Wednesday briefing: Decoding the junior doctors’ strike – from patient safety to public support

Good day. Despite illness never being timely, this week is exceptionally grim as the NHS shrouds into its usual winter crisis which generally reaches its zenith in early January. Over 125,000 positions remain vacant, and nearly 6.5 million people are queuing for regular consultations, with over a million needing more than one procedure. Today marks the continuation of the junior doctors' strike in England, scheduled for six days in length. A pay agreement has been sorted in Scotland, although Welsh doctors are set to strike later this month, and Northern Ireland's doctors are in the middle of an ongoing vote. The disagreement over pay and conditions still seems a long way from being resolved, almost a year after the initial strike. As the strikes persist, it may be challenging to discern where the truth lies within the rhetoric of both parties. This newsletter aims to fact check the assertions and rebuttals. In the meantime, try to stay healthy while reading this, and here are some current updates. Top five stories: Israel and Gaza conflict | Senior Hamas official, Saleh al Arouri, died in an Israeli drone attack in Beirut, escalating threats in Israel's fight against Hamas and its associated clash with the Lebanese militant group Hezbollah. Read Jason Burke’s analysis; Japan | A devastating accident at Tokyo's Haneda Airport involved a coast guard plane crashing into a passenger jet which had been cleared to land, according to Japan Airlines executives. All 379 passengers were safely evacuated from the burning jet, but five coast guard crew members were killed; UK news | Camila Batmanghelidjh, founder of the Kids Company children's charity and a prominent advocate for underprivileged youth in the UK, has passed away at 61; Climate Crisis | The second hottest year on record in the UK came in 2023, according to Met Office provisional data, reflecting the continued escalation in climate crisis. Scientists stated this extreme weather would only occur once in 500 years, barring human-induced global warming; US news | Harvard University president Claudine Gay has stepped down amid criticism regarding her response to accusations of antisemitism at US colleges and alleged plagiarism in her academic work. She served the shortest tenure in the university's history- just six months. As we analyze the claims made by both sides, what lies at the heart of their argument? As we write this, junior doctors are beginning a strike that is anticipated to persist until 7am on January 9. While the new health secretary, Victoria Atkins, has a somewhat better relationship with the British Medical Association (BMA), which represents junior doctors, than the previous health secretary, Steve Barclay, there's still a significant gap between the two sides. Andrew Gregory's Q+A provides a deeper insight. As you hear both sides engaging with the media, here's what you need to know about what they're saying. Claim: Patient safety is threatened by the strike:Junior doctors have timed their strikes for the greatest effect throughout the disagreement- a typical practice among workers' groups. However, this time, it's a step further with an uninterrupted 144-hour stoppage during what's ordinarily the busiest week of the year. According to the NHS Confederation, representing hospital trusts, some establishments are in a precarious position. Emergency care will still be available, but thousands of treatments will be postponed, impacting patients like those affected by cancer and people with sight conditions. If a hospital confronts an unexpected emergency, staff can be called back to work via a joint letter from the BMA and NHS England. Junior doctors are still defending their salaries from 15 years ago, claiming 35% would restore salaries to that level. The BMA also says it would be reasonable to achieve this over a few years. There's no debate that junior doctor’s salary has significantly decreased in real terms. Calculations differ on whether the major cuts range from 11-16% since 2010, although doctors have suffered more than many other professions, as shown in this chart. Claim: Junior doctors are supported by the public: Recent polls show that the public continues to strongly back the junior doctors. In September, 53% of the public were found to support the doctors. However, this figure has only decreased by one percentage point in the same survey conducted in April last year. Meanwhile, 45% of voters blame the government for the strikes more than the BMA (21%), found a YouGov poll conducted in September. So, despite predictions that the strikes would dent the junior doctors' reputation, the opposite seems to be the case. Claim: The government refuses to propose an offer and junior doctors refuse to talk: After the negotiations collapsed in early December, the BMA announced that the government's offer of a 3% increment wasn't credible, whereas Victoria Atkins alleges there was no specific final offer. Atkins now calls for the BMA to “come back to the negotiating table.” However, the BMA has declined due to its demands for salary