Zoe Conway & Rob England
BBC News

Trade unions talk about ‘a decade of lost pay'. They argue that for years public sector wages have failed to keep up with inflation or the price of things. But is that accurate?

The BBC has analysed Office for National Statistics’ data , externalon earnings for different professions. It shows that some public sector workers salaries have done better at keeping up with inflation than others.

Secondary school teachers pay has not kept up: they earn on average £41,000, which is £4,500 behind where it would be had it increased with inflation. However, it’s above the £33,000 wage of an average full-time employee in the UK.

Our analysis also shows that the salary of an average full-time paramedic has grown more than inflation, yet ambulance drivers and emergency medical technicians have been some of the hardest hit. They earned £27,515 as of 2022, which was £1,561 less than what their pay would have been had risen with inflation.

The wages of the most junior civil servants – who might work in call centres or job centres - have kept up with prices. They earn on average £27,700. That’s nearly £1,300 better off than if their salary had just been increased by inflation over the past 10 years.

Image source, Getty Images

Earlier we heard from Professor Banfield, chair of the British Medical Association, telling the Today programme on Radio 4 about the sacrifices junior doctors make every day.

"We have the worst crisis in the NHS that I have ever known and it's seeing junior doctors leave in their droves," he told PA, from a picket line outside Birmingham's Queen Elizabeth Hospital this lunchtime.

Prof Banfield puts the blame squarely on the government's "refusal" to listen, saying doctors "feel they have been driven" to take industrial action.

"No one wants to strike but strike action has to be effective."

He added: "What is going on, day in, day out, is that patients are dying.

"The Royal College of Emergency Medicine estimates that between 300 and 500 people are dying unnecessarily, because of the state of emergency departments across the UK, per week.

"That is an absolute national scandal."

Image source, PA Media

"The way to resolve strikes is to get around the table - and to negotiate and compromise and come to a settlement," said Labour leader Sir Keir Starmer during a visit to a fuel cell manufacturer in Surrey this morning.

"That's what the Government needs to do."

Sir Keir said many people would be "really anxious" at the onset of three days of strike action.

"They know there isn't full emergency cover, they know that operations are now going to be cancelled, including in serious areas like cancer.

"The anxiety this will put upon people who rely on the NHS is huge."

Gem O'Reilly
BBC News

Junior doctors across the country have been sending us photos from the picket lines. Let's have a look at some of them, from the North West to East Sussex.

Image source, Doctor handout

Image source, Doctor handout

Image source, Doctor handout

Image source, Doctor handout

Gem O'Reilly
BBC News

Dr James Collins, an anaesthetist from Eastbourne has sent us his view from the picket line in East Sussex.

Hugh Pym
Health editor

Dr Vivek Trivedi, co-chair of the BMA junior doctors’ committee, is on a picket line outside Newcastle’s Royal Victoria Infirmary.

He's been asked why the BMA rejected the government’s offer of pay talks.

“They Imposed pre-conditions which would have kicked the can down the road," he said.

"They insisted they would only talk about a one-off payment for this year and that we had to cancel strikes."

"We want talks in a credible way, including on the principle of restoration of lost earnings because of inflation”.

A quick look back to the Today programme on Radio 4 now and more from NHS England's medical director Sir Stephen Powis. He appeared with the chief executive of Ipswich and Colchester Hospitals, Nick Hulme

Hulme said hospitals would suffer significant disruptions over the next 72 hours, and beyond, "particularly outpatients.

"Planning over the next few days will be done on an-hour-by-hour basis", he added.

Sir Stephen says the disruption caused by this strike "could be the most severe in the NHS' history" for two reasons: how many junior doctors make up the workforce and because it's going on for three days.

A resolve is needed as soon as possible, he told the BBC.

To get a deal over the line, Hulme says three things must be achieved:

1. A quick resolve, to minimise disruption
2. A deal that's fair for doctors and clinical staff
3. A plan that's funded outside existing budgets

All morning we've been asking if you've been taking part in the strikes as well as hearing about how they are affecting you. This person got in touch to tell us about a delay in getting treatment.

“They told me the person down to do my surgery is a consultant who is needed to provide cover for the emergency admissions and critical care in the absence of the junior doctors.

“When they initially contacted me on Friday they couldn't offer another date. But in actual fact they called back in two hours and I have a new appointment on 24 March, so it’s only delayed by nine days.

“It’s bad enough for people with non life-threatening surgery to have their hip or knee replacements cancelled.

“But when it impacts people like myself and others who may be down for surgery relating to life-threatening conditions, then I would say it’s morally wrong for the junior doctors to effectively be putting patient lives at risk with this widespread action.

“But I am grateful that the consultant was able to reschedule the appointment without too much delay.”

Often during, or in the lead up to, NHS strikes, there are concerns around potentially life-saving appointments such as cancer treatment.

Professor Sir Stephen Powis, the medical director of NHS England, suggests it's likely that cancer care could be affected during this 72-hour action.

The NHS is doing "everything we can to ensure that urgent cancer procedures go ahead but, unfortunately, even some of those may be affected this week, such is the extent of the disruption that we're likely to see," he told Times Radio.

"If that does occur, we will reschedule people as quickly as possible."

Consultants are expected to provide some cover during strikes, but Prof Powis admits it's "going to be a hard three days and it's going to be quite challenging".

Nick Triggle
Health Correspondent

Ministers made a last-minute attempt to get the junior doctor strike called off.

The government in England offered the British Medical Association the chance of formal pay talks to discuss both this year 2022-23 and 2023-24, which starts in April. But made it clear this strike must be called off.

The offer was made late on Friday night and rejected by the BMA on Saturday.

