Summary

  • Thousands of junior doctors in England have started a three-day strike over pay and conditions

  • Hospitals have cancelled appointments in advance, but NHS managers report A&E units are busy as senior staff cover for striking doctors

  • Junior doctors are asking for a 35% pay rise and argue their pay has been cut by 26% since 2008 once inflation is taken into account

  • But the Health Secretary Steve Barclay says the union's demands are "completely unaffordable"

  • It begins a week of walkouts, with one of the the biggest days of industrial action for years planned for Budget day on Wednesday

  • Junior doctors make up more than 40% of the medical workforce, the term covers everyone who has just graduated to those who have years of frontline experience

  1. Keep up to date on BBC Newspublished at 16:58 Greenwich Mean Time 13 March 2023

    That's a wrap from us and our live coverage. Thanks for joining us and for sending in your own experiences and concerns to the Live team here at BBC News. This page was written by Gem O'Reilly, Krystyna Gajda, Victoria Lindrea and Sam Hancock and was edited by Jamie Whitehead and Rob Corp.

    You can keep up to date with the latest news and analysis during the 72-hour strike at bbc.co.uk/health

    There's more live coverage to come on the BBC News website this evening as we bring you a joint press conference by US President Joe Biden, UK Prime Minister Rishi Sunak and Australian PM Anthony Albanese where we think we will get more details about a pact to supply Australia with nuclear-powered submarines. That's expected at around 8pm tonight.

  2. Thanks for joining uspublished at 16:53 Greenwich Mean Time 13 March 2023

    Gem O'Reilly
    BBC News

    Today has seen thousands of junior doctors take to picket lines across England at the start of a 72-hour strike over pay, working conditions and the retention of NHS staff.

    We've heard from doctors about why they are taking action, as well as patients affected by appointments being cancelled and managers attempting to mitigate the impact on hospitals.

    The BMA is asking for a 35% pay rise after years of inflation has meant that junior doctor wages have been cut by 26% since 2008.

    But Health Secretary Steve Barclay says that whilst he values their work, he wants to find a fair settlement that recognises the wider economic pressures facing the UK.

    More strikes are planned this week by workers in other sectors - including the final day of the junior doctors' action on Wednesday when teachers in England, some civil servants and London Underground staff also walk out.

    You can keep across the rest of our coverage this week on BBC News.

  3. ‘Enough is enough’published at 16:37 Greenwich Mean Time 13 March 2023

    Gem O'Reilly
    Live reporter

    Dr James Collins is an anaesthetic registrar working in the south-east of England and this is his sixth year as a doctor. I asked him about what the strikes mean to him.

    “What this record ballot highlights is the strength of feeling among junior doctors that enough is enough," he tells me. "It reflects the feeling that we aren’t valued as much as we should be at the moment."

    He says there's an "unprecedented staffing recruitment and retention crisis" in the NHS - and that, ultimately, the starting salary paid to the most-junior doctors of £14 an hour isn't enough "for someone who has to deal with life and death situations day in, day out".

    Other countries across the world pay doctors more on average than the UK, such as Australia, which James tells me has an active campaign to poach the UK's doctors because they know they can offer better.

    “This is about treating our staff better and realising our value is more than £14 an hour," he says.

    Dr James CollinsImage source, Dr James Collins
  4. 'All united together over one message'published at 16:25 Greenwich Mean Time 13 March 2023

    Gem O'Reilly
    Live reporter

    Media caption,

    Junior doctor strikes: 'All united together over one message'

    We heard earlier from Mavi Capanna, a junior doctor working in psychiatry in London, about what today means to her.

    She sent us footage from her picket line in Ealing, explaining what it feels like to be surrounded by her colleagues striking.

    She said: "It's just good to be all united together over one message."

  5. 'I love my job, I love the patients - but it's unsustainable'published at 16:16 Greenwich Mean Time 13 March 2023

    Dr Jessica CaseyImage source, Dr Jessica Casey

    Dr Jessica Casey is a junior doctor in Obstetrics and Gynaecology at West Suffolk Hospital with 11 years' experience.

    She says that she’s taking part in the strike for two main reasons – intense pressure of work as well as the rising cost of living.

    She mentions one colleague who is unable to get a mortgage and has to rent, and says that two other colleagues have recently left the NHS to move to Canada.

