The longest strike in NHS history
The longest strike in NHS history kicked off today as thousands of junior doctors across England took to the picket line to begin their six-day walkout.
Junior doctors – who represent almost half of the medical workforce – will have urgent care covered by senior staff. But an estimated 88,000 routine appointments are likely to be cancelled in this fresh spate of industrial action. This will pile further pressure on the NHS’s record waiting list of 7.8 million – a backlog which has grown every month since Sunak made his pledge this time last year to cut it.
Over the course of 2023, more than 1.2 million appointments have been cancelled due to strike action, which is estimated to have cost the NHS over £2bn.
“Junior doctor” is a broad term covering the entire cohort of staff below consultant level. Pay ranges anywhere from £29,000 a year for those fresh out of university to around £77,000 for medics with up to a decade of experience.
In November, the BMA union – which represents doctors – finally re-entered negotiations with the health secretary after a standoff lasting over 100 days. But even these long overdue talks resulted in failure. The government offered junior doctors an extra 3% from January on top of an average pay rise of nearly 9% given to junior doctors back in April. But the BMA said the figure was too little.
Junior doctors have taken part in 28 days of strike action since their first walkout in March last year. Yet other NHS pay disputes were resolved months ago: last May, all NHS staff aside from doctors accepted a pay offer of 5% extra, plus a one-off lump sum.
Which begs the question, why is the doctor dispute proving so much harder to resolve?
The government insists that the BMA is especially militant, labelling its demand of a 35 per cent pay rise “wildly out of step” with other public pay settlements.
The BMA, meanwhile, maintains that its demand is simply “pay restoration” to make up for 15 years of pay erosion.
Have junior doctors suffered more brutal real-terms pay cuts compared to other NHS colleagues?
Crucially, there are different ways to measure inflation. The BMA has used a contentious one – RPI – to assert that doctors have suffered a 26 per cent real-terms pay cut. The union says it used RPI because that’s the measurement the government uses when charging junior doctors interest on student loans. However, the ONS has made its position on RPI clear: “we do not think it is a good measure of inflation and discourage its use.”
According to IFS estimates, made using the ONS’s preferred measurement for inflation of CPI, consultants and junior doctors have suffered real-terms pay cuts of closer to 17 and 15 per cent respectively since 2010.
That said, the IFS’s figures do suggest that doctors have seen their pay erode the most. For instance, nurses’ pay has declined by 12.5% over this same period, senior managers by 9.5 per cent, and ambulance staff by 3.8 per cent.
Ending these junior doctor strikes once and for all should be a vital New Year’s resolution for Sunak. It may be wise to listen to a plea made by Matthew Taylor, the NHS Confederation’s chief executive, all the way back in April: call in the Advisory, Conciliation and Arbitration Service, an independent public body, to oversee negotiations and act like a referee.
There is a precedent for this: ACAS helped break the deadlock after junior doctors went on strike in 2016.
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