The BMA said it could not accept the pre-conditions as well as the fact the government was not willing to discuss what had happened to pay since 2008, so it's asking for a 35% rise to make up for cuts in pay once inflation is taken into account over the last 15 years.

Government sources say the offer is the same one that got the health unions representing other staff such as nurses, physios and ambulance workers around the table last week.

Those talks have centred on whether the government will increase its 3.5% pay rise offer for next year, while making a bonus payment to top up 2022-23 pay.

Meetings are continuing this week with those unions.

Speaking from a picket line in Oxford, Dr Matt Bilton, who's in his third year of work after leaving medical medical school, gives a snapshot of the roles a junior doctor might cover.

He says it could be someone who is straight out of medical school, or a medic with 10 or 11 years' experience.

The term "junior doctor" can cover a brain surgeon, someone working in emergency medicine, or doctors looking after a whole department at night.

Are you taking part in strike action? Have you had an appointment cancelled or delayed due to the strikes? Email haveyoursay@bbc.co.uk.

Please include a contact number if you are willing to speak to a BBC journalist. You can also get in touch in the following ways:

• WhatsApp: +44 7756 165803, external
• Tweet:@BBC_HaveYourSay, external
• Upload pictures or video
• Please read our terms & conditions and privacy policy

Nick Triggle
Health Correspondent

Image source, PA

The British Medical Association believes junior doctors are under-paid, saying they get £14 an hour.

That is the amount they get in basic pay during the first year after finishing university – less than 10% of junior doctors are at this stage.

It works out at £29,000 a year. But the average first year junior doctor gets around 30% more in extra payments for things like working unsociable hours.

When they move into year two, their basic pay goes up to the equivalent to £16.30 an hour. Again, 30% more will be paid in extra payments on average.

There are five core pay points in the junior doctor contract. By the end of training they will be earning around £28 an hour in basic – although this can take 10 years to get to.

Once those extra payments are taken into account, that works out at around £77,000 a year on average.

It is likely to be enough to put them in touching distance of the top 10% of earners.

Gem O'Reilly
BBC News

This morning, Health and Social Care Secretary Steve Barclay has said that he hugely values the hard work of junior doctors and that he wants unions to "come to the negotiating table" to enter formal talks., external

He also says that he urges doctors to cancel strikes which risk patient safety and may impact NHS backlog.

In a statement Barclay said: “It is incredibly disappointing the British Medical Association (BMA) has declined my offer to enter formal pay negotiations on the condition strikes are paused."

He also said that he wants to come to "a fair settlement" which recognises the crucial role of junior doctors and the wider economic pressures facing the UK.

He added that the government has been working with NHS England on contingency plans to "help protect patient safety during strikes".

Katharine Da Costa
Health reporter

“Under paid, overworked” - that’s the chant from a group of more than 50 junior doctors outside the John Radcliffe hospital in Oxford. They’re calling for pay to be restored back to 2008 levels which would require a 35% pay rise.

The British Medical Association says their pay has fallen by a quarter in real terms over the last 15 years. Junior doctors typically leave medical school with around £70,000-£90,000 worth of debt and train for many years, taking on a high level of responsibility before becoming a consultant.

Dr Matt Bilton’s in his third year of work after medical school and says junior doctors are asking to increase pay from £14 per hour to £19 per hour for those in their first year of work.

“We’re here in Oxford, one of the most expensive cities to rent in in the country and it’s not sufficient anymore", he says.

He’s personally considered leaving the NHS or moving abroad to find higher paid work elsewhere.

Image source, PA

The health secretary says the strike action by junior doctors will cause "huge disruption" and threaten patient safety.

Writing in The Telegraph, Steve Barclay calls the demand for a 35% pay increase by unions "eye-watering" and "simply unaffordable."

The British Medical Association has rejected the government offer for pay talks, citing "intolerable pre-conditions."

The deputy council chair of the British Medical Association, who is also a junior doctor says she is "really sorry" that the strike action is affecting people personally - but says the government is at fault.

"I have to put the blame at the door of (Health Secretary) Steve Barclay, who has known since August that we were planning to move towards strike action," Dr Emma Runswick told BBC Breakfast.

She denies that demands for a 35% pay rise mean junior doctors are out of touch.

"It's only large because that's how much we've lost."

Gem O'Reilly
BBC News

Junior doctor titles span across various years, from first qualifying until just before consultant level.

Dr Kiara Vincent has been working in the NHS for 10 years. She’s a registrar and still classed as a junior doctor.

I asked her to explain who is classed as a junior doctor and how many people this will impact.

Image source, Getty Images

Let's hear a bit more from Professor Banfield, the chair of the British Medical Association, who's been telling the Today programme on Radio 4 about the sacrifices junior doctors make.

He says they work unsociable hours, "often away from home", and can be responsible for up to 400 patients at a time on shifts. "They are the first point of call in an emergency" he says, adding: "There's nothing junior about junior doctors."

As we reported earlier, the term junior doctors covers everyone who has just graduated from medical school through to those with years of experience on the front line.

Prof Banfield suggests the weight of their responsibility means they should be paid better. Challenged on how the strike will affect patients, he adds that "it's in the government's court to sort this out".

We've just been hearing from Prof Philip Banfield, chair of the BMA doctor's union, who told Radio 4's Today programme that today's strike action has been caused by a series of "sub-inflation pay rises".

He says this means doctors are "getting about a third less than they would've been in 2008", affecting their ability to buy houses or provide childcare.

Junior doctors qualify "with about £100,000 worth of debt and then earn about £14 an hour," he tells presenter Justin Webb.

Describing the situation as "ridiculous", Prof Banfield says without change, doctors will continue to "vote with their feet and move abroad" where they can earn more money and feel they get a better quality of life.