Consultants go on strike – how bad is it going to be?  

Welcome to Thursday’s Early Edition from i.

At 7am today, thousands of the country’s top doctors will walkout of their jobs in a strike over pay – their first major action in nearly 50 years. NHS bosses have said it will leave hospital care at a “standstill”. Yesterday, NHS national medical director, Sir Stephen Powis, said: “This could undoubtedly be the most severe impact we have ever seen in the NHS as a result of industrial action. Consultants will not only stop seeing patients themselves, but they won’t be around to provide supervision over the work of junior doctors, which impacts thousands of appointments for patients.” The action comes hot on the heels of a five-day strike by junior doctors, which has added to the painfully long waiting lists plaguing the health service. How severe will today’s and tomorrow’s strikes be? And what are the issues behind it? We’ll take a look after the headlines.

Today’s news, and why it matters

Environmentalists and experts have cautiously welcomed the news that a £4bn battery gigafactory will be built by Tata, owners of Jaguar Land Rover, in Somerset. The project is believed to have been secured by as much as £500m in subsidies from the Government and follows extensive criticism that Britain was falling behind the EU and US in funding the green transition.

Former Bank of England interest rate-setters, economists and financial experts have told i that interest rates are likely to be increased by 0.25 percentage points rather than 0.5 in early August, given the UK’s lower than expected inflation figure. Former rate-setters also told i that even though the inflation rate fell on Wednesday, they still think the PM’s pledge to halve inflation by the end of the year – leaving it at just over 5 per cent – hangs in the balance.

A British holidaymaker with a home in southern Italy has cancelled her planned trip because of the “ridiculous” heat, while a retired UK couple say they are ditching their baking B&B as temperatures soar in Sardinia. The holiday island was forecast to reach 48°C on Wednesday, making it the hottest Italian region, and a pair of British pensioners touring its pristine wilderness say they feel trapped in “a frying pan”.

Labour has a “mountain to climb” to win Boris Johnson’s former seat of Uxbridge and South Ruislip, party sources believe. While Sir Keir’s party was bullish about taking the west London seat when Mr Johnson resigned as MP more than a month ago, a row over the expansion of London’s Ultra Low Emission Zone (Ulez) traffic emission scheme has overshadowed their campaign and some fear could deny them victory.

In Somerton and Frome, the Lib Dems are worried even lifelong Tory voters switching sides may not be enough to swing Thursday’s by-election. The Lib Dems are trying to convince people to vote tactically, but their former confidence has taken a knock.

Tobias Ellwood, the chair of Parliament’s Defence Select Committee, has apologised for a video in which he claimed Afghanistan had been “transformed” under the Taliban. In the clip posted to Twitter from Afghanistan on Monday, Mr Ellwood, a former defence minister, said corruption was falling and security had “vastly improved” – with no reference to the harsh restrictions re-imposed by the Taliban on rights for women and girls.

Three questions over the consultants’ strike:

How disruptive will the next 48 hours be? The latest junior doctors’ strike meant more than 100,000 hospital appointments and procedures in England were cancelled, NHS figures say, and the consultants’ strike is expected to add to that. Over 650,000 appointments and procedures have been delayed since the strike started in the NHS in December. Cancer screenings are likely to be delayed this week and cause an influx of patients with “deteriorating” chronic illness in A&E departments, NHS leaders warned. Thousands of operations, procedures and appointments have been cancelled and are being rescheduled. Under contigency plans made by hospitals, elective appointments and operations have been reduced to create space and capacity for life-saving emergency and urgent services. Adam Brimelow, director of communications at NHS Providers, previously told i: “Trusts are expecting widespread disruption to patient care with junior doctors and consultants taking almost back-to-back strike action. With waiting lists already at a record high, there is a real worry about the ‘invisible impact’ of these strikes with more people in pain, discomfort and poor health waiting longer than they should for treatment, arriving at A&E as emergency admissions with deteriorating conditions.”

What do doctors say? In a powerfully worded letter to Steve Barclay, the Health Secretary, consultants from the University Hospital Trusts in Dorset say they want pay restoration over meaningful time. They say that their earning figures published in the press are misleading as they do not reflect a standard 40-hour working week, pension changes and the levels of debt doctors incur for their studies. “After 15 years of real term paycuts, many of us are now working extra weekends and taking additional duties in the NHS to support our families and loved ones,” it says. The British Medical Association (BMA) says consultants on a 2003 contract earn a starting salary of £88,364 in basic pay, rising to £119,133 after around 19 years. The Department of Health said extra payments such as clinical excellence awards and cash for being on call would take the average NHS pay for consultants in 2023-24 to around £134,000. One consultant wrote on Twitter: “I qualified from med school 18 years ago, but if I qualified today, I would have 3x more debt (>£100k) at a higher interest rate and during my junior doctor career (at least 8 years, for me it was 13!) I would earn 30-40 per cent less under the current contracts”. He added: “I will sleep well tonight, knowing my patients will be safe tomorrow, between the consultants on call and not striking, there’ll be more consultants working than a weekend, and my junior doctors are excellent, they really do deserve more, now and in the future.”

