Patient safety fears as junior doctors across West Midlands begin walkout
Hospitals across the region will be impacted by the 96-hour walkout.
Junior doctors across the West Midlands have started a four-day strike in a worsening dispute over pay, which threatens huge disruption to the NHS.
An estimated 250,000 appointments, including operations, will be cancelled as a result of the walkout by members of the British Medical Association (BMA).
Doctors across England will mount picket lines outside hospitals from 7am until Saturday morning in the longest stoppage of the wave of unrest which has seen nurses, ambulance crews and other health workers take action since last year.
Managers have warned that patient care is "on a knife edge" because of the strike.
Fresh advertisements by the BMA show how "little" junior doctors are paid for their roles in surgical procedures and emphasise they are often anything but junior in skill and expertise.
Three doctors with 10, seven and one-years experience are pictured in an operating theatre where an appendix is being removed, one of thousands of similar operations that takes place every day in England.
For the procedure, which lasts about an hour, they would earn ÂŁ28, ÂŁ24.46, and ÂŁ14.09 respectively, a total of just ÂŁ66.55 for a potentially life-saving procedure, said the BMA, which has estimated that the pay of junior doctors has fallen by 26% in real terms over the past 15 years.
Dr Jennifer Barclay, a surgical doctor in the North West, said: "There is nothing "junior" about the work I have done as a doctor.
"I'll be trying to focus on steady, controlled hand movements, thinking about the next steps and communicating with the rest of the team.
"Meanwhile, my bleep is going off incessantly in the background with more and more patients waiting to be seen as soon as I get out of theatre.
"For that hour of work that might save a life I can be paid ÂŁ19.
"I'll be working a busy on-call shift; treating unwell patients, assessing new patients, consenting and preparing patients for surgery and answering never ending bleeps, when we have to run to theatre.
"I haven't had time to eat or nip to the loo and I know I'll be in theatre for around an hour.
"An appendicectomy like the one in this advert would be a typical case.
"I want the doctors treating my loved ones to be well rested and able to provide the best care possible.
"I don't want them to be burnt out, worried about paying the bills or up to ÂŁ100,000 of debt or thinking about alternative careers whilst making life and death decisions.
"My dad, an electrician, tells me to quit and retrain in his footsteps; I'd be earning more, have less stress, less responsibility, better hours and a better work-life balance after three years.
"Surely, this life, the training, responsibility, debt and crushing workload is worth more than ÂŁ19 per hour?
"I'll be on the picket line this week because doctors believe that it is."
Dr Robert Laurenson and Dr Vivek Trivedi, BMA junior doctors committee co-chairs, said: "It is appalling that this Government feels that paying three junior doctors as little as ÂŁ66.55 between them for work of this value, is justified.
"This is highly skilled work requiring years of study and intensive training in a high-pressure environment where the job can be a matter of life and death.
"Why then has the Government allowed junior doctor pay to be cut in real terms by over a quarter in the last 15 years?
"Why do Ministers not understand that only by valuing and retaining NHS staff will the NHS be able to deliver the high quality healthcare it once could?
"Full pay restoration is not a high price to pay for healthcare that junior doctors deliver.
"It would see these same 3 doctors only being paid around ÂŁ90 between them, still extremely good value for a surgical emergency.
"That is why this week they are striking to be paid what they are worth.
"As we have made clear in our latest offer to begin talks, we are always ready to talk and Mr Barclay can stop the strikes at any time if he proposes a credible offer."
Health and Social Care Secretary Steve Barclay said: "It is extremely disappointing the BMA has called strike action for four consecutive days.
"Not only will the walkouts risk patient safety, but they have also been timed to maximise disruption after the Easter break.
"I hoped to begin formal pay negotiations with the BMA last month but its demand for a 35% pay rise is unreasonable - it would result in some junior doctors receiving a pay rise of over ÂŁ20,000.
"If the BMA is willing to move significantly from this position and cancel strikes we can resume confidential talks and find a way forward, as we have done with other unions.
"People should attend appointments unless told otherwise by the NHS, continue to call 999 in a life-threatening emergency and use NHS 111 online services for non-urgent health needs."
Chief executive of the NHS Confederation Matthew Taylor said the likely impact of the strike is "heartbreaking" and called on both sides to end their "battle of rhetoric".
Mr Taylor said there is "no question" this strike will be more disruptive than the 72-hour walkouts by NHS staff last month, which led to 175,000 cancelled appointments.
Shadow health secretary Wes Streeting said : "The junior doctors' strike this week will cause huge disruption to patient care.
"Where is the Prime Minister and why hasn't he tried to stop it?
"Rishi Sunak says he 'wouldn't want to get in the middle of' NHS pay disputes.
"Patients are crying out for leadership, but instead they are getting weakness."