Junior doctors’ latest strike dates send a message but gameplan is unclear

Ministers and hospital bosses were desperately hoping that junior doctors’ leaders would demonstrate the same pragmatism that their consultant counterparts did last week when they agreed details of a deal that, subject to a ballot, will end their long-running pay dispute.

However, those hopes proved forlorn. Junior doctors’ talks with the government have collapsed. The NHS in England and all those needing its help now face the nightmare scenario of nine days of strikes in quick succession, just before and just after the holiday fortnight. The dates chosen are 20-23 December and 3-9 January. Those walkouts will come during the winter crisis when the always overstretched service is under its greatest pressure, when reports of chaotic A&Es, queues of ambulances outside hospitals and the plight of seriously ill patients unable to get urgent care often dominate news bulletins.

Is the decision of the BMA junior doctors committee (JDC) to strike for so long, and at such a precarious time for the NHS, anything other than the most unapologetic V-sign to ministers? As its co-chairs, Dr Robert Laurenson and Dr Vivek Trevedi, put it: “We have no choice but to take action that demonstrates doctors are as determined as ever in reversing their pay cuts.”

Matthew Taylor, the chief executive of the NHS Confederation, said: “The worst fear of health leaders has come true. The BMA has targeted some very challenging weeks for its next phase of junior doctor walkouts.”

The JDC intends the fresh stoppages to demonstrate its resolve to ministers. But the people they will directly affect are hospital managers, anyone needing care on strike days and their consultant colleagues. The latter will be forced to cover for junior doctors who are out on picket lines. Patients’ safety will be paramount but potentially harder than usual to guarantee. Even more outpatient appointments and operations will be rescheduled on top of the 1.1m already postponed.

One consultant was unimpressed with the JDC’s decision. “Three weeks with four ‘normal’ working days in the middle of winter is likely to be a health disaster. And this at a time when Victoria Atkins, the new health secretary, seems genuinely intent on engaging with BMA negotiators to try and avert any further doctor strikes. It does not look like the juniors actually want a solution,” they said.

Junior doctors have taken 25 days of strikes since 13 March in pursuit of a 35% pay rise, possibly phased in over several years, to make up for their real-terms loss of income since 2008. Since those walkouts began, ministers have imposed a salary uplift averaging 8.8% for this year and now offered what the BMA says is another 3%. But 11.8% is not 35%, so the dispute rumbles on.

It is hard to see what the JDC’s gameplan is. To strike even more often and for even longer than the six days planned for next month? An indefinite walkout? Those 25 days have yielded only modest progress towards the 35% “full pay restoration” that remains its sole goal.

So how does it see this ending? In a compromise, like the one it has just rejected, or in potentially never-ending strikes? Until that becomes clear, patients and the NHS will continue to be caught in the middle.