Will there be more negotiations? Currently – no. Under plans announced for public sector workers by the Government last week, hospital consultants will receive a 6 per cent pay rise. But the BMA has called this “derisory” and says consultants have seen real-terms take-home pay fall by more than 35 per cent over the last 14 years. Dr Vishal Sharma, BMA consultants committee chair, said: “Consultants don’t want to have to take industrial action, but have been left with no option in the face of a Government that continues to cut our pay year after year. However, it is not too late to avert strike action and the Government simply needs to come back to us with a credible offer that we can put to our members. The BMA is calling for “full restoration” of pay, equivalent to a 35.3 per cent pay rise. The Government insists the pay rise is the final offer, and Rishi Sunak added there would be “no more talks on pay”. However BMA leaders are still urging the Health Secretary to discuss how to avert strikes, with more currently planned for August.

 Around the world

Two people have been killed and six injured in a shooting at a construction site in Auckland, New Zealand, just hours ahead of the opening match of the Fifa Women’s World Cup. Police said the shooting was “not a national security risk” and that the gunman was also dead.

Vladimir Putin is planning a record-breaking landslide win in Russia’s presidential election next year in an effort to shore up his regime, according to independent Russian media. “The administration has decided that he should win with at least 80 per cent of the vote,” reported news website Meduza, citing sources close to the regime.

The European Space Agency has warned that the hottest European temperature ever could be logged this week, breaking the record 48.8ºC seen in Sicily in August 2021. Spanish authorities said more than 300 people had died because of excessive heat in a three-week period. Italy put 23 cities on red alert on Wednesday, warning that temperatures could reach 46ºC. Red alerts have also been issued in north-eastern Spain, Croatia, Serbia, southern Bosnia and Herzegovina, and Montenegro.

Yevgeny Prigozhin, the head of infamous private army Wagner, has reportedly been sighted in Belarus – his first public appearance in nearly a month after leading a mutiny against the Russian state. In a new video, a man identified as Mr Prigozhin confirms he and Wagner troops are in Belarus and says they will not be immediately rejoining the war in Ukraine.

The cost of taking a train from London to Barcelona is up to 30 times more expensive than travelling by plane, analysis by Greenpeace says. The environmental group is using the figures to highlight what it calls the “outrageous” tax breaks on more polluting forms of transport, which is heating the planet.

The EU has upset British diplomats by endorsing an Argentina-backed declaration referring to Islas Malvinas, the Argentine name for the Falkland Islands, upsetting British diplomats. “The UK is not part of the EU. They are upset by the use of the word Malvinas. If they were in the EU perhaps they would have pushed back against it,” an EU official said.

Watch out for…

more strike action – this time from train drivers at 14 companies. 

Thoughts for the day

Forget the Cabinet catwalk in reshuffle, it’s mid-ranking ministers who often matter most. Continuity of expertise among ministers of state should be seen as a mark of success, argues Paul Waugh.

I’m 40, childless and happy about it – and I have Barbie to thank for feeling like I can say that. It is easier for me to say I can’t have kids – when really I have never wanted them, says Catherine Renton.

My son has been waiting over a year for a filling with an NHS dentist – his pain makes me feel like a failure. Our children deserve better and the longer we leave it, the worse it’s going to get, writes Georgina Fuller.

Culture Break

Simon Mayo: ‘My show was rudely interrupted by the BBC – Greatest Hits gave me another chance’. After a bumpy exit from the BBC the legendary broadcaster turned thriller writer has settled into a new phase, thanks to advice from Tom Hanks.

The Big Read

Aiden Aslin, the British man who fought for Ukraine: ‘War is 80% boredom and 20% total crazy stuff’. Ten months after his release as a prisoner of war, Aiden Aslin reveals his trauma from torture and why he recently went back to Ukraine.

Sport

Why the 2023 Women’s World Cup could be the most open, unpredictable tournament ever. This could finally be the year when the USA are stopped – with England’s Lionesses among the favourites to pip them to the trophy, writes Katharine Lucas.

 Something to brighten your day

Australian sailor rescued after months lost at sea speaks of his relief – but he’s leaving his dog behind. They drifted aimlessly at sea for nearly three months after a storm destroyed equipment on Tim Shaddock’s catamaran. But now they’re safely on land, he’s saying goodbye to Bella, the dog that joined him on the journey.