Junior doctors’ strikes cost NHS £1bn

Strikes by junior doctors have cost the NHS around £1 billion so far, official figures suggest, ahead of the latest walkout on Friday.

The 16 days of industrial action so far have cost the health service hundreds of millions of pounds in cover for absent staff, and disruption, as well as for making up lost appointments.

On Thursday, Steve Barclay, the Health Secretary, said the strikes were diverting “significant amounts of money” away from front-line services, as well as causing the cancellation of hundreds of thousands of operations and consultations.

It comes as the latest NHS figures showed a record 7.6 million people waiting for care, meaning one person affected for every three households.

The data revealed how the waiting list rose by 102,000 in June after a three-day strike by junior doctors led to 106,000 appointments and procedures being cancelled.

On Friday, junior doctors will embark on their fifth round of walkouts in a four-day strike lasting until Tuesday.

So far, consultants providing cover have been paid up to £2,000 a day – and £5,000 for a 24-hour shift – after the British Medical Association (BMA) demanded “eye-watering” rates for medics with average NHS earnings of £134,000 a year.

Health officials said the “premium rates” paid to consultants to step in for striking junior doctors were fuelling vast bills for the walkouts.

Julian Kelly, the NHS chief financial officer, told the most recent NHS England board meeting that the cost of April’s five-day junior doctors’ strike was £315 million.

He said a third of the spending was “down to the direct net cost of effectively paying more senior staff to cover junior staff who have gone on strike, who you are paying at premium rates”.

Research by Health Service Journal showed around one in four NHS trusts meeting the BMA’s “rate card” – with hourly rates of more than £160 for weekdays, and more than £260 an hour at night – despite warnings from NHS leaders that the sums were “eye-watering”.

Mr Kelly said a third of the strike costs were the result of “lost activity” – cancelled operations and appointments – which will have to be rescheduled, often through “higher cost, higher premium initiatives” such as overtime to clear backlogs.

‘Final’ offer

The BMA has claimed that meeting its pay demands would cost the NHS £1 billion a year, taking into account income tax and National Insurance paid back to the Treasury. 

Mr Barclay has said the gross cost to the NHS pay bill would be £2 billion a year. The total NHS budget is £160 billion.

Official figures show the total number of appointments postponed as a result of all NHS strikes has hit around 830,000, with three-quarters of them owing to junior doctor strikes alone.

NHS leaders say the true figure may be twice as high, with up to two million consultations affected. Many hospitals affected by strike action did not schedule appointments in the first place, to avoid the disruption of cancelling them.

Mr Barclay urged the BMA to end the strikes, saying the pay award they had been given was “final” and not open to discussion.

He said: “Patients are bearing the brunt of the impact of continuous strikes across the NHS and further action by the BMA will cause more appointments and procedures to be postponed, while costing the NHS significant amounts of money that should be spent on front-line services.”

He said the latest pay award would give doctors in training an uplift of 10.3 per cent, with an average pay rise of between £3,000 and £4,700 depending on the stage of training.

“Our award balances the need to keep inflation in check while recognising the incredibly important work they do,” he added.

“My door is always open to discuss how to improve doctors’ working lives, but this pay award is final so I urge the BMA to end its strikes immediately.”

The BMA is currently reballoting its members to extend its mandate for strike action by a further six months as it seeks “pay restoration”.

However, analysis suggests support may be waning. The number of junior doctors taking part in strikes in England has dropped by more than a quarter between the first round of industrial action in March and the latest walkouts.

Since Rishi Sunak pledged to tackle the NHS waiting list at the start of this year, it has risen by 360,000.

Dr Robert Laurenson and Dr Vivek Trivedi, co-chairmen of the BMA junior doctors committee, said the union’s members had “no choice” but to embark on strikes. 

In a joint statement, they said: “We are now at the stage where a whole new cohort of junior doctors is entering the profession, only to be immediately given no choice by the Government but to go on strike for their future.  

“The Government should be ashamed that this is the state of the profession they are presenting to our newest doctors.” 

Health officials said the NHS was already contending with its busiest summer on record, with highest-ever levels of accident and emergency attendances across June and July.

Prof Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said on Thursday: “Today’s data is a reminder of the significant pressure on staff with this summer, currently on trajectory to be the busiest in NHS history, all while industrial action continues to disrupt services.”

Ahead of Friday’s strikes, Prof Redhead said “the NHS will need to prioritise emergency care once again”.

Sir Julian Hartley, chief executive of NHS Providers, said hospital leaders were “very worried” about the impact of six more days of disruption this month. A second round of strikes by consultants is due on Aug 24&25.

He said concerns were mounting about how patient safety will be maintained during the strikes this month, with many NHS services even more stretched with staff on holiday.

Health officials have also warned that pressures may be exacerbated by a High Court ruling last month that means the NHS cannot use agency workers to fill in for striking staff, as was the case during previous strikes.

Those taking part in the walkouts include foundation Year One doctors, who only started their first roles after medical school on Aug 2.