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Doctors strike over pensions shakeup – live coverage Doctors strike over pensions shakeup – live coverage
(40 minutes later)
12.48pm: How easy is it for junior doctors to take industrial action today, asks doctor and journalist Kate Adams.
Two days ago I spoke to a friend of mine who is a junior doctor in a hospital in the east of England. She said: "I can't strike because I'm covering acute inpatient care. Most junior doctors working in medicine have jobs where they are involved in caring for ill people so they can't strike. It's going to put pressure on your colleagues and means the person left on the ward is going to have twice as much to do."
I have just spoken to Dr Ben Molyneux, who said it is more tricky for junior doctors to take action. Ben said while there is a huge appetite to get involved in the industrial action, junior doctors are often in frontline jobs doing work that can not be delayed for patient safety reasons. Ben works in a paediatrics unit in east London that looks after sick children. The same applies to junior doctors working in A&E and those working for maternity services. He said that there is good camaraderie on the ground with doctors supporting their colleagues who may be struggling to cover today.
12.43pm: Nicola Sturgeon, the Scottish health secretary, says that 60% of GP practices in Scotland have been affected by today's action and more than 3,200 outpatient appointments have been cancelled, the BMA blog reports. Sturgeon said the action in Scotland was "unfortunate and unnecessary" but urged the BMA to remain involved in Scottish-level talks.
12.42pm: The BMA has accused the government of making "misleading" comments about doctors' pension reforms and of presenting "partial representations of the facts".
Health secretary Andrew Lansley's claims that taxpayers subsidise £4 out of every £5 of doctors' pensions is false, the union said. A spokesman said:
The NHS pension scheme does not work by building up a pension pot - staff working now pay for the pensions of NHS staff who are retired. The scheme currently brings in £2bn more than it pays out - this money goes back to the Treasury.
The health secretary's remarks that a more generous deal for doctors would mean a less fair deal for NHS staff overall were also misleading, the BMA said.
The spending envelope which the government says NHS pension entitlements must now be funded within is an entirely arbitrary amount, set with no regard to the actual funding position of the NHS scheme or the 2008 reforms.
Pitting one staff group against another to stay within this "envelope" is a completely false proposition. Doctors rightly pay more than lower paid workers and we are not seeking to change that.
12.36pm: At Wimbledon Village surgery in south-west London two of the three GPs on duty today are not BMA members - but all three have joined in the action, Denis Campbell reports.
"My colleagues are doing that because their pensions are being affected in the same way as me, even though they're not BMA members," explained Dr Paul Cundy, one of the three partner GPs at the surgery and the only BMA member amongst the trio. "We are all very, very angry about the changes that the government is making. Before the 2008 agreement [the overhaul of NHS pensions under labour] my personal pension contribution was 7% of my salary. After that it went up to 10.5% because we weren't paying our fair share, so doctors willingly opened their wallets to contribute on an appropriate basis. Lansley now wants to put my contributions up to 14.5% from next April. I don't know of any other group anywhere whose pension contributions have been forced to double in five years. This is deeply unfair."
Four or five of the surgery's six GPs are usually on duty on a weekday and between them see about 100 to 120 patients at routine appointments each day. One of the GPs is on holiday and another is providing medical support at the qualifying tournament for the Wimbledon tennis championships, which are held little more than a Roger Federer volley away, so only three were due in. In order to support the industrial action the surgery decided not to book any such consultations for today. They are typically people having regular check-ups for conditions such as diabetes, depression or high blood pressure. But the three GPs have been seeing patients who have rung up and said they felt their symptoms meant they needed to see a GP today - seven so far.
"One had a cough, a cancer patient had pain in their tummy, someone else had a swollen eye, another had an exacerbation of their asthma - though not an asthma attack - and a lady had abdominal pain and heavy periods. One had a condition that is too specific to mention, in case that identifies the patient, and the seventh came in to have a blood pressure device fitted because the control of their blood pressure was causing concern," said Cundy. Apart from that, he adds, "our doctors have got empty surgeries".
So is it all a bit unusual, to have so little custom? "It's lovely. So far it's been very relaxed. I take the fact that patients aren't ringing us as a form of support - that is, they know we're here and dealing with urgent stuff but they aren't bothering us unnecessarily."
