
NHS England approach to doctors' strike ‘seriously risky', BMA warns
'We've had proven systems over the last decade that have made sure that where we have to take strike action, senior doctors cover urgency and critical care,' she said.
'This time round, NHS England are pushing for the continuation of non-urgent and scheduled care in a way that we think at best is confusing and will create on-the-day cancellations – and at worst could be risky and lead to harm in emergency departments and on wards, because senior doctors cannot physically be in two places at once.
'We think that a notional guidance from NHS England which is saying that basically all scheduled work should continue to go ahead has potential to be seriously risky for patients.'
Her comments come amid an escalating row between NHS bosses and the BMA over how hospitals should respond to the strike, which is due to begin at 7am on Friday.
During previous rounds of industrial action in 2023 and 2024, NHS England told trusts to cancel large volumes of non-urgent care so that consultants could step in to cover emergency services.
But under the leadership of new NHS England chief executive Sir Jim Mackey, hospitals have now been instructed to cancel non-urgent work only in 'exceptional circumstances' – and only with prior approval.
The BMA argues this new approach risks spreading non-striking doctors too thinly, with Dr Runswick warning: 'Senior doctors are needed to be freed up in order to provide urgency and critical care.
'We think the vast majority of planned and unscheduled care should be shifted.
Health Secretary Wes Streeting has ruled out any additional pay rise (Lucy North/PA)
'There are always, in every hospital, local medical managers, local clinical leaders, who will make decisions about what is safe to go ahead – but trying to maintain scheduled care during this strike is not safe in many cases.'
When asked why the union could not avoid strikes altogether, she said walkouts can be delivered safely if planned properly.
'Strikes by doctors do not have to be risky,' she said. 'Strikes by doctors have been run safely in 2016 and 2022, 2023, 2024.
'We are entirely capable of running strikes safely – they just have to be planned for with local medical leadership, and we've done that before. We can do it again.'
She said the BMA was still hopeful a resolution could be reached before the walkout begins and was 'keen to work with NHS England to ensure they are best planned for the safest care'.
Talks between the Government and the BMA have continued in recent days, with Health Secretary Wes Streeting ruling out any additional pay rise this year but indicating other aspects of the contract – such as student debt, exam fees and working conditions – may be up for negotiation.
Resident doctors, formerly known as junior doctors, were awarded an average 5.4% pay increase this financial year, following a 22% rise over the previous two years.
However, the BMA says real-terms pay has still fallen by around 20% since 2008, and is pushing for full 'pay restoration'.

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an hour ago
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One politician could benefit most from the doctor's strike: Wes Streeting
Is it possible that the junior doctors have bitten off more than they can chew? That, in abandoning the care of their patients for five days, they risk losing the support and sympathy of the very people whose support they need? That is the dilemma that resident (formerly known as 'junior') doctors face this week after talks between their trade union, the British Medical Association (BMA), and the Government broke down without agreement. Wes Streeting, the Health Secretary, gives the impression of someone who has had three Weetabix for breakfast, describing the doctors' insistence that strike action would go ahead from Friday as showing 'a complete disdain for patients and the wider recovery of the NHS'. This is strong stuff, particularly from a Labour health secretary. In fact it's measurably more robust than the language that any Conservative health secretary could probably use, given Britain's political culture when it comes to the NHS. Tory ministers still seem to labour under the belief that they must continue to apologise for their party's decision to oppose the creation of the NHS nearly 80 years ago, just as Labour MPs who were born after the fall of the Berlin Wall seem keen to take personal credit for Nye Bevan's accomplishments. Streeting has proved time and again that, regrettably uniquely among his ministerial colleagues, he is prepared to speak the truth even when – God forbid! – it offends someone. Angela Rayner may currently be in pole position to replace Keir Starmer should he decide he's not up to the job, and has reached that position by telling her fans exactly what they want to hear – more social housing, higher taxes, etc. Streeting however seems to understand that the true point of leadership is to say what your audience does not want to hear but needs to. He proved that when he supported the use of independent (private) contractors to shorten NHS waiting lists and in his pragmatic and rational response to the Cass review. Now he's marching boldly into an arena where no Labour health secretary has had to tread since 1979 – the last time a health care union dropped tools in support of higher wages under a Labour government. But he's taking a big risk. How can he be sure that the public will back him rather than the phalanx of angry, articulate medics in white coats standing in picket lines outside hospitals next weekend? The point about Streeting is that he can't be sure, but he will do what he thinks is right anyway. The contrast with other ministers is refreshing and stark. Undoubtedly he is being lobbied daily by Labour backbenchers pleading with him to give way and offer residents yet another inflation-busting pay award to add to the one they got last year. 'Just say yes', after all, has been the central principle this Government has applied to virtually every pay demand since reaching office. And were the topic ever to be debated in the Commons, the whips would fear another populist revolt by rebellious MPs who mistakenly believe that they can escape the voters's judgment on their government by voting against it. Who will the public blame when the inevitable deaths start to occur? When a doctor isn't there to care for a critically ill patient, and instead abandons their post in support of a pay demand – 29 per cent – the likes of which is not only unattainable to them but every other worker in the UK? The BMA was previously a respected organisation with almost as much public prestige as the General Medical Council, the doctors's regulatory body. Now, thanks to its leadership's deliberate shift Leftwards, it is seen as just another trade union which, thanks in part to its new Left-wing chairman, Tom Dolphin, has taken issue with Dr Cass's four-year-long review into the medical care of young transgender people, questioning both her methodology and conclusions. And while the general public can usually be relied upon to support the 'heroes' of the NHS, claims for a 29 per cent pay increase cannot be taken seriously when most of the population is struggling on stagnant wages. Streeting faces two challenges. The first is that Keir Starmer will pull the rug from under his feet and order him to settle with the doctors. This would be humiliating for Streeting and add to the impression of an administration without direction or leadership. Therefore it can't be ruled out. The second is that the public blame him and not the doctors for the inevitable deaths and distress their industrial action will cause. This would be grotesquely unfair but can't be ruled out. If the Health Secretary can navigate both these hurdles and see the doctors return to work, he could yet prove that he has the mettle of modern political leadership.


