Heavily pregnant women and cancer sufferers are among more than 125,000 NHS patients whose hospital treatment has been postponed amid the chaos of the first ever all-out strike by junior doctors.
Hospitals were last night making desperate efforts to prepare for the mass walkout on Tuesday and Wednesday this week which will hit Accident & Emergency units, maternity units and intensive care as well as general services.
Almost 13,000 operations have been postponed and a further 113,000 appointments cancelled in an attempt to ensure essential services can still be run. Consultants are being drafted in to replace the junior doctors while NHS England has asked ambulance trusts to prepare spill-over, makeshift camps in the event A&E cannot cope. Expectant mothers said that inductions planned for Tuesday and Wednesday were being postponed, causing immense anxiety at an already stressful time.
NHS England said all expectant mothers, close to their due dates on strike days, should make contact with maternity units to check local plans. One mum-to-be posted on the internet forum Baby Centre that her hospital had contacted her to rearrange the day she was to be induced.
“My induction has been postponed due to the strikes as a lady who needs to be induced early can’t as they’re on strike so has taken my slot. Hoping my new date 5 days after the original one doesn’t get changed now!” wrote one expectant mother. Another posted: “Don’t think I can mentally take it,” after being told she might have to wait an extra two days to be induced.
A third said on the website: “I was originally booked for induction on Tuesday but consultant changed it to Sunday as she remembered about strike. She said that mine may have got cancelled as they would prioritise medical emergencies.” Chemotherapy services will also be hit hard, according to one junior doctor, because consultants will have to cancel clinics to cover in emergency areas.
Dr Chris Kane, a junior doctor in palliative care in West Yorkshire, said: “A&E departments and ITUs will be covered by consultant colleagues and that will make them safe but ultimately at what cost? “Because in order to provide that cover they’ve had to cancel operations, they’ve had to cancel clinics.
“Now some of those clinics will be very routine and can wait – but other ones are things like chemotherapy clinics where patients are waiting to be reviewed to see whether they can get their next dose of chemotherapy. “For me I’m not sure that I can justify taking away my labour so that consultants have to come away from dealing with those sorts of situations.”
This week’s strikes will see emergency cover being withdrawn by junior doctors in an escalation of the row with the Government over new weekend contracts. The British Medical Association, the doctors’ union, said the strikes would go ahead as planned while the Department of Health privately said it had given up hope of averting the 48-hour stoppage. In a sign of the strike’s divisiveness, Labour has also been plunged into crisis over the walk-out.
Heidi Alexander, the shadow health secretary, last week warned members of Jeremy Corbyn’s shadow cabinet that no senior frontbencher should publicly endorse the junior doctors and join them on the picket line. That puts her at potential odds with John McDonnell, the shadow chancellor, who has joined junior doctors’ on picket lines during previous strikes and who has called on workers to “bring this Government down” using direct action.
At least 14 Labour MPs joined junior doctors on the picket line during the two day strike earlier this month. But a senior Labour source told the Telegraph: “Members of the shadow cabinet are aware that patients could die and it would be unacceptable to have anyone out supporting this all out strike.
“The whole team were in agreement that it would be a political nightmare, but John had already left the room by this point.” Jeremy Hunt, the Health Secretary, has called on the party to clarify “whether or not Labour supports the withdrawal of potentially lifesaving care from patients.”
Even the BMA’s strike leaders have admitted the full walkout by junior doctors is “difficult to defend” and “not reasonable”. In leaked emails, Dr Johann Malawana, the head of the BMA’s junior doctor’s committee, urged union colleagues to exclude services for babies and children from planned “all out strikes” – but was over-ruled.
The documents show that Dr Malawana said junior doctors should continue to work in paediatric services on strike days because it was “the right thing to do” and to do otherwise would be a “difficult line to defend”. In a further twist, NHS England has admitted it is powerless to prevent the junior doctors working in the private sector on strike days.
“There is nothing we are aware of to prevent junior doctors doing private work on the side. We have nothing in place to prevent that,” said an NHS England source. The BMA said junior doctors, who had been due to work on strike days, would not be able to work privately in case they were needed by the NHS in extreme emergencies such as a major disaster or terrorist attack.
Last week the General Medical Council urged medics to “pause and consider again the possible implications for patients” before taking part in industrial action and have already warned doctors that they could be struck off if their patients come to harm because they are on strike.
A senior Government source close to Mr Hunt admitted last night: “This is very serious. We all want to get through this without anybody coming to any harm but it would be far easier to ensure that if the striking doctors provided emergency cover.”
The BMA said it regretted the disruption but firmly blamed the Government. A spokeswoman said last night: “Doctors want to do their utmost to protect patients, which is why the BMA has given trusts several weeks’ notice to plan ahead. “Junior doctors deeply regret disruption to patients but they are taking this action because they fundamentally believe the Government’s plans will be bad for patient care in the long term.”
The Royal College of Obstetricians and Gynaecologists moved to assuage the fears of pregnant women due Caesarean sections or who are due to be induced on strike days. Dr David Richmond, its President, said: “We can reassure women that they and their babies will receive safe care from senior doctors during the industrial action.
Women who for medical reasons need to have a Caesarean section or be induced on the strike days will be able to have these procedures as required. “Due to the increased demand on the service it’s possible that some elective procedures may be brought forward or delayed provided there is no risk to the mother or baby.”
Dr Anne Rainsberry, National Incident Director for NHS England, said: “All NHS trusts which provide maternity services have plans in place to do so during the period of action. “But we are asking all expectant mothers who are near their due date to check access arrangements with their local maternity unit.
All pregnant women should also make sure they know how to contact their midwifery team if they need any help or advice.” NHS England said “all trust boards across the country” had been asked “to provide assurance that they have adequate plans in place to manage the impact of the strike, focussing on essential services – emergency care, maternity, resuscitation teams, mental health crisis intervention teams and major incident plans”.
The organisation said trusts had put those plans in place “although services may be staffed differently and there may be delays or other changes”. It described the strike as “an unprecedented situation during a time of heightened risk” and that “the escalation of the action have also led to significantly more postponed elective operations during this strike”.
Repeated concern over the strike has been voiced by senior figures in the NHS. Dame Sally Davies, the chief medical officer, has said: “The withdrawal of emergency cover will inevitably lead to patients suffering, and sadly has the potential to bring far more serious consequences.”
Sir Bruce Keogh, medical director of NHS England, said: “I worry that the withdrawal of emergency cover will put our sickest, most vulnerable patients at greater risk. This challenges the ethical framework on which our profession is founded and runs against the grain of our NHS and our personal and professional values.”