Regardless of the success or otherwise of today's action, and irrespective of whether or not today prompts ministers to rethink what he sees as an unfair "special tax" on doctors, Cundy thinks the BMA should hold a second day of action to press their case. The BMA's ruling council will decide on that next Thursday at the union's annual general meeting in Bournemouth.
12.19pm: Nine out of 10 hospital doctors are working normally in London, 490 operations and 3,200 outpatient appointments have been rescheduled, and 83% of GPs' surgeries are offering a full service, Denis Campbell reports. That's according to figures just released by NHS London, which is the strategic health authority for London - the regional arm of the Department of Health, in effect.
Here's what an NHS London spokesman has just said in a press release:
Early figures indicate that more than 90% of all hospital doctors in London are working normally. Although members of BMA are taking industrial action today, all emergency and urgent care is continuing. This means that those doctors participating in the industrial action
will be attending their place of work.
Hospitals in the London area have had to reschedule around 490 operations. This represents around 10% of the total number of operations anticipated on the day. We also understand that around 3,200 outpatient appointments have been rescheduled. This represents just under 5% of appointments on the average working day.
83% of all GP practices in London are working normally today. The remaining 17% will be open but may be providing a reduced service by treating only urgent cases. Anyone with an appointment scheduled today should attend as planned unless they have been notified of a change. Where possible, arrangements are also in place for hospital doctors who are not taking industrial action to cover non-urgent appointments, if clinically appropriate. As with any other day, if you feel ill and require advice, please contact NHS Direct on 0845 4647. Health advice is also available at www.nhs.uk/nhsdirect.
To help doctors and nurses working in A&E care for the most seriously ill and injured patients quickly, we would urge Londoners not to call for an ambulance or go to A&E unless it is a real emergency. A&E and 999 services are for people with a life threatening or serious condition that needs immediate attention, such as a heart attack, a stroke, breathing problems, or a serious accident. For less urgent care, treatment will be available in local urgent care centres, walk-in centres and pharmacies.
12.11pm: Over on the Reality check blog, my colleagues Hilary Osborne and Jill Insley are asking: are doctors' pensions too generous? They sum up the dispute between doctors and the NHS like this:12.11pm: Over on the Reality check blog, my colleagues Hilary Osborne and Jill Insley are asking: are doctors' pensions too generous? They sum up the dispute between doctors and the NHS like this:
Doctors are on strike over changes to the NHS pension scheme which will mean an increase in contributions and longer working lives. The British Medical Association says the changes are unfair, because the scheme is in surplus and reforms in 2008 made it viable for years to come; the Department of Health says the last set of reforms did not allow for the cost of increased life-expectancy.Doctors are on strike over changes to the NHS pension scheme which will mean an increase in contributions and longer working lives. The British Medical Association says the changes are unfair, because the scheme is in surplus and reforms in 2008 made it viable for years to come; the Department of Health says the last set of reforms did not allow for the cost of increased life-expectancy.
They go on to explain the system in detail, and quote Laith Khalaf, pension expert with Hargreaves Lansdown, as saying you would need a pension pot of £1.5m to buy an index linked pension income equivalent to the sum doctors can expect to retire on at the age of 65.They go on to explain the system in detail, and quote Laith Khalaf, pension expert with Hargreaves Lansdown, as saying you would need a pension pot of £1.5m to buy an index linked pension income equivalent to the sum doctors can expect to retire on at the age of 65.
He adds that we should all be aiming to contribute 14.5% (9% plus tax relief for a higher rate taxpayer) of our pensionable earnings from the age of 25 if we want to achieve a good pension income in retirement. "If you asked me was I prepared to pay 14.5% of my salary to get a defined benefit pension like this, then I would be prepared to pay that. Quite frankly I would bite your hand off for it," he says.He adds that we should all be aiming to contribute 14.5% (9% plus tax relief for a higher rate taxpayer) of our pensionable earnings from the age of 25 if we want to achieve a good pension income in retirement. "If you asked me was I prepared to pay 14.5% of my salary to get a defined benefit pension like this, then I would be prepared to pay that. Quite frankly I would bite your hand off for it," he says.
After the proposed increases some doctors will be contributing 14.5% including tax relief, but the government is also contributing another 10% on their behalf, meaning they will benefit from "exceptional pensions".After the proposed increases some doctors will be contributing 14.5% including tax relief, but the government is also contributing another 10% on their behalf, meaning they will benefit from "exceptional pensions".
