Junior doctors strike: Medical profession split as royal colleges refuse to back walk-out

Some senior doctors are uncomfortable at the escalation of the dispute and its potential to seriously affect patient care

In a statement made in the Commons, Health Secretary Jeremy Hunt refused any compromise on a possible deal (AFP)

Junior doctors will go into Tuesday’s all-out strike without the explicit backing of any of the profession’s royal colleges amid signs of deep concern among senior consultants that both sides in the dispute need to compromise.

Hospitals across England are finalising plans for dealing with the strike that will be the first in the history of the NHS to affect emergency, paediatric and maternity services. It will run from 8am to 5pm Tuesday and Wednesday. So far, more than 125,000 appointments and operations have been cancelled.

But the scale of the action – and the potentially dangerous impact on patient care – has split the medical profession. In statements over recent days, each of the specialist medical royal colleges have stopped short of endorsing the industrial action and have called for an end to the “damaging stand-off”.

While most are sympathetic to the broader concerns of their younger colleagues, many are also privately critical of the hard line stance taken by the junior doctors committee of the British Medical Association.

“Senior people are extremely frustrated at the absolute impasse in this sorry situation,” the president of one of the royal colleges told The Independent. “There are a range of views but most of us think that both sides need to step back from the brink and talk.”

Some senior doctors are uncomfortable at the escalation of the dispute and its potential to seriously affect patient care. In a letter sent to David Cameron on Monday, the leaders of 13 royal colleges called on the Prime Minister to directly intervene and “bring both parties back to the negotiating table”. Tellingly, the letter did not explicitly support the action by junior doctors, while one source said there was heated debate within the colleges about the stance they should take.

Significantly, not a single royal college head signed an open letter by consultants sent at the weekend to Health Secretary Jeremy Hunt. The letter said the consultants would be able to cover during the strike, ensuring that “juniors can take this action with the complete confidence that their patients are safe”.

In statements over the past few days, the royal colleges have expressed sympathy for the concerns of junior doctors – many of which are not directly related to the contract – but stopped short of endorsing the industrial action.

“The escalation of the junior doctors' action into an all-out strike, to include acute and emergency services, is extremely worrying,” said Jane Dacre, president of the Royal College Physicians. “All doctors are trained to act in their patients’ best interests. I urge all my colleagues to think carefully and to do what is in their patients’ best interest, for now and for the future.”

The Royal College of Emergency Medicine, whose members will be among those most affected by the strike, also failed to endorse it. “We are currently asked whether we support industrial action that includes withdrawing emergency cover,” the college said in a statement. “The college is of the view that such action is a matter for individual members of the BMA. In hospitals in which there are too few senior doctors to provide such safety, then conscience will dictate the actions of the members of the college.

“Where junior doctors continue to provide such cover to ensure patient safety, this must not be regarded by the protagonists in the dispute as anything other than the actions of reasonable people in very difficult circumstances.”

Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists, said: “The RCOG’s primary concern is to ensure patient safety and the college urges all doctors – trainee or otherwise – to carefully evaluate the implications of their actions and to determine their own personal criteria for industrial action before the proposed strike dates.”

Others were more supportive of the junior doctors but also stopped short of endorsing the strike. The President of the Royal College of Paediatrics and Child Health, Professor Neena Modi, said: “The imposition of this ill-conceived contract has derailed the aim of delivering effective seven-day services and alienated those on whom the future of the NHS depends. “Consultants will continue to support juniors who feel the current impasse leaves them no option but industrial action.”

Speaking in the House of Commons on Monday, Mr Hunt accused junior doctors of trying to “veto” an election pledge made to improve the NHS by creating a truly seven-day-a-week service.

“No trade union has the right to veto a manifesto promise voted for by the British people,” he told MPs. ”We are proud of the NHS as one of our greatest institutions but we must turn that pride into actions and a seven-day service will help us turn the NHS into one of the highest quality healthcare systems in the world."

Mr Hunt appealed to junior doctors not to withdraw emergency cover during the strike, but ruled out the Government compromising on imposing a new contract on NHS staff. He said that there were plans in place to provide safe care, particular in maternity, A&E and crisis mental health services.

Privately, Government sources accused the BMA of trying to bring down the Government, saying it had radicalised a ”generation of junior doctors“.

Danny Mortimer, chief executive, NHS Employers, said there was “no justification” for doctors refusing to care for the sickest patients in the NHS.

”The contract that is now being implemented reflects agreement to the overwhelming majority of proposals made by the BMA during our talks with them between November and February,” he said. “Even with the outstanding issue of enhanced payment on Saturdays, we have ensured that the doctors who work them most frequently will receive increased rates of pay."