For the first time in the history of the National Health Service, thousands of junior doctors are staging an all-out strike in England in protest against the imposition of a new working contract by the government.

Never before have NHS doctors undertaken a full withdrawal of care, including emergency and intensive care cover, highlighting the strength of feeling over new conditions, which, they argue, are “bad for the future of patient care, the profession and the NHS as a whole”.

The impact of the next two days of strike action will be unprecedented, with over 110,000 outpatient appointments and over 12,500 operations cancelled.

“These two days of industrial action mark one of the lowest points in the wonderful history of the NHS,” said BMA junior doctors committee chair Johann Malawana. “We have made the Government a clear offer as to what it will take avert industrial action. We offered a simple choice - lift imposition and the strikes would be called off, but unfortunately the health secretary simply refuses to do that.”

Saturday pay

But in a letter to BMA council chair Mark Porter, Health Secretary Jeremy Hunt argued: “had the BMA not gone back on its word to negotiate on the principal outstanding issue - Saturday pay - we would have an agreed contract by now and imposition would have been avoided”.

The BMA is rejecting Hunt’s stance that the key bone of contention is Saturday pay, citing a number of “critical issues” concerning work-life balance, excessive working hours, improvements in training and crucially, workforce and funding implications for seven day services. 

“The proposed contract is deficient in failing to address these issues properly, hence our concerns for patient care, the long-term future of the NHS and the recruitment and retention of doctors,” Dr Porter said.

In a statement to parliament, Hunt noted that, over the course of this “pay dispute”, around 150,000 sick and vulnerable people have seen their care disrupted, “and the public will rightly question whether this is appropriate or proportionate action by professionals whose patients depend on them”.

Public backing

However, a new poll by Ipsos MORI for the BBC shows that the majority of the public still stands behind junior doctors, although support has dipped somewhat with the complete withdrawal of care. 

Of more than 800 adults surveyed, 57 percent said they are in favour of the all-out strike and 26 percent were opposed; the previous survey, undertaken just before the 48-hour action (excluding emergency care) in March, showed that 65 percent were in support of junior doctors.

The poll also found that the majority of those surveyed (54 percent) still blame the government for the current impasse, and last night the leaders of 13 royal colleges also urged prime minister David Cameron to end the ‘damaging’ stand-off. 

“In our view, as leaders of the medical profession, the ongoing impasse in the dispute between Government and junior doctors poses a significant threat to our whole healthcare system by demoralising a group of staff on whom the future of the NHS depends.”

“At this eleventh hour, we call upon you to intervene, bring both parties back to the negotiating table, end this damaging stand-off, and initiate an honest debate about the serious difficulties facing UK health services,” they wrote to the PM.