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| Junior doctors' strike 'unjustifiable in struggling hospitals' | Junior doctors' strike 'unjustifiable in struggling hospitals' |
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| Junior doctors in hospitals that will be hit hard by next week’s all-out strikes should not take part in case patients end up suffering harm, the medical profession’s regulator has said. | |
| In updated guidance for trainee medics before the total withdrawal of junior doctor cover in all areas of medical treatment, the General Medical Council said that doing so was unjustified in hospitals that would struggle to ensure safe care. | In updated guidance for trainee medics before the total withdrawal of junior doctor cover in all areas of medical treatment, the General Medical Council said that doing so was unjustified in hospitals that would struggle to ensure safe care. |
| The GMC’s move is designed to prompt England’s 45,000 junior doctors – everyone below the level of consultants – to think twice about walking out on 26 and 27 April. They will be the first all-out stoppages in the NHS’s 68-year history and are an escalation of the British Medical Association’s industrial action against the contract Jeremy Hunt intends to impose from August. Unlike previous strikes, the stoppage will affect A&E, maternity and intensive care departments and emergency surgery. | The GMC’s move is designed to prompt England’s 45,000 junior doctors – everyone below the level of consultants – to think twice about walking out on 26 and 27 April. They will be the first all-out stoppages in the NHS’s 68-year history and are an escalation of the British Medical Association’s industrial action against the contract Jeremy Hunt intends to impose from August. Unlike previous strikes, the stoppage will affect A&E, maternity and intensive care departments and emergency surgery. |
| The guidance states: “The GMC cannot second guess the situation facing each doctor in training in England – that must be a matter for individual judgment. But given the scale and repeated nature of what is proposed, we believe that, despite everyone’s best efforts, some hospitals may struggle to cope. | The guidance states: “The GMC cannot second guess the situation facing each doctor in training in England – that must be a matter for individual judgment. But given the scale and repeated nature of what is proposed, we believe that, despite everyone’s best efforts, some hospitals may struggle to cope. |
| “In these cases where local circumstances are particularly acute, the right option may be not to take action that results in the withdrawal of services for patients.” | “In these cases where local circumstances are particularly acute, the right option may be not to take action that results in the withdrawal of services for patients.” |
| The guidance, which toughens the council’s previous stance on doctors’ responsibilities during strikes, says: “We ask every doctor contemplating further and escalated industrial action to pause and consider again the possible implications for patients, not only in terms of the immediate action but also in terms of the cumulative impact on patients and the additional risk posed by the withdrawal of emergency cover.” | The guidance, which toughens the council’s previous stance on doctors’ responsibilities during strikes, says: “We ask every doctor contemplating further and escalated industrial action to pause and consider again the possible implications for patients, not only in terms of the immediate action but also in terms of the cumulative impact on patients and the additional risk posed by the withdrawal of emergency cover.” |
| It said striking doctors should return to work immediately if patients became “at risk” because consultants could not cope with the workload. “Where contingency plans are overwhelmed, it is vital that doctors taking action can be contacted and are available to help.” | It said striking doctors should return to work immediately if patients became “at risk” because consultants could not cope with the workload. “Where contingency plans are overwhelmed, it is vital that doctors taking action can be contacted and are available to help.” |
| Related: Withdrawing emergency cover crosses a line – it will damage trust in doctors | Related: Withdrawing emergency cover crosses a line – it will damage trust in doctors |
| Several leading doctors – including Prof Sir Bruce Keogh, the former health minister Ara Darzi and the chief medical officer, Prof Dame Sally Davies – have already called on junior doctors to think hard about the potential for patients to be harmed. | Several leading doctors – including Prof Sir Bruce Keogh, the former health minister Ara Darzi and the chief medical officer, Prof Dame Sally Davies – have already called on junior doctors to think hard about the potential for patients to be harmed. |
| The BMA has made a last-ditch attempt to prevent the walkouts by offering to call them off if Hunt drops his threat to impose the contract and resume talks over the detail of their terms and conditions. | The BMA has made a last-ditch attempt to prevent the walkouts by offering to call them off if Hunt drops his threat to impose the contract and resume talks over the detail of their terms and conditions. |
| Junior doctors gave the updated guidance a mixed reception. | Junior doctors gave the updated guidance a mixed reception. |
| Dr Rachel Clarke, a prominent junior doctor, said: “While the GMC is quite right to highlight concerns about the ‘cumulative impact’ of strikes on patients, particularly in areas where hospitals are understaffed, they have failed to acknowledge the deeply corrosive impact of this contract on patient safety in the wider context. | Dr Rachel Clarke, a prominent junior doctor, said: “While the GMC is quite right to highlight concerns about the ‘cumulative impact’ of strikes on patients, particularly in areas where hospitals are understaffed, they have failed to acknowledge the deeply corrosive impact of this contract on patient safety in the wider context. |
| “In decimating the morale of junior doctors, in driving us away from the profession in our droves, imposition of this contract is a far greater long-term risk to patient safety than the industrial action we take with such heavy hearts.” | “In decimating the morale of junior doctors, in driving us away from the profession in our droves, imposition of this contract is a far greater long-term risk to patient safety than the industrial action we take with such heavy hearts.” |
| Dr Johann Malawana, chair of the BMA’s junior doctors committee, said patients would not come to harm. “While junior doctors understand and deeply regret the disruption caused to patients, they fundamentally believe that the contract the government is trying to impose is both unfair and will undermine the delivery of patient care in the long term,” he said. | |
| “The critical message for patients is that anyone who needs emergency care during the days of industrial action will get it. The difference is that it will be provided by senior doctors rather than junior doctors.” | |
| National Voices, which represents 160 health and social care charities, said patients in some hospital units providing life-or-death care would be at particular risk next week. | National Voices, which represents 160 health and social care charities, said patients in some hospital units providing life-or-death care would be at particular risk next week. |
| “The GMC has stated that some hospitals will struggle to cope. This is significant as it is the first official acknowledgement that patients could be put at increased risk by the all-out strike action,” the NV chief executive, Jeremy Taylor, said. | |
| “We agree with the GMC about these risks, though in fact they are likely to lie with particular units and services rather than whole organisations. | “We agree with the GMC about these risks, though in fact they are likely to lie with particular units and services rather than whole organisations. |
| “Doctors have a duty to do the best for patients, and they also have a right to strike. The GMC guidance is welcome for making it clear that these two things are inevitably in tension and that doctors must think carefully about the impact of their action on patients.” | “Doctors have a duty to do the best for patients, and they also have a right to strike. The GMC guidance is welcome for making it clear that these two things are inevitably in tension and that doctors must think carefully about the impact of their action on patients.” |