    "I am striking today rather than delivering babies because my colleague is leaving to go abroad for better pay and conditions".

    "I love my job, I love the patients, I love the NHS but my rising mortgage costs, childcare costs and bills are making this unsustainable”.

  6. Concerns over longer wait times for patientspublished at 16:00 Greenwich Mean Time 13 March 2023

    A major concern about this strike action is the safety of patients, particularly those who've had procedures rescheduled.

    Rachel Power, who's chief executive of the Patient's Association, says she believes the NHS is at its lowest point in years, potentially its history.

    She says she wrote to Health Secretary Steve Barclay earlier this year to tell him he needed to "acknowledge the crisis that is in the NHS right now".

    A recent Patient's Association survey revealed the impact of waiting for treatment, Power says, outlining the detrimental effect it had on people's mental health and feelings of loneliness and isolation.

    "With seven million on the elective list at the moment, there is a concern that the knock on effect will [lead to] patients waiting for longer," she adds.

    Quote Message

    We call on the government in the union to get back around the table and stay there and find solution to this."

  7. Both sides must get down to talks - NHS Confederationpublished at 15:44 Greenwich Mean Time 13 March 2023

    More now from Matthew Taylor now, who's head of the NHS Confederation - an umbrella group for healthcare providers in England.

    He today called on both the British Medical Association (BMA) - the main doctors' union - and the government "to get down to talks as soon as possible".

    There's a need for each party to be "creative about what it is we can do in relation to current pay," he tells the PA news agency.

    Doctors strike outside a hospital in LondonImage source, Getty Images

    In a separate interview, with Radio 4's The World at One, he warns that the "overall impact" of this 72-hour junior doctors' strike is likely to be worse than the impact of last year's NHS strikes, which saw nurses and ambulance workers stage walkouts.

    It's important "to avoid this becoming something that happens on a regular basis", he says, amid increasingly more frequent strike action - not just in the NHS but across several industries including transport and schools.

  8. Junior doctors demand politicians' attention in Whitehallpublished at 15:31 Greenwich Mean Time 13 March 2023

    Yetunde Yusuf
    Reporting from central London

    Striking doctors gather in Whitehall

    Hundreds of junior doctors are congregating at the heart of government in central London this afternoon, turning up from picket lines all over the country.

    One has a placard showing a map of Australia with the words: ‘I’ll send you a postcard’, reiterating the claim that many junior doctors are leaving the profession for better paid jobs abroad.

    The British Medical Association believes there will be around 3,000 people here by the end of the day.

    They’re making a lot of noise, trying to get the attention of politicians in the buildings behind them.

  9. Leaving the medical profession for a job at Aldipublished at 15:19 Greenwich Mean Time 13 March 2023

    Simon Dedman
    Reporting from Harlow

    Around a dozen doctors were on the picket line at The Princess Alexandra in Harlow when I was there this morning.

    Dr Simon Pullen, an anaesthetist, says some of his colleagues have quit the NHS to take up positions overseas - something he has considered himself.

    Other colleagues have changed profession entirely - for industries with fairer pay and less stress - with one fellow doctor becoming a store manager for Aldi, he tells me from the picket line.

    "A lot of people are struggling with the high intensity of work they have to do,” says Dr Pullen, adding colleagues often go home in tears.

  10. 'It’s really demoralising’published at 15:05 Greenwich Mean Time 13 March 2023

    Gem O'Reilly
    Live reporter

    I’ve been chatting to junior doctors over the last few days who work across the UK about what today means to them.

    Dr Kiara Vincent works in the Midlands in emergency medicine as a registrar. She said: “We’re all in the same situation, we’re finding it difficult to carry on in the state that we’re in”.

    I asked Kiara what it feels like at the moment in her role and about working conditions. She explained: “It’s really demoralising. We’re trained to a high level to provide a high standard of care and at the moment we go to work knowing, through things completely out of our control, we can’t give that level of care to patients.

    "I come to work and can see that there’s a patient waiting eight hours to see a doctor. There are some days where I finish my shift, come back the next day and then I see the same patient still sat waiting in A&E the next day.

    That’s horrendous coming to work knowing that you can’t help the people that you care for.”

    Kiara told me that she doesn’t want to go on strike and she’s sorry it’s come to this, but ultimately she just “wants the government to listen”.