However he points out that the move to "career average" rather than "final salary" will have a much bigger effect on doctors compared to others in the NHS scheme. "Final salary schemes are scewed towards people who have high career progression and end up on very big salaries. From that point of view I understand why they have a problem with the move to career average as they have the most to lose."However he points out that the move to "career average" rather than "final salary" will have a much bigger effect on doctors compared to others in the NHS scheme. "Final salary schemes are scewed towards people who have high career progression and end up on very big salaries. From that point of view I understand why they have a problem with the move to career average as they have the most to lose."
11.52am: One of the contributors to our blog today is Kate Adams, who has been a doctor for 13 years, and a GP in Hackney, east London, for the past 12 years. She also works for the GP out of hours service in Tower Hamlets and is a joint clinical lead for urgent care (a commissioning role) in east London. Kate is also a journalist and is currently doing an MA in science journalism at City University. She writes:11.52am: One of the contributors to our blog today is Kate Adams, who has been a doctor for 13 years, and a GP in Hackney, east London, for the past 12 years. She also works for the GP out of hours service in Tower Hamlets and is a joint clinical lead for urgent care (a commissioning role) in east London. Kate is also a journalist and is currently doing an MA in science journalism at City University. She writes:
I spoke to Dr Alex Freeman at 10.30am. Alex is a GP in Southampton. She works part time for the Primary Care Trust and also works as locum. Alex is supporting the industrial action today by not working and is forfeiting a day's pay. Alex is aware of at least two surgeries taking action in Southampton.I spoke to Dr Alex Freeman at 10.30am. Alex is a GP in Southampton. She works part time for the Primary Care Trust and also works as locum. Alex is supporting the industrial action today by not working and is forfeiting a day's pay. Alex is aware of at least two surgeries taking action in Southampton.
"Everybody thinks this is about doctors wanting more money. It's not; it's about doctors having money stolen from them.""Everybody thinks this is about doctors wanting more money. It's not; it's about doctors having money stolen from them."
A lot of doctors feel strongly about this issue. There was a pension deal agreed four years ago and doctors agreed to put more money into the pension scheme to make it financially viable. In fact it is £2bn in surplus. The extra money now being paid by doctors is not going into the scheme but to the Treasury. This is an extra tax on doctors. Many doctors I know feel the government has been dishonest in saying that the pension scheme is not financially viable.A lot of doctors feel strongly about this issue. There was a pension deal agreed four years ago and doctors agreed to put more money into the pension scheme to make it financially viable. In fact it is £2bn in surplus. The extra money now being paid by doctors is not going into the scheme but to the Treasury. This is an extra tax on doctors. Many doctors I know feel the government has been dishonest in saying that the pension scheme is not financially viable.
Alex reports that so far surgeries are eerily quiet this morning. Mid-morning is usually the busiest time for surgeries. It may be that given the high level of media coverage of this dispute, despite reassurances that people with urgent health problems will be seen, patients are in fact keeping away.Alex reports that so far surgeries are eerily quiet this morning. Mid-morning is usually the busiest time for surgeries. It may be that given the high level of media coverage of this dispute, despite reassurances that people with urgent health problems will be seen, patients are in fact keeping away.
11.29am: Denis Campbell reports that one in three GP surgeries across the UK is affected to some extent by the doctors' day of action, according to the BMA.11.29am: Denis Campbell reports that one in three GP surgeries across the UK is affected to some extent by the doctors' day of action, according to the BMA.
The union has just released that figure, which is new, and it stresses is an estimate. But it believes it is accurate and is based on intelligence received from its industrial relations staff based in its regional offices in England, Scotland, Wales and Northern Ireland.The union has just released that figure, which is new, and it stresses is an estimate. But it believes it is accurate and is based on intelligence received from its industrial relations staff based in its regional offices in England, Scotland, Wales and Northern Ireland.
"Our estimate at the moment is that around one third of GP practices are taking action. They are affected to some degree," said a BMA spokesman. That doesn't mean that a third of surgeries are closed or that all the doctors in them are unavailable - far from it. "That could be one doctor at the practice taking action or potentially all the doctors there," added the BMA spokesman."Our estimate at the moment is that around one third of GP practices are taking action. They are affected to some degree," said a BMA spokesman. That doesn't mean that a third of surgeries are closed or that all the doctors in them are unavailable - far from it. "That could be one doctor at the practice taking action or potentially all the doctors there," added the BMA spokesman.
