Junior doctors start their longest strike in NHS history – here’s what they want
Junior doctors in England are due to walk out for six days, starting this morning.
The industrial action, from 7am on 3 January to 7am on 9 January, is the longest in the history of the NHS.
Health service executives have said the strike could mean “one of the most difficult starts to the year the NHS has ever faced”.
But the British Medical Association (BMA) has said it was forced to take action and reject the government’s December pay offer as it fails to compensate for real-terms pay cuts going as far back as 2008.
Here Sky News looks at why the strikes are happening and what both sides have said about them.
Who is striking?
The strikes only involve junior doctors in England. Under the NHS system, a junior doctor is any medical school graduate with between one and nine years’ experience.
They can be either members of the BMA or the Hospital Consultants and Specialists Association union.
NHS consultants took strike action in September and October and agreed to an extra 4.95% pay rise for senior doctors on top of the annual 6% increase already offered to them by the government.
This will be voted on by members of their union this month.
Medical students and staff who are not junior doctors are not legally allowed to join their colleagues on the picket line when scheduled to work.
But they can offer support and supplies when not on duty.
Junior doctors who work within the armed forces are also not permitted to take part.
BMA members on strike outside University College Hospital in London on 20 December
What do junior doctors want?
The government gave junior doctors an 8.8% pay rise last summer, with an extra 3% offered during the last round of negotiations towards the end of the year.
The BMA said it rejected the 3% offer because it does not make up for a real-term pay cut of nearly a quarter for junior doctors since 2008.
Instead, they are calling for:
• Full pay “restoration” to reverse real-term cuts in pay since 2008/9;
• A new pay mechanism to prevent any future pay decreases against inflation and the cost of living;
• A reformed Doctors’ and Dentists’ Review Body for independent and fair pay recommendations for staff to “safeguard recruitment and retention of junior doctors”.
The BMA claims junior doctors in England were subjected to a 26.1% real terms pay cut between 2008 and 2022.
First-year doctors on 2016 contracts get paid £32,398 a year – while those on the previous 2002 contract earned £28,274, according to the BMA website.
And with 6.4 million patients on the waiting list for treatment, the union says staff are suffering burnout and leaving the country or the profession altogether.
They say the strikes are designed to “save the NHS” from conditions that put patient care at risk.
Why are these strikes significant?
Junior doctors also went on strike for three days between 20 and 23 December.
With this week’s round of action, it means there will have only been four weekdays unaffected by strikes or the Christmas holidays over a period of three weeks.
Gloucestershire Hospitals NHS Trust decided to close Cheltenham A&E during the last strike – and is doing the same between 8pm on 1 January and 8am on 9 January.
Figures released in September showed that rescheduled appointments due to strike actions by both junior doctors and consultants have now surpassed one million.
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NHS England’s national medical director, Professor Sir Stephen Powis, said the strikes will not only affect the health service this week – but also for “weeks after… as we recover services and deal with additional demand”.
He described them as having a “significant impact on almost all routine care”, with almost half of the medical workforce on picket lines.
Urgent care will be covered by non-striking, more senior staff, but routine appointments and operations are likely to be rescheduled.
What has the NHS said?
Julian Hartley, chief executive of NHS Providers, said hospital trusts are “worried” by the level of industrial action.
“It does mean that there will be a huge amount of concern around managing patient safety and quality during this period because urgent care will be the priority, but a lot of planned care will have to be rescheduled for later in the new year,” he said.
Professor Sir Stephen added: “Six consecutive days of industrial action comes at one of our busiest periods – the action will not only have an enormous impact on planned care, but comes on top of a host of seasonal pressures such as COVID, flu, and staff absences due to sickness – all of which is impacting on how patients flow through hospitals.
“Our colleagues across the health service are doing their very best for patients every day, with extensive preparations in place, but there’s no doubt they are starting 2024 on the back foot.”
He warned people to only use hospital services in emergencies – but said people must still call 999 or attend A&E if they are in genuine need.
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Strike ‘not the way’ to secure settlement, says health secretary
What has the government said?
During the December strikes, Health and Care Secretary Victoria Atkins said she was prepared to return to the negotiating table if the strikes were called off.
On Tuesday, the prime minister’s spokesperson reiterated: “As the health and care secretary made clear, we are willing to have further discussions, but obviously the first thing to do is to stop striking.”
He added that the strikes are impacting the NHS’s ability to clear the waiting list backlog, with 88,000 appointments likely to be cancelled this time.
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The government wants a “fair resolution… for the taxpayer and hard-working doctors and health workers”, he said, adding: “It’s still very much in their gift to call off the strike action.”
Rishi Sunak told parliament last year the junior doctors’ strikes were “disappointing”.
He said: “We have now reached a resolution with every other part of the public sector and every other part of the NHS.
“And I’d also say that it was the junior doctors who received the biggest increase in their pay through the independent public standing pay review process of around a 10% increase for a typical junior doctor.”
It has become almost impossible to book a driving test on the government website due to bots on the booking system, driving instructors have told Sky News.
The only official way to book a practical car driving test is through the Driver and Vehicle Standards Agency (DVSA) website.
New test slots are released by the DVSA at 6am every Monday, but “no matter how fast I am, there’s nothing available”, said Aman Sanghera, a driving instructor based in west London.