Telegraph
2 hours ago
- Telegraph
Union leader behind doctors' strikes compared Luigi Mangione to Jesus
The union leader behind the latest round of doctors' strikes compared the alleged killer Luigi Mangione to Jesus. Dr Tom Dolphin, chair of the British Medical Association (BMA) council, appeared to praise the 26-year-old Ivy league graduate who was indicted for the murder of the UnitedHealthcare chief executive Brian Thompson in New York last year. In one post to his Bluesky social media account, Dr Dolphin compared a photograph of Mr Mangione being led to a police station by the NYPD in December to a painting of Christ before his crucifixion. He also said that the alleged murderer, who is accused of gunning down Mr Thompson because of his objections to the American health insurance system, '[stood] up to the rich and powerful' and had 'threaten[ed] the wealthy'. The BMA has announced it will bring some NHS care across England to a standstill on Friday, when 50,000 resident doctors will strike for a 29 per cent pay rise. The strike has been condemned by Wes Streeting as 'reckless and needless', and the union has said patient safety will be put at risk because the NHS is planning to continue with scheduled treatments during the walkout. Stuart Andrew, the shadow health secretary, said: 'These are deeply troubling remarks. For the chair of the BMA to be comparing a man charged with murder to Jesus is highly disturbing – and totally unacceptable. 'Mr Dolphin has serious questions to answer, and should immediately withdraw these comments.' The strike will take place between 7am on Friday and 7am on Wednesday July 30, after ministers refused to agree to the pay increase and pointed out that resident doctors, formerly known as junior doctors, had received the most generous pay rises of any public sector workers over the last two years. Dr Dolphin, a consultant anaesthetist in London and failed prospective Labour parliamentary candidate, has developed a reputation as a hardline union activist at the BMA. In his posts about Mr Mangione, he also criticised US police for the extensive manhunt that followed Mr Thompson's murder on December 4 2024. He posted a photograph of Mr Mangione's 'perp walk', when he was led away by police officers in an orange jumpsuit, alongside El Greco's 1579 painting 'The Disrobing of Christ'. 'Dramatic scene' The painting depicts Christ being undressed for the crucifixion, after he was sentenced to death at Pontius Pilate's palace, which is described in the New Testament as the Praetorium. Dr Dolphin said: 'This dramatic scene was the authorities trying to show what happens when one man stands up against the rich and powerful. 'I don't think this was how the NYPD were anticipating it would look. Perhaps El Greco's piece should be retitled 'Christ's Perp Walk To The Praetorium'...' He later clarified that while Mr Mangione was 'alleged to have used violence to further his cause', Jesus 'did quite the opposite'. 'I was just struck by the visual imagery and how the NYPD made Mangione look, presumably unintentionally,' he said. Three days earlier, Dr Dolphin had posted another photo of Mr Mangione's walk to jail with the caption: 'They want to be very clear what happens to people who threaten the wealthy.' During the five-day manhunt for Mr Mangione, which ended with his arrest in a McDonald's in Pennsylvania, Dr Dolphin posted: 'Good to see the police in the US applying the same level of effort and diligence to finding the Thompson killer that they do for all homicides.' He added: 'Did you know, privilege literally means 'private law'?' Mr Mangione denies the eleven state charges and four federal charges against him, which include first-degree murder, murder in furtherance of terrorism, criminal possession of a weapon, and stalking. His arrest, and the subsequent discovery of an alleged 'manifesto' criticising health insurance bosses for 'corruption and greed', have turned him into a cult hero on the American Left. Some supporters of Mr Mangione, many of whom are young women, appeared at his federal plea hearing in April to protest against prosecutors' decision to seek the death penalty for him. In January, a poll of US college students found that half viewed the killing of Mr Thompson extremely or somewhat favourably.