So what does these surgeries' involvement mean? "It means there's some action taking place there. That could be that routine appointments are being postponed and that patients who had pre-booked appointments have had them rearranged," he said. But any patient who feels their condition or symptoms mean they need to be seen will be seen.So what does these surgeries' involvement mean? "It means there's some action taking place there. That could be that routine appointments are being postponed and that patients who had pre-booked appointments have had them rearranged," he said. But any patient who feels their condition or symptoms mean they need to be seen will be seen.
There are some 10,159 GP practices across the UK. There are 8,316 in England, 1,002 in Scotland, 483 in Wales and 358 in Northern Ireland.There are some 10,159 GP practices across the UK. There are 8,316 in England, 1,002 in Scotland, 483 in Wales and 358 in Northern Ireland.
The union has already said that 80% of hospitals have postponed planned operations or outpatient clinics today because of the industrial action. This is their first assessment of the impact on GP services.The union has already said that 80% of hospitals have postponed planned operations or outpatient clinics today because of the industrial action. This is their first assessment of the impact on GP services.
11.16am: The Press Association has been speaking to patients at the Princes Park Health Centre in Eastbourne, east Sussex, where there was a normal service today. Linda Law, 58, from Pevensey, said:11.16am: The Press Association has been speaking to patients at the Princes Park Health Centre in Eastbourne, east Sussex, where there was a normal service today. Linda Law, 58, from Pevensey, said:
I had an injection and I was straight in, straight out. There were no queues in there at all. I wasn't worried because I had made an appointment so I didn't think there would be a problem ... Doctors work very hard. I think I would support them. They deserve it, and my doctor is fantastic, but if it really affected me I possibly wouldn't.I had an injection and I was straight in, straight out. There were no queues in there at all. I wasn't worried because I had made an appointment so I didn't think there would be a problem ... Doctors work very hard. I think I would support them. They deserve it, and my doctor is fantastic, but if it really affected me I possibly wouldn't.
Trainee accountant Shannan Barrett, 21, from Eastbourne, said:Trainee accountant Shannan Barrett, 21, from Eastbourne, said:
It was fine and fast. I was in and out. There were no delays and I was in there for about 10 minutes. I think doctors deserve good pensions. When you think that footballers get millions of pounds for kicking a football around, I think doctors deserve it.It was fine and fast. I was in and out. There were no delays and I was in there for about 10 minutes. I think doctors deserve good pensions. When you think that footballers get millions of pounds for kicking a football around, I think doctors deserve it.
But another woman, who declined to be named, disagreed. She said: "I don't think doctors should strike. They are well-paid but it's their decision, like in all walks of life."But another woman, who declined to be named, disagreed. She said: "I don't think doctors should strike. They are well-paid but it's their decision, like in all walks of life."
Another patient said she could not support the doctors' cause because she felt their existing earnings and pension benefits were already generous enough. She said:Another patient said she could not support the doctors' cause because she felt their existing earnings and pension benefits were already generous enough. She said:
If it was a case of somebody like me and they were striking because they were low paid then I would say yes, strike, as that's the only comeback they have got. But if I was dying, what would happen?If it was a case of somebody like me and they were striking because they were low paid then I would say yes, strike, as that's the only comeback they have got. But if I was dying, what would happen?
10.39am: A third of GPs' surgeries are affected by the industrial action today, Denis Campbell reports.10.39am: A third of GPs' surgeries are affected by the industrial action today, Denis Campbell reports.
10.31am: Below the line, onegpprotest writes about his/her local protest:10.31am: Below the line, onegpprotest writes about his/her local protest:
Our GP practice is open and working as usual. I have just sent an unwell man into hospital.Our GP practice is open and working as usual. I have just sent an unwell man into hospital.
But we are wearing protest badges and have put up information in the waiting room as to why we are protesting. This is our version of "industrial action".But we are wearing protest badges and have put up information in the waiting room as to why we are protesting. This is our version of "industrial action".
The BMA has been pretty useless at highlighting the structural underlying problem and as a result doctors have come across as greedy.The BMA has been pretty useless at highlighting the structural underlying problem and as a result doctors have come across as greedy.
