Forty thousand physicians in England planned a 24-hour walkout starting Tuesday that was called off late Monday.
The strikes were planned by junior physicians who seek a change in Secretary of State for Health Jeremy Hunt's revised requirements for physician working conditions. Mr. Hunt wants to change physicians' contracts to create a seven-day NHS with non-emergency health services available across the weekend and outside office hours.
But the British Medical Association, the physicians' union, says that would result in physicians working dangerously long hours without overtime pay. Physicians in the United Kingdom are largely employed by the National Health Service, which provides free healthcare to all U.K. residents.
The NHS issued a warning to the public to avoid emergency departments during the first of three planned protests Tuesday. Late Monday, last-minute talks between the BMA and NHS resulted in the cancelation of all three planned protests, according to BBC. The move came too late for many hospitals and patients, though. Upwards of 4,000 routine procedures and treatments were already canceled in light of the planned walkouts.
Here are five things to know about the planned strike.
1. Mr. Hunt's contract aims to redefine physicians' normal work week to include Saturday, and narrow overtime pay rates. Currently, junior physicians receive greater pay for shifts worked any time on the weekend and between 7 p.m. and 7 a.m. on weekdays. Under Mr. Hunt's plan, this higher pay rate would narrow, only applying between 10 p.m. and 7 a.m. on weekdays and after 7 p.m. on Saturdays.
Physicians are concerned that the changes will remove safeguards preventing the NHS from overworking them. Virtually all junior physicians — 98 percent — supported strike action, according to The Guardian.
"We regret the inevitable disruption that this will cause but it is the government's adamant insistence on imposing a contract that is unsafe for patients in the future, and unfair for doctors now, that has brought us to this point," said a spokesman for BMA, according to The Guardian. "Rather than attacking junior doctors, the secretary of state should be taking up the BMA's offer to discuss how we resolve this dispute through [the advisory, conciliation and arbitration service]. It was disappointing that he appears already to have rejected this already."
2. The more than 40,000 junior physicians planned three days of protests in total. They planned to provide only emergency care for 24 hours beginning Tuesday, Dec. 1, at 8 a.m. The physicians were then poised to take full strikes from 8 a.m. to 5 p.m. on Dec. 8 and 16. Army physicians were likely to be called in to provide care in place of physicians, according to The Guardian.
3. Mr. Hunt argues the extended work week is necessary to curb the dangers of lower weekend hospital staffing, as research shows patients are more likely to die during staff shortages over weekends than during weekdays when more staff are on call, according to the Daily Mail. He told The Guardian the BMA junior physicians, the chair of the Junior Doctors Committee and some "militant" supporters were trying to turn the contract dispute into "an ideological dispute when the truth is it is about improving patient care at weekends, nothing more, nothing less."
4. Although a temporary agreement was reached late Monday, hospitals already canceled surgeries or postponed treatments. One hospital canceled 80 percent of its planned operations Tuesday, according to the BBC, while others called off 10 to 25 percent.
5. The BMA has until 13 January to take action if the next round of talks does not reach a permanent agreement.