  11. What impact will the strikes have?published at 14:53 Greenwich Mean Time 13 March 2023

    Nick Triggle
    Health Correspondent

    Junior doctors represent around 45% of the medical workforce in England. They include those fresh out of university through to doctors with 10 years of experience, so the strike action will have a major impact.

    About two thirds of the junior doctor workforce are BMA members. They are walking out of both emergency and planned care as well as general practice where some junior doctors will be working as GP trainees.

    It means NHS bosses are drafting in consultants and other senior doctors to cover them in emergency care, such as A&E and intensive care. This will lead to the postponing of lots of planned treatment, such as knee and hip replacements.

    How much is unclear as yet. Walkouts by nurses over the winter caused some trusts to cancel 20% of routine treatments. It is likely the impact of the junior doctor walkout will be greater.

    What is more this is affecting every part of England – the Royal College of Nursing only ever had a mandate for half of services.

  12. Doctors threaten more strikes if no unconditional talks offeredpublished at 14:40 Greenwich Mean Time 13 March 2023

    Rob Sissons
    Reporting from Leicester

    Tal, on the picket line at Leicester infirmary
    Image caption,

    Tal believes junior doctors have been left with no choice but to strike

    The picket line at Leicester infirmary, 13 March 2023
    Image caption,

    The picket line at Leicester infirmary

    In Leicester, striking junior doctors say they're prepared to mount more action if this 72-hour walkout doesn't lead to talks, without preconditions.

    There's been a picket line at the Leicester Royal Infirmary since 7am. Only union representatives are talking to the media, as part of a strategy to keep the campaign for better pay and conditions focused on key messages.

    BMA rep Dr Tal Ellenbogen 28 accuses the government of undervaluing junior doctors.

    "None of us want to be striking, but we have been left with no choice," he says, adding it's in "patients' interest as well that we get our pay restoration," he continues.

    Asked if the strike could harm patients, he adds:" Consultants are going to be staffing emergency services completely - and I have full confidence in their ability to do so."

    Leicester's hospitals, in common with others, have negotiated premium extra payments to consultants while they cover for striking junior doctors.

  13. Junior doctors' strike: How we got herepublished at 14:27 Greenwich Mean Time 13 March 2023

    Striking NHS junior doctors on the picket line outside the Maidstone Hospital in KentImage source, PA Media

    Just joining us? Here's what you need to know:

    • Thousands of junior doctors have walked out as part of three days of industrial action
    • Those on strike are asking for a 35% pay rise - a demand described by the union as “pay restoration”, following what it says is a 26% real-terms pay cut since 2008
    • Junior doctors make up about 40% of the NHS medical workforce and can encompass both new graduates and those with 10-years of experience
    • Health Secretary Steve Barclay says the union's demands are "completely unaffordable".
    • Barclay says he "hugely values" the work of junior doctors and wants them to negotiate a "fair settlement" - but no formal talks have taken place so far
    • The government offered pay talks last Friday, on the condition the strike was called off, but the BMA said it could not accept pre-conditions
    • NHS England boss Sir Stephen Powis says the 72-hour disruption caused by this strike "could be the most severe in the NHS' history"
    • Labour leader Sir Keir Starmer has called on the government to negotiate and compromise, to put an end to further strikes and patient anxiety
  14. A&E departments 'very busy' despite strike - NHS Confederationpublished at 14:15 Greenwich Mean Time 13 March 2023

    It appears hospitals in England remain very busy, despite the three-day strike by junior doctors which started today.

    Matthew Taylor, chief executive of the NHS Confederation, says in other strikes "the public have tended to use the health service less on those days" but today "that hasn't really happened".

    "The public are using the health service as they normally would, which means that some of our emergency pathways are very busy," he tells BBC Radio 4's The World at One programme.

    Taylor says, generally, the NHS is managing the situation "because we had weeks to plan" for it - but admits some managers only found out which of their employees were striking when they didn't turn up for work this morning.

    "Junior doctors are not required to inform their employers if they intend to strike," Taylor explains, saying additional operations were cancelled as a result.

  15. 'A thank you from the government isn’t enough'published at 14:05 Greenwich Mean Time 13 March 2023

    Sharon Barbour
    Reporting from Newcastle

    She has helped saved hundreds of lives, attended more than 100 cardiac arrest calls, and works around 70 hours a week.

