‘There is no good time to strike,’ says Rob Laurenson, BMA junior doctors committee co-chair, standing with dozens of BMA members at the picket line at St Thomas’ Hospital in London.

However, as junior doctors in England begin the longest single strike action in NHS history on 3 January, he insists: ‘Strike action is the only thing that works.’

The Government has taken a stance that strikes must be called off for it to resume negotiations – while the BMA has consistently said it will resume talks at any time.

When the Government failed to make a credible offer by the mutually agreed deadline in early December, this round of action – as well as three strike days before Christmas – were called.

More than four weeks have passed since that deadline, with the Government refusing to make its ‘final offer’, which health secretary Victoria Atkins has said is still up her sleeve.

Door open

The JDC negotiating team is ready to talk at any time throughout the 144 hours of industrial action, which last until 7am on 9 January but will not call off strikes to get round the table.

Speaking to The Doctor at the St Thomas’ picket line, JDC co-chair Robert Laurenson says: ‘If Victoria Atkins has another offer to make, it begs the question, “why doesn’t she make it?”.

‘Why let more strikes go on when she has had this offer ready for four weeks. Why doesn’t she sit down and work in collaboration with us to find a negotiated settlement?’

Dr Laurenson said the Government’s ‘bad faith’ in negotiations was evident through the pay offer made to nurses in 2023.

Nurses received 5 per cent uplift, below last year’s inflation levels, and a one-off sum of £1,655 – this was rejected by the Royal College of Nursing but, because other health unions accepted, the Government imposed it.

Firm approach

Dr Laurenson said: ‘It just goes to show the Government only responds to strike action.

‘Nurses called off their strikes. How have their pay negotiations gone? Have they even had any? Strike action is the only thing that works.’

Doctors’ pay has eroded by 26 per cent in real terms for 15 years from 2008 while student-loan debts have soared and working conditions have worsened owing to staffing shortages.

The Government imposed a 6 per cent uplift in June, along with a one-off sum of £1,250. Foundation year 1 doctors now earn £15.50 an hour, up from £14.09 when the dispute began.

JDC said a further 3 per cent offered last month, unevenly spread across doctors’ grades, was still not credible enough to take to members.

Dr Laurenson said: ‘We see the winter pressures year after year, and they get worse and worse.

‘Perhaps we should’ve taken strike action years ago, but we waited this long because we were always promised that things will get better – but they never have.’

The mood on the picket line at St Thomas’ Hospital, close to Parliament, was one of defiance among doctors.

Paolo, a specialty trainee 3 in paediatric cardiology, said: ‘It’s been slow but progress has been steady. We have seen the Government move, albeit slowly. The action is working.’

He criticised government spin, which suggests doctors are putting patients’ lives at risk by going on strike during the busy winter period.

‘Excess deaths are happening every day,’ he added, saying paying doctors fairly would mean fewer rota gaps and lead to better results.

Anna, an internal medicine trainee 1, felt less hopeful the Government would make a credible offer. She said: ‘I am striking because I don’t feel the NHS is safe because it’s not properly funded. We are not retaining staff, and that’s related to pay.’

She pointed out that waiting lists had risen to record levels before strike action had been called. ‘That’s one of the reasons we need to strike,’ she said.

Rohan, a psychiatry core trainee 1 in Oxleas, is an international medical graduate who began working in the NHS after training in Hungary.

‘I’ve already seen one winter crisis,’ he said. ‘But it’s a perpetual crisis that happens every year.

‘Doctors feel cheated by the Government because it keeps promising improvements that never happen.

‘If they don’t talk to us, how else do we get the Government to listen other than going on strike? We are seeing a brain drain [of UK doctors leaving to work overseas] and doctors working as locums because the pay and conditions are so low.’

Almost a year has passed since JDC opened its first ballot for industrial action.

After 28 strike days in 2023, doctors feel slow but tangible progress has been made.

As JDC co-chairs Dr Laurenson and Vivek Trivedi say: ‘Doctors want 2024 to be the start of a renewed workforce, which can finally provide high-quality care for patients again – it is for the Government to put forward a credible offer and facilitate that journey.’

(Images by Sarah Turton)