Junior doctors told to charge consultant rates to work during strikes

Junior doctors are striking for better pay
Junior doctors are to start a five-day walkout on Saturday after pay talks broke down

The British Medical Association (BMA) told junior doctors to charge consultants’ rates to work during strikes, a leaked letter has revealed.

Correspondence between NHS England and the BMA shows health officials expressed concern about the vast sums being sought by any doctor required to work during strike action on safety grounds.

Senior managers had already expressed outrage about the “eye-watering” rates of up to £269 an hour being sought by hospital consultants covering shifts for junior doctors.

But the union demanded the same rates be paid to junior doctors who work during strikes. It meant pay of more than £2,000 for an eight-hour shift. A junior doctor’s basic starting salary of £32,300 equates to around £150 a day.

It comes as tens of thousands of junior doctors are set to embark on a five-day strike, the tenth round of walkouts, after talks with the Health Secretary broke down.

During the last strikes in January – the longest in NHS history – NHS trusts made 40 requests for mitigation to be granted allowing junior doctors to cross picket lines and return to work to protect patient safety. Just two were granted.

The letter from NHS England officials, sent last month and seen by this newspaper, reveals that even in such negotiations, the BMA was demanding premium rates for any junior doctor who did work.

In the letter, Dame Cally Palmer, NHS England’s national cancer director, and Prof Peter Johnson, the clinical director for cancer, also warn Prof Phil Banfield, the chairman of the BMA’s council, that cancer patients are suffering “significant disruption” as a result of strikes, with those requiring surgery the most affected.

It warns that during junior doctors strikes there have been 7,329 fewer cancer operations, with a 27 per cent reduction in activity.

It continues: “We do not share the BMA’s view that organisations offering to pay junior doctors at the ‘rate card’ of up to £269 per hour is either a reliable basis on which to plan, or a fair and equitable use of NHS resources.”

‘Difficult to stomach’

In an interview with The Telegraph, Victoria Atkins, the Health Secretary, raised concerns about the risks to the public as junior doctors start a five-day strike on Saturday.

By the time the latest round of walkouts are completed, junior doctors will have been on strike for one in eight days of this year.

Ms Atkins said it was “very difficult to stomach” scenes of junior doctors singing on picket lines, while patients were suffering harm and distressing delays.

More than 1.4 million NHS operations and appointments have now been cancelled as a result of health service strikes.

Earlier this week, The Telegraph revealed that more than 7,000 cancer operations, including time-sensitive procedures, have been delayed as a result of junior doctors’ strikes.

The latest round of industrial action will end at 23.59 on Wednesday Feb 28, when the doctors’ union’s six-month mandate for strike action comes to an end.

The BMA is balloting members to extend its mandate for a further six months, having secured it twice in the past year with a substantial majority.

Junior doctors are demanding a pay rise of 35 per cent, which they say is required to restore pay to previous levels in real terms, but that they would accept it over several years.

They have already received an average pay rise of 8.8 per cent for the current year, with the most junior earning 10.3 per cent extra.

Delays in cancer care

Talks between the Government and the doctors’ union broke down again earlier this month after the BMA announced the latest strikes.

Last month, consultants, who are also in dispute with the Government over pay, narrowly rejected an offer that would have seen their salaries rise by as much as £20,000 per year.

Prof Banfield said: “The Health Secretary is right to be concerned about patients coming to harm and the delays in caring for cancer patients occurring each and every day. Cancer targets have been missed each year since 2015, as doctors face, and try to manage with too few staff, and not enough high dependency and intensive care beds for patients.

“Our members tell us that they are asked to prioritise more of the less poorly patients in order to make waiting lists look better; there is no slack in the system, so patients are coming to harm and increased risk every day. Where extra staffing is needed – be it for gaps in the rota or to provide cover during a strike – then this is additional work, and it is entirely appropriate that this attracts either extra pay or time off in lieu.

“The derogation system – trusts requesting doctors to return to work during the strike period – exists to ensure that doctors can return to work in a critical emergency. It is a misuse of that system for the NHS to seek derogation simply to avoid paying market rates for extra-contractual medical care.

“It is the Government’s choice to perpetuate the increasing cost of strikes, which is expected to rise to £3 billion, rather than come up with a credible offer to resolve the disputes and retain the staff that the service so desperately needs.”