NHS bosses urge Steve Barclay to accept Acas role in dispute with junior doctors - The Guardian

NHS bosses have urged the health secretary to let the arbitration service Acas see if it can help to break the deadlock in his deepening dispute with junior doctors in England who are striking over pay.

The NHS Confederation has written to Steve Barclay and the British Medical Association (BMA), the main doctors’ union, asking them to accept the Advisory, Conciliation and Arbitration Service as an honest broker that could set up talks to end the row.

It emerged on Wednesday that the BMA had begun talking to Acas to explore the possibility of it ending the impasse.

The confederation’s initiative and the union’s decision to talk to Acas has put pressure on Barclay to agree. It is unclear if he will do so, however, and the Department of Health and Social Care did not immediately reply to questions.

The confederation represents the 220 NHS trusts in England and the health service chiefs that run them. It has estimated that this week’s four-day strike by junior or trainee medics will lead to as many as 350,000 appointments and operations being rescheduled.

Barclay has called the BMA’s demand for a 35% pay rise for England’s 61,000 junior doctors unreasonable, but he did not respond last week when their leaders signalled their readiness to compromise on the figure by asking him to put forward a credible offer as the basis for negotiations to begin and the 96-hour walkout to be called off.

The NHS Confederation’s chief executive, Matthew Taylor, told Barclay and the BMA in his letter that health service bosses were worried that the dispute would significantly harm the NHS unless the two sides agreed to engage in meaningful discussions.

“While we await what we hope is inevitable eventual negotiation, our members are questioning how much damage will be caused along the way,” he wrote. “Health leaders want both sides to do everything within their power to find some common ground as soon as possible, and it seems that the current approach is not working here.”

There are no talks ongoing, only increasing public hostility between the sides. In reference to that, Taylor wrote: “Therefore we are now urging you both to invite Acas, the Advisory, Conciliation and Arbitration Service – or another mediation service – to support with negotiations and help to bring this industrial action to a close.

“With both sides having seemingly incompatible preconditions for negotiation, we believe this option should be explored as a matter of urgency to help bring both sides to the table and find a way forward.”

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The BMA’s leader, Prof Philip Banfield, said that because “the government consistently refuses offers to meet and puts up obstacles to prevent any meaningful talks occurring”, he hoped ministers would drop their preconditions and agree to Acas playing a role.

Despite the BMA’s willingness to compromise, Barclay claims it is insisting on its 35% claim as a precondition for talks to occur. Banfield denied that and accused him of being “seemingly intransigent and inflexible to all our attempts to reach a settlement”.

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2023-04-12 20:50:00Z
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Prince Harry was convinced to attend King Charles' Coronation due to massive 'fear' - Daily Record

Prince Harry was convinced to go to King Charles Coronation out of fears he would regret not going, sources have claimed. Despite his estranged relationship with the royals, Harry will be attending the celebration on May 6.

Buckingham Palace announced on Wednesday that the Duke of Sussex would be part of the congregation inside Westminster Abbey for the historic event next month. But he will be attending solo, as Meghan Markle will remain in California with their two children.

It's believed that Prince Archie and Princess Lilibet didn't receive invitations to the Coronation due to their age, as sources cited the Sussexes children are "very young". While Harry will attend the event, he is not expected to take part in the King’s Procession or the Coronation Procession to and from Buckingham Palace, writes the Mirror.

Archie will turn four on May 6 this year - the same day as King Charles' coronation (Image: Getty Images)

He is also unlikely to stand on the balcony, as Charles has reserved that for working members of the royal family. According to royal sources, Harry was aware that the historic occasion will be "pretty much the most important day" of his fathers life.

Sources told The Telegraph that Harry knew he would always regret it if he turned down the invitation to the Coronation. While Meghan has always spoken highly of Charles, she doesn't have the same connection to the royals or the UK.

Harry wanted a meeting with Charles and William ahead of the Coronation (Image: Getty)

Wednesday's announcement now ends weeks of speculation about whether or not the couple would be at the Coronation, which has been causing a lot of drama behind-the-scenes.

In a statement, the Palace: "Buckingham Palace is pleased to confirm that the Duke of Sussex will attend the Coronation Service at Westminster Abbey on 6th May. The Duchess of Sussex will remain in California with Prince Archie and Princess Lilibet."

Top TV news

According to sources, Harry wanted a meeting with his estranged father and brother to clear the air before the Coronation. A source told The Mirror: "Harry has been very clear and his position hasn't wavered – he isn't going to come if he feels the atmosphere will be as toxic as it was during the Queen’s Platinum Jubilee and funeral.

"He's said he wants to reconcile with his family and it’s their call, but so far nothing has changed."

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2023-04-12 18:16:14Z
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Suspected pipe bombs found in Northern Ireland cemetery ahead of Biden visit - The Telegraph

Four suspected pipe bombs were discovered at the scene of a dissident republican march on Tuesday as Joe Biden flew into Northern Ireland pledging to “keep the peace”.

