Doctors strike again amid flu crisis – The Latest

0:00This is The Guardian.

0:12This is not an ordinary industrial dispute. Resident doctors are absolutely determined to get full pay restoration. Pay is important. We must value our doctors in this country. The trouble for Wes Streeting is that he's won the battle for the hearts and minds of the public, but not the hearts and minds of the resident doctors. Mr Speaker, let me be clear about the strikes. They're dangerous and utterly irresponsible. Why resident doctors are striking just before Christmas and what it means for the NHS dealing with a flu crisis. From The Guardian's Today in Focus, this is The Latest with me, Lucy Hoth.

0:51I'm joined by Dennis Campbell, who is health policy editor at The Guardian. So resident doctors, formerly junior doctors, are walking out today for the first day in a five-day strike just before Christmas. Talk to me about the scale of the walkouts and the likely impact that they're going to have today and in the days coming. So across England today, many, many thousands of resident doctors are on strike. There are about 70 ,000 resident doctors in England. That's about half of the NHS entire medical workforce. so they're really important people to the smooth running of the NHS. Many people refer to them as the workhorse of the NHS.

1:29These are the doctors up to just below the level of consultant. They do a lot of very, very important work in clinics, in operations, in any department, across the board and across the whole terrain of NHS care. Many, many thousand of them are on strike. We won't get the numbers until a few days after the strike has finished but we know that the impact on the NHS is significant. and NHS England itself has said today that the disruption will probably be the greatest yet of all the strikes. West Streeting, the House Secretary today, has been saying he doesn't want people to think that if they have a medical issue that they shouldn't go into hospitals and that senior doctors will be covering for their resident doctor colleagues.

2:07But this comes at a terrible moment. You did mention that there has been an outbreak of what's been called a super flu that's come two and a half weeks earlier than usual, which means that hospitals have been under really great pressure in the last couple of weeks. That's right. At the moment, in NHS hospitals in England, there are more people in bed seriously ill with flu, generally people who can't breathe normally because flu has corrupted their lungs, than any year ever before. The NHS winter crisis is almost as traditional as Christmas itself. It comes around predictably all the time. It's come earlier this year.

2:44The reason for it is this. particularly virulent strain of flu. So more people are occupying more hospital beds than usual for the time of year. The head of the NHS England has already said it's about 2 ,600 at the moment. He's already said that that could go up to as many, potentially as many as 8 ,000 within the next week or two. So hospitals are really under the cosh, earlier than usual and probably more than usual already for the time of year with the worst winter yet to come. So let's have a look at why resident doctors are striking today. So this is a dispute, as I said, that started in 2023.

3:19So it's been running for about two years. There have been 14 walkouts in that time. Last year, when Labour took office, the new health secretary, Wes Streeting, was able to reach a settlement with resident doctors that gave them, on average, a 22 % pay rise. But there was continued concerns about pay, weren't there? And there's now new concerns about training roles once people finish their graduate studies. So walk me through why BMA doctors are worried. When Labour won the election in July of last year, the first meeting that new Health Secretary Wes Streeting had was with the British Medical Association to try and sort out the issue of junior doctor pay.

4:02That was one of many, many, many problems he had inherited from the previous Conservative government. He said, I'm going to fix this as an urgent priority. Within a few weeks, he gave junior doctors in England a 22.3 % pay rise for last year and this year, 24, 25, 25, 26. And he thought and said publicly he'd fixed it. He hadn't, sadly. So the British Medical Association decided that they wanted full pay restoration. In other words, the real terms value of junior doctor pay restored to 2008-9 levels, factoring in inflation that's happened since. So although they got 29 % over three years, the last year of the Conservatives plus the 22 % from West treating, they want a further 26 % over the next few years to restore the full terms, the real terms value of the pay and get around the fact that they have had pay erosion over that long time.

5:00So BMA doctors who've been speaking to the media in the last few days would say that they are very concerned that they are underpaid, that they're hemorrhaging doctors to places like Australia, to Ireland because of poor working conditions in the NHS. They would also stress that point that they've had a real terms pay cut in the last few years. But clearly that is a line that is not washing with the government. I mean, the government has been very strong. And Keir Starmer says it's beyond belief that resident doctors are striking today and West Streeting has let his frustrations be very well known.

