An unprecedented four-day strike by tens of thousands of hospital doctors has paralyzed the English healthcare system this week, once again leading to severe restrictions on patients. Up to 350,000 examination appointments, treatments and operations have to be cancelled. About half of the medical staff in the hospitals will be absent until Saturday morning.

Philip Plickert

Business correspondent based in London.

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It is an unprecedented strike by the "junior doctors" that puts the state, tax-financed health care system NHS in England in severe distress. Since last year, the NHS has been repeatedly affected by major strikes by nurses and ambulance drivers demanding wage increases above the rate of inflation.

Minister: 35 percent demand is "unreasonable"

Now it is again about a lot of money. The British Medical Association (BMA) is calling for a 35 percent salary increase for its members. This leap is necessary to compensate for real wage losses over the last decade and a half, argues the BMA. Health Secretary Steve Barclay criticized the demand as unreasonable and unrealistic.

Talks with the union could only be resumed if the medical association moved significantly away from this position and cancelled the strikes, warned the conservative minister. The strike is highly regrettable and threatens patient care, he said. The union accuses Barclay of treating them "with contempt". The disruptions in hospital operations are necessary for the government to move. Matthew Taylor, the head of the NHS association, called it "depressing" that the two sides could not get closer in the dispute.

The staff ceiling in the hospitals is extremely thin

Currently, the conflict is once again being carried out on the backs of the patients. Emergency and intensive care units are also affected. Vital operations, for example for cancer patients or emergencies, should be carried out, it is said. But almost all other appointments for patients are cancelled. Stephen Powis, the NHS medical director, warned that staff levels in hospitals were extremely thin and patients were at risk. The NHS, founded in 1948, has never seen such a strike as now.

In the foreseeable future, the strike will lead to a further increase in the backlog of patients waiting for examinations and treatment – in some cases for many months. The "real damage" will probably only be visible in the near future, a leading NHS employee was quoted as saying. It will take months until the large hospital organization on the island can work through the mountain of failed appointments. Indirectly, the strike would also have an impact on seriously ill citizens, such as cancer patients.

In March, the junior doctors had already gone on strike for three days. Previously, several times nurses and emergency doctor drivers had gone on strike on a daily basis. The population is called upon to refrain from all dangerous activities and risky sports that can lead to injuries.

Union members picketed in front of numerous hospitals on Tuesday. Some sang songs. On posters, they criticized that wages were not fair. Young doctors received only 14 pounds (just under 16 euros) hourly wages, according to the BMA. Newcomers to the profession receive just under £30,000 basic salary in the first year. With extras for overtime and night bonuses, they come in the second year over 40,000 pounds, after three years just over 50,000 pounds and after eight years to a good 75,000 pounds, according to the ministry.

More than 7 million patients on the waiting list

The situation in the NHS is extremely tense. A symbol of the misery is the waiting list, which has become drastically longer since the corona crisis, because tens of thousands of Covid patients had to be cared for and millions of screenings and treatments were postponed during the lockdowns.

Before Corona, there were about 4.5 million patients on the NHS system's waiting list. Currently, there are more than 7 million waiting for an appointment or treatment, almost half of them longer than 18 weeks. Around 380,000 patients even wait more than a year until the desired date in the tax-financed system. The average waiting time is fourteen weeks.

In addition, there is a "hidden backlog" of patients who no longer try to get an appointment, according to the BMA. The situation is also drastic in many emergency rooms. 30,000 patients per month waited more than twelve hours until they were treated in the emergency department and admitted to a normal medical ward.

The trade union and the Labour opposition accuse the government of having weakened the health system through years of austerity. The government counters that it has allocated additional billions to the NHS. In the next financial year, the Department of Health will give the NHS England a good £160 billion directly.

According to recent polls, a majority of respondents in Britain support the striking doctors and think more money for health care is right. It is undisputed that hospitals suffer from staff shortages. About a tenth of the positions – more than 120,000 in NHS England, including about 9000,<> medical positions – are vacant.