The picket line outside Great Ormond Street Hospital, London. Image: Al Riddell.

Thousands of junior doctors across England have taken part in a 24 hour strike which began at 08:00 GMT on Tuesday morning.

The strikes have arisen from contract changes proposed in 2012, after which unsuccessful negotiations between the British Medical Association (the trade union for doctors within the UK) and government ministers led to talks breaking down altogether in 2014.

The dispute has escalated since the summer after ministers said they will impose the deal.

The strikes are only taking place in England as other countries in the UK would not be affected by the contract changes. 

There are over 150 pickets across England where more than 38,000 doctors are striking; the largest NHS strike for over 40 years. 

Dr Johann Malawana, chair of the British Medical Association junior doctors’ committee has told the BBC:

Junior doctors in their thousands have made it quite clear what they think of the government’s plans to impose contracts in which junior doctors have no confidence…We deeply regret the level of disruption caused, but this is a fight for the long-term safety of patients and junior doctors’ working lives.

Proposed changes to the contract include a 25% reduction in the number of hours during the week that are classed as ‘unsociable’- which attract a greater rate of pay.

It is feared this could lead to many doctors being overworked and underpaid.

Also, salary increases linked to the time spent in a job are set to be replaced by a pay system which involves passing certain training phases.

It is thought this may be detrimental to junior doctors’ career progression.

However, in a fresh proposal last November, junior medics were offered an 11% rise in basic pay.

This offer was rejected.

LMMN reporter Harriet Onyett was in Southwark to speak to patients being treated at Guy’s Hospital about their thoughts on the strike action.

There were mixed feelings about the strike.

Many had sympathy towards the doctors and thought action was necessary but there was a concern about the level of care patients may receive during the strike- junior doctors who support the industrial action are providing only emergency cover during the 24-hour period.

However, some had faith that the doctors had patient safety as their main priority and “wouldn’t do it if they were putting lives at risk.”

Negotiations between the BMA and the government have failed on numerous occasions. This strike is the first of 2016 with more action planned for later in the month if negotiations break down again.

Katherine Murphy, chief executive of the Patients Association, agrees with the need for continued negotiations, but insisted that:

Both sides must remember that their first concern must always be to patients, who deserve much better than this.

At Guy’s Hospital on Tuesday morning many patients believed that despite the potential disruption to patient care, everyone has a right to strike.

There was a lot of support for the junior doctors. As one patient put it, what affects the NHS “affects us all.”

A junior doctor holding a placard supporting the strike action. Image: Al Riddell.

The government has described the current arrangements as “outdated” and “unfair”, pointing out they were introduced in the 1990s.

However, the doctors on the picket line at Great Ormond Street Hospital this morning disagree.

LMMN reporter Al Riddell spoke to Nick (left), a junior doctor working in an intensive care unit, who thinks that the contract changes will lead to hospitals being understaffed and could put patients at risk.

Also standing on the picket line was Hoong-Wei Gan, a junior pediatrician. He believes that if the contract is applied in its current form, the whole future of the NHS may be in jeopardy.

And its not just junior doctors present at picket lines. Lucy is a student at University College London, who has ambitions to work for the NHS and has concerns about the changes. She thinks its important to show solidarity with the junior doctors during the strike action.

Health secretary Jeremy Hunt described the 24 hour strikes as “completely unnecessary” and urged the junior doctors taking the action to get back around the negotiation table.

Hunt also said that a new agreement must be reached if the NHS is able to deliver a satisfactory 7 day service to the public.

“We have some disagreements with the BMA over pay. But we all want to promise every patient who uses the NHS the promise of the same high-quality care every day of the week,” he said.

“And at the moment we have an NHS where if you have a stroke at the weekends, you’re 20% more likely to die. That can’t be acceptable.”

A placard at the Great Ormond Street picket line. Image: Al Riddell.

The Patients Association, an independent health charity, also urged “both sides to continue discussions.”

Any new contract must offer terms that are fair for doctors and protect them. Junior doctors are the backbone of the NHS, and it is vital that they are able to provide the safe and effective care that patients need.

A 48-hour strike is scheduled for Tuesday 26 January for which emergency cover will again be provided.

An all-out junior doctors’ strike is planned for Wednesday 10 February – emergency cover will not be provided.

It is unclear how effective the strike will turn out to be, as the negotiation stalemate continues.

Government ministers and BMA representatives are set to get around the table for more talks later this week.

Reporting by Harriet Onyett and Al Riddell