    Dr Amanda Baird earns £23 an hour and started working towards becoming a doctor at the age of 14.

    Now 27, she has completed five years at medical school and nearly five years as a doctor on the front line.

    She’s worked through Covid. She’s worked in Intensive care, and is now working towards becoming a consultant in Accident and Emergency.

    This is why she joined around 100 others outside Newcastle’s Royal Victoria Infirmary today, leaving behind her patients and senior doctors – consultants - to do the work of their striking juniors.

    Dr Amanda Baird

    The hardest part of Dr Baird’s job is when she and her colleagues can’t save the life of critically ill patients, especially when they are children. Working all through Covid too was tough.

    But she says the best part is when you bring a life back and the patient says “thank you” – it can “save our soul”.

    The government says the doctors' pay demand is unaffordable but could more recognition for the work they do help?

    “No” says Dr Baird, “a thank you from government isn’t enough.”

  16. Strikes incredibly disappointing, says health secretarypublished at 13:53 Greenwich Mean Time 13 March 2023

    Earlier today, Health Secretary Steve Barclay issued a statement ahead of the strike starting.

    He said is was "incredibly disappointing" the British Medical Association has declined his offer to enter formal pay negotiations "on the condition strikes are paused".

    Barclay added that he "hugely" values the work of junior doctors, and urged them to come to the negotiating table and cancel their action.

    "I want to find a fair settlement which recognises the crucial role of junior doctors and the wider economic pressures facing the UK," he said.

    Barclay goes on to say he has been working closely with NHS England on contingency plans to protect patient safety during strikes - prioritising emergency, urgent and critical care - but "there will inevitably be some disruption for patients".

    In earlier comments, the BMA said there have not been "any credible negotiations" in the dispute, leaving them with "no choice but to strike".

    Steve BarclayImage source, Reuters
  17. Postpublished at 13:40 Greenwich Mean Time 13 March 2023

    Graphic: Junior doctors: Who are they?

    With all this talk about junior doctors, you may well be wondering what their job entails - how long they train and how much they can expect to earn in the early years of their career, for example.

    The above graphic gives you all the information you need.

    Thousands of junior doctors in England are staging a three-day strike over pay and conditions, calling for a 35% pay increase.

    To see how this compares to other professions, read this.

  18. ‘There’s a lot of hidden costs to being a doctor’published at 13:18 Greenwich Mean Time 13 March 2023

    Gem O'Reilly
    BBC News

    I've been talking to Dr Mavi Capanna, a psychiatrist based in London, and asking her why junior doctors specifically need better pay, when many professions have seen an erosion of pay due to inflation and the cost of living.

    She says there are a lot of "hidden costs" in medicine, which people don’t realise, such as having to "to fund a lot of our own training [sic]".

    "We have to pay for our registration fees and every exam we take, to be able to progress our careers," she tells me.

    "These additional costs come on top of a decline in pay and a rise in inflation are what’s making that figure come up."

  19. Good afternoonpublished at 13:13 Greenwich Mean Time 13 March 2023

    Rob Corp
    Live reporter

    We have a change of personnel on this live page, as my colleague Jamie has been hard at it since first thing this morning, so I'll be guiding things for the rest of the day.

    Just to recap then - thousands of junior doctors in England have started a 72-hour strike in support of their claim for a 35% pay rise, which they argue is necessary to make up for a 26% real-terms pay cut.

    Health Secretary Steve Barclay says he "hugely values" the work of junior doctors and wants them to negotiate a "fair settlement".

    We've also heard from patients whose operations have been cancelled because of the strike - and we're keen to know what you think so do get in touch by sending us an email.

  20. Patient 'in agony' after appointment postponedpublished at 12:56 Greenwich Mean Time 13 March 2023

    Maxine LittleImage source, Family handout

    Maxine Little, 80, from Fareham, has been telling the BBC she feels "so frustrated" that her knee operation consultation was postponed by six months due to the junior doctor strikes.

    The appointment, due to take place today at The Queen Alexandra Hospital in Portsmouth, will now happen on 6 September.

    She says she is “in agony” and wants nothing more than to regain her mobility.

    "Junior doctors are asking for 35%, I just think it’s incredible. The country can’t afford it".

    "They said their aim is to see patients out of pain. They’re standing there waving their banners, but they don’t see the pain on our faces".