Telegraph
3 hours ago
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I'm seven months pregnant and scared of the birth. This is what every mother should ask
In 1928, my great-grandmother, Bertha, died from puerperal fever after giving birth. She was 32. Her baby, Audrey, also died. My grandmother, then two years old, was subsequently raised by her aunt. That same year, penicillin was discovered – and in the ensuing decades we entered a golden age of maternity care where the maternal mortality rate dropped significantly. When I was born in 1984 and my mother contracted a post-partum infection, the consequences were very different. Childbirth remains though, a complex and necessary fact of life. Women are not ignorant that it will be painful, that the unexpected will happen, that things might rip and tear. However, today they face significant other anxieties, about the very nature of the care they might receive. Maternity care services in the UK are facing significant staffing shortages, and as a result there are very real concerns about the safety and quality of care provided. Indeed, last year a study found the number of women in the UK who have died during pregnancy or soon after has risen to its highest levels for 20 years. Meanwhile, last year 41 per cent of all compensation pay outs by the NHS related to maternity care, equating to a staggering £1.15 billion. And now, Health Secretary Wes Streeting has announced a national inquiry into maternity care in England, saying there is 'too much passing the buck'. It is in this unfavourable climate that I find myself seven months pregnant. 'Fear of birth' is the label applied by the NHS for those women who are anxious about childbirth. Mine might be more reasonably called, 'Fear of bad maternity care'. Most women don't need to read about the horror in the news, they have friends and loved ones who've been snapped at by midwives, denied pain relief and been made to feel like a failure when they struggle to breast-feed. When GP Clara Doran gave birth to her son 11 years ago, she found herself in a hospital ward at 5am, crying, her baby dehydrated and losing weight, feeling like a total failure. She realised that even with all her medical training, she still needed support and hadn't been told what to actually expect. Dr Doran has written a memoir, Doctor, Interrupted, which is both a powerful and, at times, funny account of the gap between what the NHS says it offers new mums – and what they really get. Of NHS maternity care, she says: 'We do have to have trust that today's health care is guided by the right things. That healthy baby, healthy mum is the driving force. But there are unfortunately, like in any work place, other factors that can influence how that translates to your experience.' So how can pregnant women like me get the best from the NHS in this unfavourable climate? On the basis that forewarned is forearmed, here are the questions to ask your midwife ahead of giving birth. What signs should prompt me to go to the hospital urgently? Blood spotting, baby not moving, waters broken; whatever the issue, this can be a hard question for expectant mums to ask. Darcey Croft is a specialist midwife who helps women advocate for themselves and navigate the maternity system. In her experience, women feel embarrassed because the NHS is so busy. 'They don't want to make a nuisance of themselves, and they definitely should,' she says. 'I would give triage a call to the maternity unit and if you're not getting the right response, insist. Say, 'I'm still feeling very concerned, and I would like to be reviewed'. 'We know that women asking questions have safer outcomes. Even if someone is tutting at them. They will be seen.' Should I request a C-section? Requests are increasing for planned caesareans. According to Croft: 'It is a sad reflection of the confidence women have in maternity systems at the moment.' Every women has the right to ask for a planned caesarean. The reason can be medical or psychological. I knew I wanted to request a caesarean almost immediately, for a variety of reasons. One is that big babies run in my family. I was 10lb 12oz at birth, my poor mother gave birth vaginally. The main reason though is my age. Women aged over 40 are significantly more likely to have an emergency C-section compared to younger mothers. A study showed a 22.4 per cent emergency caesarean rate for women over 40, compared to 6.7 per cent for those aged 20-24. Dr Lucy Lord MBE is an obstetrician and founder of private clinic, Central Health London. She says: 'You can be lucky and labour like a 25 year old, but the chances of that are one in 10. You can be moderately lucky and labour like a 35 year old, but still over half of births in this age group end in a C-section.' She adds: 'If you're under 25, and so is your BMI, and you've got a normally growing baby and no other complications, you can be pretty sure no matter how c--p the labour ward is, you'll be OK.' The subject can be an emotive issue, with a perception that a vaginal birth is more natural. In Dr Lord's opinion good obstetric care is about risk stratification. 'I say to women, don't think with your heart, think with your head.' Not all NHS hospitals are equipped to perform immediate emergency C-sections. So if you're high risk it's worth checking, so you can move to another hospital if necessary. Am I a good candidate for a home birth or would the hospital be safer? One in 50 births each year in England and Wales take place at home. There has been a small increase in recent years and Dr Doran wonders if this is part of a trend towards expecting mothers trying to avoid any intervention. If you are categorised as a low risk, home births are very safe, says Croft: 'The midwifery team and doctors should be assessing to say whether you are perfect for a home birth.' The advantage is that they are less timed than hospital births, where a cascade of interventions can ensue. During a home birth midwives can usually tell which way things are heading before there is ever an emergency, adds Croft. 