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.”
UK
What women in prison miss most, the prison schemes helping them rebuild their lives and why fewer may end up going to jail
In a workshop in the far corner of the Styal prison estate, glass, plastic and metal are being smashed to the beat of pumping music.
Women at workstations are dismantling electronics with the energy of gym enthusiasts.
TVs and laptops, discarded at local recycling centres across England, have ended up here, on the edge of Wilmslow, Cheshire.
But amid the whiz of drills, the crunch of screens being separated from their plastic casings and the clatter of electronic boards ripped out and chucked in big bins, something else is being recycled – women’s lives.
“You get a lot of frustration out, because obviously a lot of girls have got a lot of anger, you know,” says Joanne*, who is serving time for drug offences.
She has joined this activity not for the £10 per 70 TVs she breaks apart, but because the programme – called Recycling Lives – could give her the skills and the support to keep her out of jail in the future.
Only 12% of women are employed six months after leaving prison, compared to 25% of men. In the general population employment levels between men and women are 78% to 72%.
Ex-prisoners with a job are far less likely to re-offend. So, women prisoners are at a disadvantage. Often a man is connected to the crime they committed.
“For 90% of the women in prison, there’s always a male involved in why they’ve committed crime, it is the case with me as well,” says Joanne, who tells me she was pressured into dealing drugs by her partner.
Official Ministry of Justice statistics say that at least 60% of women in prison are victims of domestic violence and most will have experienced some form of abuse as a child.
Many, too, are mothers and they feel the guilt of separation every day. Joanne says of her son: “It’s my sister picking him up from school, not me.
“It’s my sister there on Christmas day, not me. Birthdays, all the special occasions. It’s heart-breaking.
“People think prison is easy. You are ripped away from your family and your children. It’s not easy.”
As if in illustration, the glass cracks on an iPad, as she peels it away with her screwdriver.
Official figures say there are around 3,500 women in prison and it is estimated that about half are mothers.
‘I’m trying to give them a future’
The workshop manager Yvonne Grime knows this all too well. A former serial offender herself, she’s the first former inmate at Styal to now hold a set of keys to the prison.
“The biggest thing for me [as a prisoner] was leaving my children,” she says, “and I still carry that guilt round, but I have come through it.”
Part of her redemption is to help the women in her workshop. The Recycling Lives programme transformed her life, and she wants to give back.
She says: “I’m trying to give them a future. I’m trying to give you some hope that they can that they can change.
“Get the children back, find a job, find a home. There is light at the end of the tunnel.”
Her work is part manager and part mentor. “When I first started, I thought I’m just going to come in and run this workshop,” she said.
“I didn’t realise I had to be their mum, their dad, their brother, their sister, the doctor, the nurse, the everything that comes with it.
“If I had a salary for every one of those professions, I’d be absolutely minted.”
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Styal isn’t what you expect a prison to look like.
Inside the high fences and barbed wire are sixteen austere red-brick Victorian houses.
Once an orphanage, they’re now the prison’s accommodation blocks.
Ted the prison cat, wanders from block to block, and has already served several of his nine lives in the compound.
Along with recycling TV sets, women can learn to guide and drive forklift trucks.
They are quick with their tools, spinning through one appliance after another with remarkable and methodical destructive pace.
But the real advantage of the programme is that it continues on the outside. Only 6% of people who go through Recycling Lives go on to commit further crime. The general reoffending rate is 25%.
In a warehouse in Preston, former inmates are involved in recycling food from supermarkets and farms, then sent to foodbanks.
Here we meet Naomi Winter, who – three years since being released from jail – is now a manager at the food distribution depot.
The hardest thing about prison for her too was being separated from a child.
“I was put in prison when my baby is only three months old,” she said.
“So, it was like losing an arm, like losing a piece of my DNA.
“I still woke up for night feeds in the night and stuff like that.”
She says there wasn’t the mental health provision inside of prison to help her deal with post-natal depression, and she spent way too much time alone with her thoughts.
She was in and out of prison for drug offences and violence eight times by the age of 30 and first jailed aged 15, for breaching an anti-social behaviour order (ASBO).
She feels even short prison sentences can ruin lives, and says: “You take women who’s robbed a block of cheese to feed the child.
“They put them in prison for 28 days. They take the home, take the kids, they lose the family, and they get out with nothing. You just create a criminal right there.