Driving instructor Aman Sanghera wants ‘stronger oversight and regulation’ from the DVSA
When asked about the cause, she said: “All of the tests are taken by bots, they are definitely taking over the booking system.”
In this context, bots are automated software designed to mimic human behaviour and programmed to carry out actions like searching for and reserving driving test appointments on the official government website much faster than humans can.
Individuals and companies use bots to block-book driving test slots and then resell them at a profit, which is not illegal, although it is a violation of the DVSA’s terms of use.
Recent data shows the DVSA has closed over 800 business accounts for misuse of its booking service in the past two years.
It takes five months on average for a test in England – unless you pay a middleman
Ms Sanghera, who has been in the trade for over a decade, said the usage of bots started a few months ago “but is now getting out of hand”.
She said: “I’ve actually heard about driving instructors being approached by certain individuals to then take on their IDs to log in and to run this scam.
“I struggle to actually book a test for my students, which means that by the time my students are logging in, they’ve got no chance.”
Driving instructors can book driving tests on behalf of their pupils using a dedicated service, allowing them to bypass the general queue and potentially secure test slots more efficiently.
As a result, Ms Sanghera said students are “forced to go to third-party sites” to secure “the same test dates which are then available later on during the day at a premium rate of like £200-£300”.
She added: “Given that the DVSA is a government-regulated body, one would expect a more robust and fair system to ensure affordability and accessibility for all candidates.”
The long waiting lists and high demand for tests has led some to take advantage
The standard test fee is £62, offered by the DVSA, which is responsible for carrying out driving tests in Great Britain.
The biggest concern for the driving instructors Sky News has spoken to, including Ms Sanghera, is “the fact that students are being exploited”.
When Ahmed Ali struggled to find a practical test on the DVSA website, he turned to third-party sites – a decision he now regrets.
Ahmed Ali started looking for a test two years ago
He said: “I’ve spent about £650 on driving tests, and I’ve sat zero tests. I’ve given all this money to third-parties that look for cancellations so they could try to get you a faster test.”
But the 20-year-old said that despite making the payments, he “didn’t hear back from them again”, which is illegal.
“When you lose all that money, you get to a point where you can’t really afford to find another driving test,” he said.
“I just feel very frustrated because I’ve spent all this money, all this time into driving, and I haven’t sat a single driving test.”
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The DVSA urged applicants to only book tests via the official Gov.uk website and told Sky News it “deploys enhanced bot protection to help stop automated systems from buying up tests unfairly”.
“These applications, however, are constantly evolving and changing, and DVSA’s work on this is ongoing,” it said.
From Tuesday, the DVSA will require learner drivers to provide 10 full working days’ notice to change or cancel their car driving test without losing the test fee, up from the current three days.
Also part of the DVSA’s crackdown to reduce waiting times is a consultation expected to launch in spring 2025 “to streamline the driving test booking process” and “tighten terms and conditions”.
The last blast furnaces left operating in Britain could see their fate sealed within days, after their Chinese owners took the decision to cut off the crucial supply of ingredients keeping them running.
Jingye, the owner of British Steel in Scunthorpe, has, according to union representatives, cancelled future orders for the iron ore, coal and other raw materials needed to keep the furnaces running.
The upshot is that they may have to close next month – even sooner than the earliest date suggested for its closure.
Read more: Thousands of jobs at risk as British Steel consults unions over closure
The fate of the blast furnaces – the last two domestic sources of virgin steel, made from iron ore rather than recycled – is likely to be determined in a matter of days, with the Department for Business and Trade now actively pondering nationalisation.
The upshot is that even as Britain contends with a trade war across the Atlantic, it is now working against the clock to secure the future of steelmaking at Scunthorpe.
The talks between the government and Jingye broke down last week after the Chinese company, which bought British Steel out of receivership in 2020, rejected a £500m offer of public money to replace the existing furnaces with electric arc furnaces.
The sum is the same one it offered to Tata Steel, which has shut down the other remaining UK blast furnaces in Port Talbot and is planning to build electric furnaces – which have far lower carbon emissions.
These steel workers could soon be out of work
However, the owners argue that the amount is too little to justify extra investment at Scunthorpe, and said last week they were now consulting on the date of shutting both the blast furnaces and the attached steelworks.
Since British Steel is the main provider of steel rails to Network Rail – as well as other construction steels available from only a few sites in the world – the closure would leave the UK more reliant on imports for critical infrastructure sites.
However, since the site belongs to its Chinese owners, a decision to nationalise the site would involve radical steps government officials are wary of taking.
They also fear leaving taxpayers exposed to a potentially loss-making business for the long run.
The dilemma has been heightened by the sharp turn in geopolitical sentiment following Donald Trump’s return to the White House.
The incipient trade war and threatened cut in American support to Europe have sparked fresh calls for countries to act urgently to secure their own supplies of critical materials, especially those used for defence and infrastructure.
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Gareth Stace, head of UK Steel, the industry lobby group, said: “Talks seem to have broken down between government and British Steel.
“My advice to government is: please, Jonathan Reynolds, Business Secretary, get back round that negotiating table, thrash out a deal, and if a deal can’t be found in the next few days, then I fear for the very future of the sector, but also here for Scunthorpe steelworks.”
British Steel declined to comment.
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