5:34So does it feel like there's the possibility of a deal? I know that there was some last ditch talks last night to try and prevent this walkout. This is not an ordinary industrial dispute. Usually when you have teachers or other public sector workers, train drivers for example, they pitch for the high percentage increase that they want in their pay. There are maybe some strikes, certainly negotiations, and then a settlement is reached somewhere in the middle or towards what they want. And that's been the case over the last few years with those sorts of groups of workers. that doesn't apply in this case because the resident doctors are absolutely determined to get full pay restoration which they calculate as a further 26 % on top of the 29 % they've already had they're not prepared to meet in the middle they say it's a matter of principle that they get this, that they deserve it they do valuable vital work and no one would dispute that they point as you say to the fact that doctors can, UK trained doctors can go abroad to Ireland Canada, US, Australia and earn much more money and work in some of those countries in health systems that are much better resourced and where they have much less pressure on them.

6:47So, and we are suffering, we are seeing that sort of brain drain going on. I sadly don't see any obvious easy resolution to the pay demand that they want. West Streeting understandably says, listen everybody, the public finances are very, very straightened. We read about that every day. there just isn't the money to give this group of workers the big big big pay rise they want whether it's factored in over a few years or not there just isn't the money. And on the jobs aspect of it resident doctors affiliated with the BMA say that there are tens of thousands of newly qualified medics who are unable to get speciality training positions meaning that there is a shortage at a time where tens of thousands of people each year are being treated in hospital corridors and there is this clear and visible shortage of specialised medics to handle that.

7:41So they say, is there any chance of movement? Because I know that was part of the deal that was offered by West Street and the health secretary last week, but was turned down. So these training places are, if you're a young, early career doctor, this is really, really important. You do your four or five or six year medical degree. You do the first two years of training called foundation training, F1, F2. and then generally you look to move on into specializing in psychiatry, surgery, intensive care medicine, whatever it might be, A &E medicine, whatever it might be, your chosen area. There's always been competition to get those places and there's always been some people who miss out.

8:21But in the last couple of years, many more young early career doctors have been missing out. So there's now this big bottleneck of doctors who in some cases are left literally unemployed because they can't progress their careers in the normal fashion. This is very, very hard for West Streeting to fix. He initially said, I'll create 1 ,000 extra training places. He upped that offer to 2 ,000. And last week, he doubled that again to 4 ,000. The BMA said, we'll put this to our resident doctor members. They did so in a survey that finished on Monday this week. And then on a turnout of 65%, 83 % of those who voted said, no, sorry, not good enough.

9:00We're going to continue with our strike plan. And that's what's happening. Yeah, which is an overwhelming majority, but it stands in quite stark contrast with public polling on support for the resident doctors' strikes. And public opposition has been growing, hasn't it? It now stands at about 60 % strongly opposed or opposed to the strikes, with about 30 in support. So that's moved quite substantially since this sort of began in around 2017, hasn't it? public opinion has flipped completely when particularly under the previous government the then junior doctors were making the case very forcibly saying some of us are paid less than baristas and pret for example that seemed to resonate with the public, the public seemed to get that this group of very important workers were underpaid for the work they did, the last government made some attempt to settle that, didn't get very far they had 11 strikes under the last government now that after the 22.3 % pay rise that West Streetian gave them public opinion has gone the other way from majority sympathy for the junior doctors to majority opposition to the strikes my reading of that would be that enough people see 22 % pay rise, actually 29 % over three years is pretty good for any group of public sector workers at any time, particularly when the public finances are so straightened and I think that's probably the reason why public opinion has slipped.

10:26The trouble for West Streeting is that he's won the battle for the hearts and minds of the public but not the hearts and minds of the rest of them doctors. Anyone who thought this was going to be different under a Labour government is in for a surprise. Well Dennis, thank you so much. My pleasure.

10:44That's it for today. Thanks for listening to the latest. The new evening edition of Today in Focus will be in your feeds every weekday evening with what you need to know about the story everyone's talking about in around 10 minutes. For more on the Resident Doctors strike, head to theguardian.com. And today in Focus, we'll be back with you tomorrow morning and we'll be back with you tomorrow night. This episode was presented by me, Lucy Hoth. The producer was Bryony Moore. The senior producer was Ryan Ramgobin.

11:13This is The Guardian.