Suggest you read these two letters to the Lancet, one of them by Tower Hamlets GPs which is where I work.Suggest you read these two letters to the Lancet, one of them by Tower Hamlets GPs which is where I work.
http://bit.ly/LEWK8F and http://bit.ly/LlsY7whttp://bit.ly/LEWK8F and http://bit.ly/LlsY7w
We have enlarged copies of the letters and hung them in the waiting room.We have enlarged copies of the letters and hung them in the waiting room.
9.37am: Andrew Lansley, the health secretary (left), has also accused the BMA of wanting a pension deal that would decrease those of lower-paid NHS staff. He said:9.37am: Andrew Lansley, the health secretary (left), has also accused the BMA of wanting a pension deal that would decrease those of lower-paid NHS staff. He said:
We needed something that was fairer for other NHS staff as well. The contributions do need to be properly progressive and they do need to reflect the highest paid paying a greater proportion into their pensions overall.We needed something that was fairer for other NHS staff as well. The contributions do need to be properly progressive and they do need to reflect the highest paid paying a greater proportion into their pensions overall.
He said that current arrangements meant that often the highest paid received twice as much back in pension benefits than lower-paid staff.He said that current arrangements meant that often the highest paid received twice as much back in pension benefits than lower-paid staff.
I'm afraid we are in a position where the BMA are out on their own and what they seem to be aiming for is to try and change things back so they get more and nurses and porters and others in the NHS get less.I'm afraid we are in a position where the BMA are out on their own and what they seem to be aiming for is to try and change things back so they get more and nurses and porters and others in the NHS get less.
Dean Royles, director of NHS Employers, which represents hospital trusts in England, said patients awaiting an operation to remove a cataract or benign lump, or replace a worn-out hip or knee, were among those whose care had been postponed, but only in some places. "I don't have any hard numbers [of patients affected] but in some places it will be very disruptive and in other places it will be very minimal."Dean Royles, director of NHS Employers, which represents hospital trusts in England, said patients awaiting an operation to remove a cataract or benign lump, or replace a worn-out hip or knee, were among those whose care had been postponed, but only in some places. "I don't have any hard numbers [of patients affected] but in some places it will be very disruptive and in other places it will be very minimal."
9.11am: The BMA and the health secretary have already been taking to the airwaves to put their sides of the story. On Radio 4's Today programme, Hamish Meldrum of the BMA (left) was repeatedly asked whether doctors were putting at risk their enviable public standing by taking industrial action today.9.11am: The BMA and the health secretary have already been taking to the airwaves to put their sides of the story. On Radio 4's Today programme, Hamish Meldrum of the BMA (left) was repeatedly asked whether doctors were putting at risk their enviable public standing by taking industrial action today.
Meldrum said: "Just to emphasise, no patients are being put at risk … We have to respond to what our members say, and they pretty overwhelmingly said that they were angry and they wanted to take this action. Nobody is happy about taking any action which inconveniences patients, but the nature of a doctor's job means it's almost impossible to find anything that won't do that. So that's why we emphasise public safety. I really hope that we can find a resolution to this. Nobody is happy about this. No doctor wants to do this."Meldrum said: "Just to emphasise, no patients are being put at risk … We have to respond to what our members say, and they pretty overwhelmingly said that they were angry and they wanted to take this action. Nobody is happy about taking any action which inconveniences patients, but the nature of a doctor's job means it's almost impossible to find anything that won't do that. So that's why we emphasise public safety. I really hope that we can find a resolution to this. Nobody is happy about this. No doctor wants to do this."
On ITV's Daybreak, Meldrum responded to Andrew Lansley's claim that the strike would be "pointless".On ITV's Daybreak, Meldrum responded to Andrew Lansley's claim that the strike would be "pointless".
I hope [the action] is not pointless and futile because we are very anxious to seek a resolution to this dispute and if this helps to highlight the problem and to get to that resolution then I hope it will have some point to it …I hope [the action] is not pointless and futile because we are very anxious to seek a resolution to this dispute and if this helps to highlight the problem and to get to that resolution then I hope it will have some point to it …
We doctors have enjoyed a good relationship, high trust, with their patients and we don't want to do anything to get rid of that, but what we feel we've had is lack of trust from the government.We doctors have enjoyed a good relationship, high trust, with their patients and we don't want to do anything to get rid of that, but what we feel we've had is lack of trust from the government.
