The government commenced a consultation process to make minimum service levels mandatory amidst ongoing strikes by NHS doctors over pay. Under the government’s plan to extend the minimum service level regulations to the health sector, doctors and nurses may be required to work during strikes. The Department of Health and Social Care (DHSC) launched the consultation on this plan while NHS consultants in England began another round of strikes. Currently, staffing levels during strike days are negotiated by employers and trade unions, with certain personnel exempted from industrial actions through agreements known as “derogations.”
The government now intends to enforce normal levels of care during strike days for in-patients already receiving hospital care, existing patients requiring urgent elective treatment or assessment, and new patients presenting to hospitals that require unplanned assessment, diagnostics, and/or treatment. This will apply to hospitals in England, Wales, and Scotland.
According to NHS England, strikes since December 2022 have affected around 885,154 hospital appointments. The DHSC stated that 22 critical incidents were reported due to the industrial action, resulting in the transfer of critical care patients and gynecology patients to other hospitals due to insufficient staffing numbers. Rescheduling of urgent cancer surgery, chemotherapy appointments, and trauma patient surgeries has also occurred.
The DHSC claimed that the British Medical Association (BMA) union rejected 17 derogation applications during junior doctors’ strikes last month, despite agreements reached between local senior clinical leaders and local BMA representatives that it was necessary to keep patients safe. In response, Professor Phil Banfield, Chair of BMA council, criticized the government’s approach, attributing the current state of the health service to years of deliberate neglect.
The BMA has maintained minimum staffing levels during strike action to ensure patient safety and has no plans for a full walkout. Dr. Vishal Sharma, Chairman of the BMA’s consultants’ committee, emphasized that the core problems leading to the strikes should be addressed by the government, as NHS staff across the sector are demoralized and burned out, necessitating the need for strike action.
The Strikes (Minimum Service Levels) Act 2023 grants the government the authority to enact regulations on service levels during strikes across various sectors, including health. The law has faced opposition from trade unions, who consider it to be draconian. The Trade Union Congress has approved motions to legally challenge the law, organize demonstrations, and hold a national march in opposition to it. Junior doctors have joined their consultant colleagues in strikes for the first time and will do so again during the Conservative Party Conference next month.
The BMA has highlighted the decline in salaries for junior doctors and consultants, along with the understaffing and under-resourcing of the NHS. Junior doctors are demanding full pay restoration, while consultants are seeking an above-inflation pay award for the upcoming year and reform of the pay review body for doctors and dentists, which they believe to be flawed.