Junior doctors have started a 24-hour strike over a new pay and working hours contract, forcing thousands of routine operations to be cancelled.
Hospitals in England have rescheduled about 4,000 non-emergency operations, or 13% of the normal daily total.
In the first strike by hospital doctors in 40 years, up to 38,000 members of the British Medical Association (BMA) began the action at 8am on Tuesday.
The doctors have agreed to provide emergency care for 24 hours only in the first of two planned strikes this month and have threatened to withdraw emergency services in a third strike in February.
Prof Sir Bruce Keogh, the NHS medical director, has told hospitals to order doctors back to work if services become dangerously overstretched. In a letter to NHS trusts, published by the Telegraph, he said doctors should be told to return if there is an “exceptional and sustained deterioration in performance”.
The BMA said Keogh was meddling with doctors’ right to strike.
Government ministers have declined to comment on the strike since it began, leaving the NHS director to defend the employers’ position.
The Labour leader, Jeremy Corbyn, urged ministers to apologise for the failure to avert a strike. In a post on Facebook he wrote: “No NHS worker takes lightly the decision to strike, but the blame must be laid at the door of this government for the way it has treated doctors and now seeks to smear them in the press. It is time for this government to apologise to junior doctors and negotiate a fair deal that gets our NHS working again.”
Sir Robert Francis QC, who led the inquiry into the Mid Staffordshire scandal and is a non-executive director of the Care Quality Commission, said industrial action would only “compromise patient safety”.
Speaking on BBC Radio 4’s Today programme, he said: “The only way that matters can be solved for doctors and patients is for talks to continue and for emergency care not to be withdrawn.”
But Francis said the government should listen to doctors and explain their offer to them more clearly. He said: “I quite understand why many of them [doctors] feel angry. They need to be listened to. One thing I would ask is done is that a better explanation is given to them all as to what the effects of any offer being made on them is personally. I’m not entirely confident that that has yet happened.”
The BMA said it had been forced to act after ministers refused to heed its concerns that the new contract proposed by Jeremy Hunt, the health secretary would be unfair on doctors and reduce patient safety. Approximately 98% of its members backed strike action in a ballot in November.
They are opposed to Hunt’s plan to classify Saturday as part of a junior doctor’s normal working week for which they are paid at only the basic rate. He also wants to see the portion of weekday evenings classified as normal time extended from 7pm to 10pm, but junior doctors fear this will lead to cuts in their pay.
Hunt has offered to raise junior doctors’ basic pay by 11% to offset the loss of overtime they currently earn for working in the evening and on Saturday, and has promised that no junior will be worse off under the new contract, which is due to start in August.