We negotiated a deal on pensions four years ago that meant that doctors would work longer, they would pay more and that they would take the risk of any future increase or impact of people living longer on the pension scheme and the government has walked away from that deal. I hope that after today we can sit down and we can talk.We negotiated a deal on pensions four years ago that meant that doctors would work longer, they would pay more and that they would take the risk of any future increase or impact of people living longer on the pension scheme and the government has walked away from that deal. I hope that after today we can sit down and we can talk.
On the same programme, Lansley urged doctors not to participate:On the same programme, Lansley urged doctors not to participate:
I know doctors don't want to go on strike. I hope they don't. I think if they have an argument and they're angry, they're angry with the government and that's our job to represent the taxpayer and the public interest, and maybe we will have that argument. But I can't see why anybody thinks there is any benefit in penalising patients. It won't serve any purpose whatsoever.I know doctors don't want to go on strike. I hope they don't. I think if they have an argument and they're angry, they're angry with the government and that's our job to represent the taxpayer and the public interest, and maybe we will have that argument. But I can't see why anybody thinks there is any benefit in penalising patients. It won't serve any purpose whatsoever.
The last time doctors took action was in 1975, when consultants suspended goodwill activities and worked to contract over a contractual dispute, and junior doctors worked to a 40-hour week because of dissatisfaction with the progress of contract negotiations.The last time doctors took action was in 1975, when consultants suspended goodwill activities and worked to contract over a contractual dispute, and junior doctors worked to a 40-hour week because of dissatisfaction with the progress of contract negotiations.
9.00am: Hello, and welcome to today's live coverage of the first doctors' strike in almost 40 years.9.00am: Hello, and welcome to today's live coverage of the first doctors' strike in almost 40 years.
The effect of the industrial action – over changes to doctors' pensions that they regard as unfair and unnecessary – is difficult to predict.The effect of the industrial action – over changes to doctors' pensions that they regard as unfair and unnecessary – is difficult to predict.
Not all doctors are taking part. About a third do not belong to the British Medical Association, which has called the action, and when the BMA balloted its members last month 21% of GPs and 15.7% of hospital consultants said they would not participate, on turnouts of 53.1% and 56% respectively.Not all doctors are taking part. About a third do not belong to the British Medical Association, which has called the action, and when the BMA balloted its members last month 21% of GPs and 15.7% of hospital consultants said they would not participate, on turnouts of 53.1% and 56% respectively.
Nevertheless, services in hospitals and GPs' surgeries in many areas will be affected. But unlike in most industrial disputes, doctors will still attend their workplaces as usual, continuing to deal with urgent and emergency cases, and only refusing to attend to routine and non-urgent appointments and consultations. So it should be business as usual in A&E departments, maternity units, for renal and cancer patients, and anyone needing an urgent diagnostic test or end-of-life care, while 80% of UK hospitals, according to the BMA, have cancelled some planned operations and some outpatient appointments.Nevertheless, services in hospitals and GPs' surgeries in many areas will be affected. But unlike in most industrial disputes, doctors will still attend their workplaces as usual, continuing to deal with urgent and emergency cases, and only refusing to attend to routine and non-urgent appointments and consultations. So it should be business as usual in A&E departments, maternity units, for renal and cancer patients, and anyone needing an urgent diagnostic test or end-of-life care, while 80% of UK hospitals, according to the BMA, have cancelled some planned operations and some outpatient appointments.
Andrew Lansley, the health secretary, has claimed that 30,000 operations will be cancelled, 1.25m GP appointments delayed, 58,000 diagnostic tests postponed, and 200,000 outpatient appointments rescheduled. But there is no way of verifying these figures because the Department of Health has asked NHS trusts not to release such details to the media. The DoH may release a summary of the impact later on today.Andrew Lansley, the health secretary, has claimed that 30,000 operations will be cancelled, 1.25m GP appointments delayed, 58,000 diagnostic tests postponed, and 200,000 outpatient appointments rescheduled. But there is no way of verifying these figures because the Department of Health has asked NHS trusts not to release such details to the media. The DoH may release a summary of the impact later on today.
We will be reporting on the impact of the doctors' day of action live here throughout the day.We will be reporting on the impact of the doctors' day of action live here throughout the day.