'Occasionally things can escalate quickly and you would need to get an ambulance.' How will you make sure I'm informed and involved in decision-making during labour? Gathering as much knowledge before labour is imperative. 'I always maintain that women can go through any birth, and come out feeling positive, as long as they feel they are involved in their own care, making the decisions and that they felt listened to,' says Croft. Trauma happens when a woman doesn't feel safe and listened to. Don't be afraid to ask for a second opinion. 'Every shift will have a coordinator, who doesn't want poor feedback. If you're not getting the answer you want, ask to speak to the coordinator.' Ask how birth partners and advocates are included in labour. 'Women often make better decision when they're supported and feel emotionally safe,' says Croft. Will my birth plan be followed? While it's a good idea to have a birth plan stating your preferences, that doesn't mean your midwife is obliged to follow it. Or indeed will be able to. From medical complications, down to all the birthing pools being full, it's best to plan for the unexpected. Croft advises her clients against writing 'epic novels': 'I always guide women towards condensing it down to bullet points, including what's non-negotiable. That will get read.' However, it is important that you and your birthing partner have talked through all scenarios and you feel comfortable that they're going to emphasise your preferences. When speaking up, Dr Doran advises leading with your vulnerability. 'Such as: the pain you are experiencing. Then it is harder for it to be ignored,' she says. Will a consultant or senior doctor be available if complications arise during labour or before? Yes. Every unit will have a consultant present or on call, even in the middle of the night. 'If it's a birth centre and a midwifery-led unit, there might not be any doctors there,' explains Croft. 'That woman will be transferred into the consultant-led unit.' What if I change my mind about pain relief? Dr Doran says: ' Pain relief will always be available as long as it is safe and appropriate for you and baby at your stage of labour. No one knows how they will cope with labour pain until they experience it so go with the flow and listen to your body. No one is keeping score.' What are the signs of sepsis or infection I should watch for after birth? Early signs include fever and flu-like symptoms. 'As soon as someone starts to feel unwell they should speak up,' says Croft. 'If they feel dismissed, just reiterate, 'No, I feel very unwell.' Ask for a blood test for sepsis. It's fine to ask.' Escalation is important. 'Mums and dads can always ask for that second opinion. And if they don't feel listened to, ask for another one.' What should I expect on a postnatal ward? You're exhausted, you want to sleep and spend time with your new baby. And yet you are on a post-natal ward with five other women with a curtain around them. Home is the right place for a new mum. 'As soon as you're fit for discharge, get home,' says Croft. After a caesarean, try to mobilise as quickly as you can: 'Four to six hours after the operation try to move. You'll still have some of the pain relief onboard. If you lie there for 12 hours and then try to move, it will be a lot harder.' Whether you gave birth by caesarean or vaginally, one night's stay in hospital as a minimum is standard, in order to access breast-feeding support. 'Six hours is on offer but normally you'd have to request an early discharge.' Again, make a nuisance of yourself. 'Use your call bell. The women who are using it and asking for help go home feeling supported. There is an element where mums have to take responsibility or dads have to help advocate for support.' Who should I turn to if I feel anxious or depressed after the birth? It's not uncommon to feel depressed or anxious after giving birth. If you're blue it's important to seek help from your GP, midwife or health visitor. As Dr Doran says: 'We talk a lot about 'getting back to normal' or feel we should be able to master everything we did in our pre-baby life when we become parents. However other cultures see this differently and encourage new mums to stay in bed or at home for as long as possible in the days after birth to rest and adjust physically and mentally to what has happened.' At the core of the anxiety women can feel is feeding. Dr Doran speaks from experience: 'Having watched videos in antenatal class of the perfect attachment and breastfeeding experience occurring seamlessly, when it came to my turn, wondering why my baby wasn't doing this in the same way and being convinced it was my fault.' Take the help and support, but also nourishment of your baby is the most important thing. If this needs to be with formula or mixed feeding, that is absolutely fine and the right decision for you and your baby. 'Don't let anyone guilt you or make you feel less of a mum because of it,' she says. 'These days and weeks are the most exciting and special time, but they can be extremely hard too and fraught with tiredness, fear and self doubt. Take it easy on yourself, what is right for you is right for your baby and remember this is just the beginning of your lives together.'