“You’ve just created a woman who’s got nothing to lose. You’re also releasing them with a sleeping bag in a tent and telling them to go and sleep in the woods.”
Naomi Winter feels even short prison sentences can ruin women’s lives
Alternatives to custody
The government recognises that prison isn’t working for many of the women who end up there.
It’s why, with women being mostly non-violent offenders and serving short sentences, the government is setting up a Women’s Justice Board to look at reducing the number who go into prison with alternatives such as community sentences and intervention projects tackling the root causes of re-offending.
The Lord Chancellor and Justice Secretary, Shabana Mahmood, told Sky News: “For many women, prison isn’t working. Most women in prisons are victims themselves. Over half are mothers, with a prison sentence separating parent and child.
“That’s why I am establishing a new Women’s Justice Board, tasked with reducing the number of women in prison by exploring alternatives to custody for female offenders.”
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Chief Executive of Recycling Lives, Alasdair Jackson says: “There are certain things we all need as human beings: One is a place to live, one is a job to be able to pay for that place to live and then a support network.
“But there are a lot more factors that women have to contend with; there’s children, there is maybe domestic abuse, there’s everything that goes on around that, but when you give people a chance, when you give people the skills that they need, it is life-changing.
“And when you change a woman’s life, you are often changing the family’s life and the children’s life.”
Alasdair Jackson says ‘when you change a woman’s life, you are often changing the family’s life’
Prison is supposed to be part punishment, part repair job. But there are limited programmes like Recycling Lives, and for many women entering jail currently, the only recycling is back into criminality.
* names have been changed
The world’s oldest man has died at the age of 112, the Guinness World Records has announced.
John Tinniswood was born in Liverpool on 26 August 1912, the year the Titanic sank. He was a lifelong Liverpool FC fan, born just 20 years after the club was founded.
He died on Monday at a care home in Southport, Guinness World Records said.
In a statement, his family said: “His last day was surrounded by music and love.
“John always liked to say thank you. So on his behalf, thanks to all those who cared for him over the years, including his carers at the Hollies Care Home, his GPs, district nurses, occupational therapist and other NHS staff.”
In April 2024, aged 111, he became the world’s oldest living man, following the death of 114-year-old Juan Vicente Perez from Venezuela.
Mr Tinniswood was born in Liverpool on 26 August 1912, the year the Titanic sank. Pic: Guinness World Records
Mr Tinniswood’s key advice for staying healthy was to practice moderation. “If you drink too much or you eat too much or you walk too much; if you do too much of anything, you’re going to suffer eventually.”
But when asked the secret to his longevity after turning 112 in August, Mr Tinniswood put it all down to “just luck”.
“I can’t think of any special secrets I have,” he said. “I was quite active as a youngster, I did a lot of walking.
“Whether that had something to do with it, I don’t know. But to me, I’m no different [to anyone]. No different at all.
“I just take it in my stride like anything else, why I’ve lived that long I have no idea at all.”
Mr Tinniswood was named the world’s oldest man in April this year.
Pic: Guinness World Records
Apart from a portion of battered fish and chips every Friday, Mr Tinniswood did not follow any particular diet, and said earlier this year he felt “no different” turning 112.
“I don’t feel that age, I don’t get excited over it. That’s probably why I’ve reached it.
“I just take it in my stride like anything else, why I’ve lived that long I have no idea at all.”
He lived through both world wars and was a Second World War veteran – having worked in an administrative role for the Army Pay Corps.
In addition to accounts and auditing, his work involved logistical tasks such as locating stranded soldiers and organising food supplies. He went on to work as an accountant for Shell and BP before retiring in 1972.
He met his wife, Blodwen, at a dance in Liverpool. They were together for 44 years before Blodwen died in 1986.
Mr Tinniswood was the oldest surviving male Second World War veteran.
Pic: Guinness World Records
Mr Tinniswood is survived by his daughter Susan, four grandchildren and three great-grandchildren, and lived to be the fourth-oldest British man in recorded history.
His family added: “John had many fine qualities. He was intelligent, decisive, brave, calm in any crisis, talented at maths and a great conversationalist.
“John moved to the Hollies rest home just before his 100th birthday and his kindness and enthusiasm for life were an inspiration to the care home staff and his fellow residents.”
The oldest ever man was Jiroemon Kimura from Japan, who lived to the age of 116 years 54 days and died in 2013.
The world’s oldest living woman, and oldest living person, is Japan’s 116-year-old Tomiko Itooka.
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