Starmer issues last-ditch appeal as thousands of doctors to strike
Resident doctors will take to picket lines across England from 7am on Friday in a move which is expected to disrupt patient care.
Members of the public have been urged to come forward for NHS care during the walkout, and are being asked to attend appointments unless told they are cancelled.
GP surgeries will open as usual and urgent care and A&E will continue to be available, alongside NHS 111, NHS England said.
Sir Keir Starmer made a last-minute appeal to resident doctors, saying the strikes would 'cause real damage'.
'The route the BMA Resident Doctors Committee have chosen will mean everyone loses. My appeal to resident doctors is this: do not follow the BMA leadership down this damaging road. Our NHS and your patients need you,' he wrote in The Times.
He added: 'Most people do not support these strikes. They know they will cause real damage.'
'Behind the headlines are the patients whose lives will be blighted by this decision. The frustration and disappointment of necessary treatment delayed. And worse, late diagnoses and care that risks their long-term health.
'It's not fair on patients. It's not fair on NHS staff who will have to step in for cover for those taking action. And it is not fair on taxpayers.
'These strikes threaten to turn back the clock on progress we have made in rebuilding the NHS over the last year, choking off the recovery.'
It comes after Wes Streeting sent a personal letter to NHS resident doctors, saying: 'I deeply regret the position we now find ourselves in.'
The Health Secretary said while he cannot pledge a bigger pay rise, he has been committed to progress to improve doctors' working lives.
He also said he does not now believe the British Medical Association's resident doctors committee (RDC) has 'engaged with me in good faith' over bids to avert the strike.
In the letter sent on Thursday afternoon to resident doctors, Mr Streeting said: 'I wanted to write to you personally about the situation we find ourselves in.
'This Government came into office, just over a year ago, with a great deal of sympathy for the arguments that resident doctors were making about pay, working conditions and career progression.
'I was determined to build a genuine partnership with the… RDC to make real improvements on all three fronts.
'We have made progress together. While some of my critics in Parliament and the media believe I was naive to agree such a generous pay deal to end the strikes last year, I stand by that choice.'
Mr Streeting said resident doctors have now had an average 28.9% pay award under Labour.
He added: 'Strike action should always be a last resort – not the action you take immediately following a 28.9% pay award from a Government that is committed to working with you to further improve your lives at work.
'While I've been honest with the BMA RDC that we cannot afford to go further on pay this year, I was prepared to negotiate on areas related to your conditions at work and career progression, including measures that would put money back in the pockets of resident doctors.'
Mr Streeting said that based on talks with the BMA aimed at averting strikes, he had been determined to tackle the 'arduous' training pathway, and 'I made it clear that I was prepared to agree actions to reduce the costs you face as a result of training'.
He said he had also been looking at the cost of equipment, food and drink, and 'was prepared to explore how many further training posts could be created – additional to the 1,000 already announced – as early as possible'.
Mr Streeting said talks had been progressing but 'I no longer believe that they (RDC) have engaged with me in good faith'.
The Health Secretary continued: 'I deeply regret the position we now find ourselves in.
'The public, and I am sure many of you, do not understand the rush to strike action.'
Mr Streeting later said there is 'no getting around the fact that these strikes will hit the progress we are making in turning the NHS around'.
He added: 'But I am determined to keep disruption to patients at a minimum and continue with the recovery we have begun delivering in the last 12 months after a decade-and-a-half of neglect. We will not be knocked off course.'
Daniel Elkeles, chief executive of NHS Providers, told the PA news agency health staff will be working 'flat out' to see as many patients as they can during the strike, after NHS England made clear it wants as much pre-planned care as possible to continue.
He said: 'Striking doctors should think carefully if they are really doing the right thing for patients, for the NHS and for themselves…
'The strike will throttle hard-won progress to cut waiting lists, but NHS trust leaders and staff will be working flat out to see that as many patients as possible get the care they need.'
It is understood that NHS chief Sir Jim Mackey had told trust leaders to try to crack down on resident doctors' ability to work locum shifts during the strike and earn money that way.
Leaders have also been encouraged to seek 'derogations', where resident doctors are required to work during the strikes, in more circumstances, the Health Service Journal (HSJ) reported.
Rory Deighton, acute and community care director at the NHS Confederation, said: 'These strikes were not inevitable – the Government entered negotiations with the BMA in good faith…
'The impact of these strikes and the distress they will cause patients rests with the BMA.'
The BMA has argued that real-terms pay has fallen by around 20% since 2008, and is pushing for full 'pay restoration'.
The union is taking out national newspaper adverts on Friday, saying it wants to 'lay bare the significant pay difference between a resident doctor and their non-medically qualified assistants'.
It said the adverts 'make clear that while a newly qualified doctor's assistant is taking home over £24 per hour, a newly qualified doctor with years of medical school experience is on just £18.62 per hour'.
RDC co-chairs Dr Melissa Ryan and Dr Ross Nieuwoudt said in a statement: 'Pay erosion has now got to the point where a doctor's assistant can be paid up to 30% more than a resident doctor.
'That's going to strike most of the public that use the NHS as deeply unfair.
'Resident doctors are not worth less than they were 17 years ago, but unfortunately they've seen their pay erode by more than 21% in the last two decades.
'We're not working 21% less hard so why should our pay suffer?
'We're asking for an extra £4 per hour to restore our pay. It's a small price to pay for those who may hold your life in their hands.'
The statement said Mr Streeting had had every opportunity to prevent the strike, but added: 'We want these strikes to be the last we ever have to participate in.
'We are asking Mr Streeting to get back around the table with a serious proposal as soon as possible – this time with the intent to bring this to a just conclusion.'
Resident doctors are qualified doctors in clinical training.
They have completed a medical degree and can have up to nine years of working experience as a hospital doctor, depending on their specialty, or up to five years of working and gaining experience to become a GP.
The Department of Health and Social Care (DHSC) said the framing of the BMA advertising campaign was 'disingenuous'.
'Given their repeated use of debunked ways of measuring inflation to overstate their pay claims, it follows a pattern of deliberately misleading calculations from the BMA,' a spokesperson said.
'The average annual earnings per first year resident doctor last year was £43,275. That is significantly more, in a resident doctor's first year, than the average full-time worker in this country earns.
'Resident doctors in their second year earned an average of £52,300 last year and at the top end of the scale, resident doctors in specialty training earned an average almost £75,000 – this is set to increase further with this year's pay award.'
The Conservatives accused Labour of having 'opened the door' to fresh strikes with a 'spineless surrender to union demands last year'.
Shadow health secretary Stuart Andrew said: 'They handed out inflation-busting pay rises without reform, and now the BMA are back for more.
'They are disrupting care, ignoring patients and gambling with lives.
'This is a betrayal of the NHS and those who rely on it.
'The public deserves hospitals where the doctors are on the frontline rather than the picket line.
'But every day Labour refuses to stand up to union overreach, Britain moves closer to a health service run on the unions' terms rather than the patients'.'
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