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.”
Donald Trump may be denied the honour of addressing parliament on his state visit to the UK later this year, with no formal request yet submitted for him to be given that privilege.
It comes after President Macron’s successful state visit this week, in which he was invited to speak in front of both Houses of Parliament.
Sky News has been told the Speaker of the House of Commons, Sir Lindsay Hoyle, hasn’t so far received a request to invite the US president to speak in parliament when he is expected to visit in September.
It was confirmed to MPs who have raised concerns about the US president being allowed to address both houses.
Kate Osborne, Labour MP for Jarrow and Gateshead East, wrote to the speaker in April asking him to stop Mr Trump from addressing parliament, and tabled an early-day motion outlining her concerns.
“I was happy to see Macron here but feel very differently about Trump,” she said.
“Trump has made some very uncomfortable and worrying comments around the UK government, democracy, the Middle East, particularly around equalities and, of course, Ukraine.
“So, I think there are many reasons why, when we’re looking at a state visit, we should be looking at why they’re being afforded that privilege. Because, of course, it is a privilege for somebody to come and address both of the houses.”
But the timing of the visit may mean that any diplomatic sensitivities, or perceptions of a snub, could be avoided.
France’s President Emmanuel Macron addressed parliament during his state visit this month
Lord Ricketts, a former UK ambassador to France, pointed out that parliament isn’t sitting for much of September, and that could help resolve the issue.
In 2017, he wrote a public letter questioning the decision to give Donald Trump his first state visit, saying it put Queen Elizabeth II in a “very difficult position”.
Parliament rises from 16 September until 13 October due to party conferences.
The dates for the state visit haven’t yet been confirmed by Buckingham Palace or the government.
However, they have not denied that it will take place in September, after Mr Trump appeared to confirm they were planning to hold the state visit that month. The palace confirmed this week that the formal planning for his arrival had begun.
Mr Trump has said he believes the trip to the UK will take place in September. Pic: Reuters
When asked about parliamentary recess potentially solving the issue, Ms Osborne said: “It may be a way of dealing with it in a very diplomatic way… I don’t know how much control we have over Trump’s diary.
“But if we can manoeuvre it in a way that means that the House isn’t sitting, then that seems like a good solution, maybe not perfect, because I’d actually like him to know that he’s not welcome.”
A message from the speaker’s office, seen by Sky News, says: “Formal addresses to both Houses of Parliament are not automatically included in the itinerary of such a state visit.
“Whether a foreign head of state addresses parliament, during a state visit or otherwise, is part of the planning decisions.”
Mr Trump made his first state visit to the UK in June 2019 during his first presidency. File pic: Reuters
It’s understood that if the government agrees to a joint address to parliament, the Lord Chamberlain’s office writes to the two speakers, on behalf of the King, to ask them to host this.
It will be Mr Trump’s second state visit.
During his first, in 2019, he didn’t address parliament, despite the fact that his predecessor, Barack Obama, was asked to do so.
It was unclear if this was due to the fact John Bercow, the speaker at the time, made it clear he wasn’t welcome to do so.
However, it didn’t appear to dampen Mr Trump’s excitement about his time with the Royal Family.
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Speaking earlier this year, he described his state visit as “a fest” adding “it’s an honour… I’m a friend of Charles, I have great respect for King Charles and the family, William; we have really just a great respect for the family. And I think they’re setting a date for September.”
It is expected that, like Mr Macron, the pageantry for his trip this time will revolve around Windsor, with refurbishment taking place at Buckingham Palace.
Fuel to the engines of the Air India plane that crashed last month appears to have cut off shortly after take-off, a preliminary report has found.
According to the report switches in the cockpit that controlled fuel moved to a “CUTOFF” position.
It said: “Engine 1 and Engine 2 fuel cutoff switches transitioned from RUN to CUTOFF position one after another with a time gap of one second.
“The Engine N1 and N2 began to decrease from their take-off values as the fuel supply to the engines was cut off.”
The crash site. Pic: AAIB
There was then confusion in the cockpit. In the voice recording, one of the pilots is heard asking the other why he “cut off”. The other pilot responds that he did not do so.
There were no conclusions as to how the switches were moved.
One of the engines was able to be restarted, but could not reverse the plane’s deceleration, the report found.
“At this stage of investigation, there are no recommended actions to Boeing 787-8 and/or GE GEnx-1B engine operators and manufacturers,” India’s Aircraft Accident Investigation Bureau (AAIB) said in the report.
A diagram in the report shows how the plane crashed into a building. Pic: AAIB
No significant bird activity was observed in the vicinity of the plane’s flight path, the report said. The aircraft started to lose altitude before crossing the airport perimeter wall, it added.
The plane plummeted into a busy area, killing 241 passengers and 19 others on the ground while incinerating everything around it.
The AAIB’s report is based on the initial findings of the probe, marking 30 days since the crash.
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Liverpool have retired the number 20 shirt in honour of Diogo Jota – the first time it has made such a gesture.
The club said it was a “unique tribute to a uniquely wonderful person” and the decision was made in consultation with his wife and family.
The number 20 will be retired at all levels, including the men’s and women’s first teams and academy squads.
A statement said: “It was the number he wore with pride and distinction, leading us to countless victories in the process – and Diogo Jota will forever be Liverpool Football Club’s number 20.”
The club called it a “recognition of not only the immeasurable contribution our lad from Portugal made to the Reds’ on-pitch successes over the last five years, but also the profound personal impact he had on his teammates, colleagues and supporters and the everlasting connections he built with them”.
Jota’s wife joined Liverpool players to view tributes at Anfield on Friday. Pic: Liverpool FC
Pic: Liverpool FC
Newly-married Jota died alongside his brother when his Lamborghini crashed in northern Spain on 3 July.
Police said this week that all the evidence so far suggests Jota was the one driving the vehicle.
Liverpool teammates joined members of Jota’s family, including his wife Rute, at a huge memorial site outside Anfield on Friday.
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A fan looks at messages on a memorial wall near Anfield. Pic: Reuters
Virgil van Dijk and Andy Robertson were among players at the funeral. Pic: Reuters
The star’s funeral took place last weekend, with Liverpool colleagues and members of the Portuguese national team in attendance.
Reds captain Virgil van Dijk carried a shirt bearing the number 20 made from flowers.
Liverpool players returned to the club’s training ground for the start of pre-season on Tuesday.
Their first game since Jota’s death will be on Sunday when they play a friendly away against Preston North End.
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