Junior doctors have announced they will stage a five-day walkout next month, which is the longest strike action in NHS history. We can't go on like this.
As a recent trust leader, I know first-hand how high the stakes are if industrial action in the NHS continues. With every day this situation is left unresolved, it gets harder to provide the best care for patients, staff morale deteriorates further, and trust leaders' time and energy gets diverted from critical work that could improve patient outcomes, cut waiting lists and meet financial targets.
The financial impact of prolonged industrial action is hitting trusts hard.
Chief Executive
More than 650,000 patient appointments and procedures have already had to be postponed as a direct result of the strikes since December. Trust leaders tell us many more were rescheduled in anticipation of the stoppages as part of a worrying "invisible impact". Whatever the true total, these aren't just numbers: they are people in pain, discomfort and poor health who are having to wait longer than they should for care. No one deserves this.
And at a time when public purse strings have become tighter and NHS budgets are increasingly under pressure, the financial impact of prolonged industrial action is hitting trusts hard. This is felt particularly from the junior doctors' dispute as senior doctors are drafted in to provide cover, often at much higher rates than usual. Many trusts are also losing income from cancelled elective appointments.
Some large NHS trusts have told me that a three-day strike can cost them up to £2.5m, and "many tens of millions of pounds" for the NHS more widely. This is an extra strain on hard-pressed budgets that could, and should, be used in other areas.
Yet without any prospect of resolution in sight in the long-running pay dispute between junior doctors and the government, NHS leaders are growing increasingly exasperated at the lack of progress. The two sides are officially in deadlock: both sides are entrenched in their respective opening offers, from which neither seem willing to move.
To resolve these disputes, the first step is for both sides to get round the table to reach an agreement that's acceptable to all involved.
Chief Executive
In the absence of improved pay offers or further meetings with the secretary of state, Steve Barclay, junior doctors say they could keep striking for another six months. The British Medical Association (BMA)'s junior doctors are currently voting on whether to do this, and we'll know the result at the end of August. Meanwhile, Barclay says there will be no meetings if they don't change their current pay demands and continue to strike. At this point, profound and long-lasting damage looms large for NHS patients and staff.
The deadlock augurs ill for other disputes. Radiographers are voting to strike for the first time, as are consultants, who plan to stage their 48-hour walkout on 20 July if the ballot is successful. To resolve these disputes, the first step is for both sides to get round the table to reach an agreement that's acceptable to all involved. But this is easier said than done. Initial negotiations between the government and the junior doctors have broken down on several occasions and have now ceased entirely. A new approach is needed urgently.
Following my extensive conversations with trust leaders across hospital, ambulance, mental health and community services in England, it's clear that if we are to shift the dial at this juncture, the only viable option remaining is to move to arbitration.
The argument for taking this step is becoming increasingly urgent, not least because of the huge impact strike action is having on patients.
These strikes have been a costly reminder that there is no NHS without its staff.
Chief Executive
The secretary of state has said he stands "ready for further discussion" with the junior doctors. This sounds promising, but action needs to follow. Both sides worked with an independent chair during earlier negotiations, but talks have now broken down completely. It's time for both sides to now use independent arbitration. This could not only achieve resolution for the junior doctors' dispute but help prevent talks with other health unions from collapsing.
There is also a much bigger picture to consider. Wider concerns over pay, reward and experience in the longer term have not gone away, and staff dissatisfaction, which ultimately impacts patients, must therefore be taken seriously.
These strikes have been a costly reminder that there is no NHS without its staff. And without a resolution to these strikes, there will be no way to prevent the situation from getting worse. Now is the time for action. Now is the time for arbitration.
This opinion piece was first published by The Times Red Box.
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