso would never have killed Mr Longworth.
The system for regulating water companies in England and Wales should be overhauled and replaced with one single body, a major review of the sector has advised.
It has recommended abolishing regulator Ofwat as well as the Drinking Water Inspectorate (DWI), which ensures that public water supplies are safe.
The report, which includes 88 recommendations, suggests a new single integrated regulator to replace existing water watchdogs, mandatory water metering, and a social tariff for vulnerable customers.
The ability to block companies being taken over and the creation of eight new regional water authorities with another for all of Wales to deliver local priorities, has also been suggested.
The review, the largest into the water industry since privatisation in the 1980s, was undertaken by Sir Jon Cunliffe, a career civil servant who oversaw the biggest clean-up of Britain’s banking system in the wake of the financial crash.
He was coaxed out of retirement by Environment Secretary Steve Reed to lead the Independent Water Commission.
Here are nine key recommendations:
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• Single integrated water regulators – a single water regulator in England and a single water regulator in Wales. In England, this would replace Ofwat, the Drinking Water Inspectorate and water-environment related functions from the Environment Agency and Natural England
• Eight new regional water system planning authorities in England and one national authority in Wales
• Greater consumer protection – this includes upgrading the consumer body Consumer Council for Water into an Ombudsman for Water to give stronger protection to customers and a clearer route to resolving complaints
• Stronger environmental regulation, including compulsory water meters
• Tighter oversight of water company ownership and governance, including new powers for the regulator to block changes in water company ownership
• Public health reforms – this aims to better manage public health risks in water, recognising the many people who swim, surf and enjoy other water-based activities
• Fundamental reset of economic regulation – including changes to ensure companies are investing in and maintaining assets
• Clear strategic direction – a newlong-term National Water Strategy should be published by both the UK and Welsh governments with a “minimum horizon of 25 years”
• Infrastructure and asset health reforms – including new requirements for companies to map and assess their assets and new resilience standards
In a speech responding to Sir Jon’s report, Mr Reed is set to describe the water industry as “broken” and welcome the commission’s recommendations to ensure “the failures of the past can never happen again”.
Final recommendations of the commission have been published on Monday morning to clean up the sector and improve public confidence.
Major other suggested steps for the government include greater consumer protection by upgrading the Consumer Council for Water into an ombudsman with advocacy duties being transferred to Citizens Advice.
Stronger and updated regulations have been proposed by Sir Jon, including compulsory water metering, changes to wholesale tariffs for industrial users and greater water reuse and rainwater harvesting schemes. A social tariff is also recommended.
Oversight of companies via the ability to block changes in ownership of water businesses and the addition of “public benefit” clauses in water company licences.
To boost company financial resilience, as the UK’s biggest provider Thames Water struggles to remain in private ownership, the commission has recommended minimum financial requirements, like banks are subject to.
It’s hoped this will, in turn, make companies more appealing to potential investors.
The public health element of water has been recognised, and senior public health representation has been recommended for regional water planning authorities, as have new laws to address pollutants like forever chemicals and microplastics.
A “supervisory” approach has been recommended to intervene before things like pollution occur, rather than penalising the businesses after the event.
A long-term, 25-year national water strategy should be published by the UK and Welsh governments, with ministerial priorities given to water firms every five years.
Companies should also be required to map and assess their assets and resilience
This breaking news story is being updated and more details will be published shortly.
A new public inquiry will “uncover the truth” behind the so-called “Battle of Orgreave”, a bloody fight between striking miners and police officers in the 1980s.
One hundred and twenty people were injured in the violent confrontation on 18 June 1984, outside a coal processing factory in Orgreave, South Yorkshire.
Five thousand miners clashed with an equal number of armed and mounted police during a day of fighting.
Police used horse charges, riot shields and batons against the picketers, even as some were retreating.
Image: Masses of miners and police clashed during the day of fighting
Image: Police officers on horses charged against protesters
In the aftermath, miners were blamed for the violence in what campaigners believe was an institutional “frame-up”.
“There were so many lies,” says Chris Peace, from campaign group Orgreave Truth and Justice, “and it’s a real historic moment to get to this stage.”
“There’s a lot of information already in the public domain,” she adds, “but there’s still some papers that are embargoed, which will hopefully now be brought to light.”
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Image: Campaigner Chris Peace
Although dozens of miners were arrested, trials against them all collapsed due to allegations of unreliable police evidence.
Campaigners say some involved have been left with “physical and psychological damage”, but until now, previous governments have refused calls for a public inquiry.
Launching the inquiry today, Home Secretary Yvette Cooper told Sky Newsi that she wanted to “make sure” campaigners now got “proper answers”.
“We’ve obviously had unanswered questions about what happened at Orgreave for over 40 years,” Ms Cooper says, “and when we were elected to government, we determined to take this forward.”
Image: A police officer tackling a miner
Image: A bleeding protester being led away by police during the ‘Battle of Orgreave’
Image: The Bishop of Sheffield, Pete Wilcox, will chair the inquiry
The inquiry will be a statutory one, meaning that witnesses will be compelled to come and give evidence, and chaired by the Bishop of Sheffield, Pete Wilcox.
“I’m really happy,” says Carl Parkinson, a former miner who was at Orgreave on the day of the clash, “but why has it took so long?”
“A lot of those colleagues and close friends have passed away, and they’ll never get to see any outcome.”
Image: Former miner Carl Parkinson
Image: Former miner Chris Skidmore
Mr Parkinson and Chris Skidmore, who was also there that day, were among the group of campaigners informed first-hand by Ms Cooper about the public inquiry at the Orgreave site.
“It wasn’t frightening to start off with,” Mr Skidmore remembers of the day itself, “but then what I noticed was the amount of police officers who had no identification numbers on. It all felt planned.”
“And it wasn’t just one truncheon,” says Mr Parkinson, “there were about 30, or 40. And it was simultaneous, like it was orchestrated – just boom, boom, boom, boom.
“And there’s lads with a split down their heads for no good reason, they’d done nothing wrong. We were just there to peacefully picket.”
Image: Police used riot shields against the picketers, even as some were retreating
Image: In the aftermath of the fighting, miners were blamed for the violence
In the intervening years, South Yorkshire Police have paid more than £400,000 in compensation to affected miners and their families.
But no official inquiry has ever looked at the documents surrounding the day’s events, the lead-up to it and the aftermath.
“We need to have trust and confidence restored in the police,” says South Yorkshire Mayor Oliver Coppard, “and part of that is about people, like this campaign, getting the justice that they deserve.
“Obviously, we’ve had things like Hillsborough, CSE [Child Sexual Exploitation] in Rotherham, and we want to turn the page.”