Summary

  • Fourth strike involving junior doctors in England began at 08:00 BST on Wednesday and lasts 48 hours

  • Doctors are providing emergency cover, but 5,000 operations and procedures are postponed

  • Comes amid long-running dispute with government over planned changes to pay and conditions

  • All-out stoppages planned for 08:00 to 17:00 BST on both 26 and 27 April

Live Reporting

Lauren Turner, James Gallagher and Dominic Howell

  1. 'It's distressing to have your operation cancelled twice'

    BBC Radio 4

    HospitalThinkstock

    Some listeners of BBC Radio 4's PM programme have had their operations and appointments postponed or cancelled. They spoke to presenter Eddie Mair about how they felt about the strikes.

    David Johnston said he had sympathy with junior doctors, but felt they were wrong to strike. He is waiting for a treatment on his eyes to stop his sight deteriorating, as well as an exploratory brain scan.

    I'm one of the lucky ones. I haven't had an operation or appointment cancelled. I'm currently waiting for appointments. If I miss them, I will have difficulty seeing, driving and walking.

    It's caused me worry, it's caused me stress, but there are thousands facing much more uncertainty. But yes, it's upsetting. And this dispute looks so entrenched, I'm worried we're facing this for the next five or ten years of the NHS."

    Anothger listener, Jenny Beumont, is waiting for a non-emergency procedure which has been cancelled twice.

    It's more of an inconvenience. I'm not in any pain or anything, but it is an operation I need. You prepare yourself when you know you're doing to go into hospital. When it's put back, it's like 'No, I've got to go through all this again'. It's a bit distressing.

    Unfortunately, both cancellations have been when the junior doctors have been on strike. When I asked if that was the cause, the answer I got was that it was due to the knock on effect. I still support the doctors strike though. I don't blame them for doing it.

  2. 'The new contract widens the gender pay gap'

    StrikeAP

    Doctor Reena Aggarwal has written for the Independent newspaper about her struggle first to overcome her family's reservations about her becoming a medic as a woman - and now the sexism she says female doctors will face under the government's new contract.

    Women still struggle to gain equal treatment in the workplace as they still do the majority of child-rearing and may elect to work part-time. Until now, salaries for female doctors in training have kept pace with men’s due to small annual pay awards to prevent part-time doctors - of whom the vast majority are women - earning less than their full-time colleagues over time.

    The new contract will remove these safeguards widening the gender pay gap in medicine. The King's Fund suggest that the gender imbalance in medicine still persists due to “…stereotyping and discrimination, organisational cultures” play a part in perpetuating the imbalance. We should be trying to make things better, not be going backwards with a draconian junior doctors contract that will hit women hardest."

  3. 'Striking doctors should be ashamed'

    On social media, many have been expressing their support for junior doctors - but some have condemned the strikes.

  4. In pictures: Picket line placards

    Here is a selection of some of the placards photographed at picket lines and protests around England today.

    StrikePA
    StrikePA
    StrikeGetty
    StrikeAFP
    StrikeGetty
    StrikeReuters
    StrikeEPA
    StrikeAFP
    StrikeReuters

  5. National Health Singers protest in song

    Press Association reporter tweets...

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  6. 'I came home from work and cried'

    Doctor

    One junior doctor on strike today, Melody Redman, has written for the Yorkshire Post about the strain she feels under in her job.

    The rota gaps are painful. The job is emotionally and physically tiring. We want to do our best, but there aren’t enough of us.

    On Thursday night, I came home from work and I cried. I cried because I found out one of my patients had passed away. The following three days were 12 and a half hour shifts. These shifts made this weekend my third working weekend in the last six weeks.

    Ayesha, another junior doctor, said to me: “I was not brave enough to leave, I stayed and got burnt out. With hindsight that was eminently preventable…”

  7. Vanessa Redgrave: Doctors are being treated like dirt

    Actress Vanessa Redgrave addressed the crowd outside the Department of Health earlier with a brief speech condemning the way medical professionals were being treated. 

    She said she was "proud" to be attending but angry that the strike was necessary. 

    The 79-year-old actress said: "Junior doctors are being treated... like dirt. 

    "Treated as if they were mad, as if they were stupid. I could cry, they work so hard."

  8. US presidential hopeful's brother backs junior doctors' strike

    Larry SandersJill Green

    Larry Sanders, brother of US presidential hopeful Bernie Sanders and Green Party health spokesman, has lent his support to striking junior doctors, calling them "heroes in the fight for a public NHS", according to the left-wing political blog Left Foot Forward.

    He told them "the fight is an international one".

    My brother, Senator Bernie Sanders, is campaigning to create a national health programme for the US. He is opposed by the same vultures who are feeding on the NHS. Their success costs us in money and in lives.”

  9. How do today's walk out figures compare to previous strikes?

    Nick Triggle
    Health Correspondent

    Don’t read too much into the NHS England figures showing 46% of junior doctors turned up for work at hospital on Wednesday. That is broadly similar to the previous walkouts when between 39% and 44% of medics worked. 

