On 12 January 2016 tens of thousands of junior doctors took industrial action for the first time in 40 years in relation to changes to their contracts.

In a November 2015 ballot, more than 99 per cent of junior doctors voted in favour of the industrial action due to objections against the prospective new junior doctors’ contract. As a result, for 24 hours, junior doctors only provided emergency care.

The proposed changes will see junior doctors’ normal working hours extend to 10pm every day except Sunday. The normal working hours are presently 7am to 7pm Monday to Friday within a standard 40 hour week. The effect of this change is that junior doctors will be paid at the basic rate in the evening and on Saturdays, rather than the previous higher rate. We previously blogged in relation to this topic in October 2015.

In the short term industrial action most directly affects patients. Despite the attempt of consultant doctors to cover the work of junior doctors, it is estimated that on 12 January 2016 around 4,000 operations and procedures were cancelled due to the industrial action.

Junior doctors were not easily replaced. Although locums already scheduled to work on a day of industrial action are permitted to work as usual, employers were prevented by law from hiring new locums from an agency to cover striking junior doctors. It was also permissible for employers to have an existing locum change their shift to work during the period of industrial action, but they then could not hire a new locum worker to cover the existing locum worker’s other shift.

Looking ahead, negotiations between the British Medical Association (BMA), NHS Employers and the Department of Health are scheduled to resume on 14 January 2016. If these do not succeed, the BMA is planning further industrial action. It is proposed that this will be emergency only care for 48 hours starting on 26 January 2016 and a full withdrawal of work by junior doctors on 10 February 2016.

Concern has now been raised over the estimated impact of further industrial action, especially if that action is the full withdrawal of labour (including emergency care) by junior doctors.

NHS England estimate that around 10,000 junior doctors reported for duty out of 26,000 scheduled to work on 12 January 2016, mostly to cover emergency care. If junior doctors do decide to withdraw emergency care in future industrial action the consequences are uncertain but likely to be significant.

This impact may not just be felt by patients. The General Medical Council (GMC) has stated that they may investigate information suggesting that a doctor’s actions during the taking of such industrial action had caused a patient serious harm, or put patients at risk of serious harm, whatever the motive underlying the doctor’s actions.

Whilst junior doctors deserve to be fairly rewarded for their work, especially in light of the pivotal role they play in the health service, the industrial action clearly hits patients the hardest, and may even give rise to unnecessary risk. Patients rely on the services of junior doctors, and in no way share any blame for the issues surrounding the proposed changes to junior doctors’ contracts. The negotiations in relation to the proposed changes need to take precedence to avoid any further action.