Junior doctors’ contract dispute timeline: January to April 2016
The ongoing dispute between the BMA and the government over junior doctor contract negotiations could affect current medical students’ pay and working conditions. Here is a timeline of the major flashpoints since January of this year, and a summary of the sticking points
January 2016: first industrial action takes place
Talks between the BMA and the Department of Health over planned changes to junior doctors’ working contracts conclude with no resolution. Industrial action goes ahead for 24 hours from 12 January with emergency care provided.
The BMA estimates that around 61% of junior doctors stayed away from work.
January 2016: progress made on talks
Talks restart and a decision is taken to suspend the 48 hour industrial action planned for 26-28 January.
February 2016: talks fail and industrial action resumes
Contract negotiations break down and conclude with no resolution. The BMA decides to go ahead with a second day of industrial action planned for 10 February with only emergency care being provided.
February 2016: strong support for second day of industrial action
Junior doctors take part in a second day of industrial action. The BMA says there is strong support for the action and thousands take to more than 160 picket lines across England.
February 2016: public mostly blame government for dispute
Public support for doctors in the dispute is indicated in an Ipsos MORI poll conducted by the Health Service Journal, which finds that 64% of the public believe “the government is more at fault for the dispute lasting this long” than junior doctors.
February 2016: government says new contract will be imposed
The government announces it will impose the new contract on junior doctors from August of this year. England’s health secretary Jeremy Hunt says it is time to “end the uncertainty” and get on with introducing the new contract. The BMA condemns the move.
9 March 2016: survey shows continued public support for doctors in dispute
A new Ipsos MORI poll for the BBC finds that around two thirds of the public (65%) continue to back junior doctors’ decision to take industrial action.
10 March 2016: industrial action resumes with 48 hour protest
Thousands of junior doctors take part in industrial action, this time for 48 hours, but which allows for emergency care to be provided.
March 2016: full walkout strike of junior doctors scheduled
The BMA escalates its action with a decision to call a full strike of junior doctors with no emergency cover to be provided on April 26 and 27 between 8 am and 5 pm on both days. This will be the first time that doctors have ever gone on full strike in the United Kingdom. Other doctors and staff will continue to provide care during this time.
March 2016: BMA launches legal action against contract imposition
The BMA launches a judicial review to challenge the legality of Jeremy Hunt’s decision to impose the new contract on junior doctors from later this year.
March 2016: government’s own equality review says single women will be worse off
The Department of Health publishes its own equality analysis of the contract claiming it is a fair contract that will advance “equality of opportunity.”
However, the analysis admits that parts of the contract will have “disadvantageous” impacts on women.
April 2016: staff launch judicial review of contract being imposed
An NHS staff group launches a judicial review challenging the government’s decision to impose a new contract on junior doctors. The staff campaign group Just Health serves a letter of action on the health secretary to challenge his decision. Around £100 000 was raised by the group in four days through the crowd funding website Crowdjustice to finance the judicial review.
and 7 April 2016: fourth round of industrial action
Thousands of junior doctors take part in the fourth industrial action for 48 hours with emergency care provided. They join more than 140 picket lines across England. The BMA again urges the government to end the dispute through talks.
April 2016: strike action could cause irreparable damage to profession
NHS England’s medical director Bruce Keogh writes in The Observer newspaper that junior doctors could “irreparably damage” the reputation of the profession if they went ahead with full strike action and put the sickest patients at risk.
April 2016: junior doctors launch permanent protest outside Department of Health
Junior doctors begin a permanent vigil on the pavement outside Richmond House, home of the Department of Health, to protest about the imposition of the contract. Two doctors will remain there for 12 hours at a time until the health secretary agrees to re-open talks on the contract.
and 27 April 2016: two day, all out strike
At the time of press, and in an escalation of the dispute, junior doctors are due to hold an all-out strike between 8 am and 5 pm for two days in late April. This will be the first time there has been a full withdrawal of labour and emergency cover during this dispute.
What are the sticking points?
The BMA and the government cannot agree on what hours should constitute normal and unsocial hours. The BMA wants everyone who works on a Saturday to be paid at 50% above the basic rate, whereas ministers have only offered extra pay after 5 pm on Saturdays, and at a lower rate of 30%. However, they have agreed to top up the pay by 30% for those who work regular Saturdays—defined as at least one in four. It unlikely that either side will give way easily on this issue.
The government has offered a basic pay rise of 13.5%, while the BMA has said it was willing to accept between a 4% and 7% rise in basic pay to cover more generous weekend pay. Neither side seems willing to move towards each other’s position.
Imposition of the contract
When the government decided that it would impose the contract from August, this only increased tension with the BMA, which is adamant that this shows the government has failed to negotiate fairly for a settlement. The government says it was left with no choice having tried to negotiate with the BMA since October 2013 on this issue.
Discrimination against women
The BMA is concerned that the new contract will discriminate against female doctors who take time off to have children or those who work part time. The government’s own equality analysis has also acknowledged that the new contract will impact adversely and disproportionately on women.
Impact on patients
The government is angry at the impact that the industrial action days are having on patients. It is estimated that collectively, more than 19 000 operations and treatments have been cancelled because of the industrial action. Hospitals are rearranging these procedures which include routine operations such as knee and hip replacements. The BMA says it regrets the impact on patients but insists that serious cases are not being affected and 19 000 operations being postponed is in the context of the NHS carrying out around 30 000 procedures every day.
Competing interests: None declared.
Provenance and peer review: Commissioned; not externally peer reviewed.