    Many of the doctors will have been staffing emergency care services as agreed under the terms of the strike – and there are about 17,000 junior doctors who are not British Medical Association members.

  10. NHS workers 'among the few who can still hold the public to ransom' - Spectator

    Weekly right-wing magazine The Spectator writes that the number of days lost to industrial action in Britain has been on the decline since the so-called "winter of discontent" in 1979.

    "Workers in Britain’s unreformed NHS are among the very few who can still hold the public to ransom," it argues.

    In the 1970s and early 1980, it was miners, steel workers, railwaymen, bin men, and British Leyland car workers who earned the worst reputations for trade union militancy. Striking was almost entirely associated with blue-collar workers standing around braziers in their donkey jackets.

    Now things couldn’t be more different. Of the above groups, only railway workers retain a reputation for industrial action, and almost all strikes are carried out by privileged white-collar public sector staff. Almost half of the days lost to strikes in 2014 were in public-sector administration, with most of the others in education and in health and social care. With the junior doctors’ strike and a walkout by teachers in West Dumbartonshire, it is a trend which is sure to continue."

  11. How does your job compare to a junior doctor's?

    DoctorsPA

    Junior doctors in England say the new contract being imposed on them by the government will lead to a big drop in their salaries - although the government denies this.

    But how does the pay for junior doctors compare with other jobs?

    Basic salary for junior doctors starts at about £23,000 but increases in the second year to about £28,000 (Pay for doctors - NHS Careers). For a doctor in specialist training, the basic salary is between £30,000 and £47,000.

    Junior doctors get more for working extra and anti-social hours (currently classified as outside 07:00 to 19:00 Monday to Friday) on top of the basic salary, which boosts their income.

    According to figures from the NHS Employers Organisation, the average total salary for a doctor in training is around £37,000.

    Read more from the BBC's Helen Briggs here - she's looked in detail at the pay, perks and typical hours of a junior doctor.

  12. 'Tomorrow will be more difficult' - NHS England boss

    Hospital

    Dr Anne Rainsberry, who is national incident director for NHS England, says the impact of the action has so far been "broadly in line with what we were expecting".

    However, "tomorrow is likely to be more difficult and we have made sure we have planned for this", she adds. 

    "Patients are at the heart of the NHS and we can only apologise to the thousands of people facing disruption and uncertainty as a result of this ongoing action. 

    "Patient safety is always our absolute priority and staff across the country will be doing their utmost to make sure patients can continue to access urgent and emergency services."

  13. Consultants take role of doctors during strike

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  14. 46% of junior doctors reported for duty - NHS England

    NHS England says trusts are reporting that 46% of junior doctors have reported for duty on the day shift. 

    That's out of a possible 26,000 working on a typical day.  

    Combining junior doctors, other doctors and consultants, the data shows 72% of the total trust medical workforce is at work today, it says. 

    Earlier this week, trusts said they expected 2,061 inpatients and 3,052 day cases would be cancelled over the course of the two-day strike.

  15. 'You step across a line when you impose a contract' - former head of NHS Employers

    More than 5,000 operations and procedures have been cancelled because of the two-day junior doctors' walk out. 

    Sian Thomas, the former director of NHS Employers, said negotiators should always try to avoid imposing a contract when involved in pay talks:

    It would never be the sort of desired outcome, because you step across a line as soon as you do this. It's always high risk and you basically put the outcome in the hands of a legal process potentially, because the risks associated with imposing a contract on morale are always very very high and it's crossing a line."

  16. Banners out at Wexham Park Hospital

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  17. Doctors stand up to 'bullying' government

    Leader of the National Health Action Party

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  18. Speech from open-top bus

    Actor and writer Jolyon Rubinstein has given a speech from the top of an open-air double-decker bus in support of the strike.

    Mr Rubinstein has previously starred in The Revolution Will be Televised on BBC Three.

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  19. Acas says it is 'ready to help'

    The independent conciliation body - Acas - has said it will help if junior doctors and the government want to use the service to try to resolve the dispute. 

    An Acas spokesman said: "We're ready to help if the sides involved in the junior doctors' dispute wish to use our services again."

  20. Action is 'desperate and irresponsible' - Department of Health

    Jeremy Hunt has not given any interviews to the media so far today, but the Department of Health has put out a response to today's strike.

    A spokesperson said the "escalation of industrial action by the BMA is both desperate and irresponsible – and will inevitably put patients in harm’s way". 

    If the BMA had agreed to negotiate on Saturday pay, as they promised to do through Acas in November, we’d have a negotiated agreement by now – instead, we had no choice but to proceed with proposals recommended and supported by NHS leaders."

    The DoH has also issued the following advice to patients in England:

    • If you have a planned operation, procedure or outpatient appointment on these days your hospital will contact you if it needs to be rearranged
    • GP practices will be open and working as normal
    • If your condition is serious or life-threatening call 999 or go to A&E
    • If you need medical help but it’s not serious or life-threatening please contact your GP, visit your local pharmacist, call 111 or consult www.nhs.uk