Police were attacked for a second day in Londonderry as officers made safe the crude homemade devices, hours before the US president arrived in Belfast to mark the 25th anniversary of the Good Friday Agreement.

The devices were found at the city cemetery off the Creggan estate where the previous day hundreds taking part in a dissident republican march were urged to “join the IRA”.

The Good Friday Agreement created the Northern Ireland Assembly, which is based on power-sharing between unionists and nationalists and Mr Biden vowed to promote Rishi Sunak’s Brexit deal and protect the peace-keeping agreement.

Northern Ireland has been divided by the new Windsor Framework and the president, a Catholic who regularly refers to his Irish roots, will tell the DUP to drop their year-long boycott of the Assembly.

“Make sure the Irish accords and the Windsor Agreement stay in place, to keep the peace. That’s the - that’s the main thing. And it’s [looking] like we’re going to - keep your fingers crossed,” Mr Biden said.

Mr Biden disembarks Air Force One upon his arrival at RAF Aldergrove airbase in Belfast Credit: Reuters

Mr Biden was greeted by Mr Sunak upon arrival Credit: AFP

The DUP has accused Mr Biden, who will spend less than than 24 hours in Northern Ireland before three days south of the border, of being anti-British.

“Pressure from an American administration which is so transparently pro-nationalist constitutes no pressure on us at all,” said Nigel Dodds, the DUP peer. 

“Our decisions will be taken with the interests of Northern Ireland at the heart of our thinking. That’s not what the Americans are about, especially Joe Biden.”

DUP MP Sammy Wilson said: “He’s anti-British. He is pro-Republican and he has made his antipathy towards protestants in particular very well known. 

“He has fully backed the EU in this whole Protocol process. He’s refusing to come to the coronation. I don’t think any of us are rushing through the door to greet him.”

PM won't attend Biden's keynote speech

Mr Biden angered unionists when he warned Britain there would be no post-Brexit trade deal with the US if the UK carried out its threat to tear up the Northern Ireland Protocol treaty with the EU.

The Prime Minister, who will also meet Mr Biden during his whistlestop visit, has since struck the new Windsor Framework agreement with the EU.

But Sir Jeffrey Donaldson, the DUP leader, has said the new treaty does not do enough to protect Northern Ireland’s place in the UK and has refused to return to power-sharing. 

Mr Biden pictured boarding Air Force Once ahead of his arrival in Northern Ireland Credit: KEVIN LAMARQUE/Reuters

Mr Biden was expected to address Stormont but instead he will meet the five leaders of Northern Ireland’s major political parties at the opening of a new branch of Ulster University in Belfast and urge the DUP in person to end the deadlock.

Mr Sunak will not attend Mr Biden’s keynote speech, with Downing Street denying that the pair’s own talks would be “low-key”.

Unionists have not forgiven Mr Biden for several gaffes and accuse him of arguing against laws making it easier to extradite IRA terrorists from the US when he was a senator. 

The DUP are facing local elections in May and the prospect of bleeding support to the hardline and virulently anti-deal Traditional Unionist Voice, which has made them more determined to resist the overtures of the world’s most powerful man. 

'He shouldn't have bothered'

“Biden is irredeemably partisan,” Jim Allister, the TUV’s leader told The Telegraph.

“His continuing stance is anti-British and anti-Unionist. With our public finances severely stretched, we could well do without squandering £7 million on security for him.”

But Stephen Kelly, the chief executive of Manufacturing NI, said the president’s visit was a great opportunity for Northern Ireland, which is the poorest region in the UK. 

“This is not just a chance to celebrate and reflect on 25 years of peace but launch the next 25 years of prosperity.”

Northern Ireland has been divided by the new Windsor Framework and Joe Biden Credit: JIM WATSON/AFP

On Belfast’s Shankill Road, locals said the president’s visit would do more harm than good as they stood amid the backdrop of murals including a tribute to the late Queen and memorials to civilians murdered by the IRA.

“He shouldn’t have bothered,” Elizabeth Jones, 65, said as she watched a unionist band parade with her daughter Miriam Martin, 44.

“He should have just gone on down south. Not that we want him anyway. He’s re-opening old wounds like the Kennedys did. He’s not interested in the peace process, all he’s interested in is Republicanism. It’s none of his business.”

Sandra Smyth had been watching the parade with her granddaughter Clara, three, who waved a union flag from her pram as family members taking part passed by.

Ms Smyth, 63, a retired nursing home worker, said: “He’s just another American president doing what American presidents do best, going to other countries, causing trouble and then going back home.”

Meanwhile, a poster lambasting prominent politicians including Mr Biden for “not listening” could be spotted on the streets of Belfast ahead of the US leader’s visit.

Hundreds of extra officers drafted in

Mr Biden arrives amid the biggest security operation in Northern Ireland since the G8 summit a decade ago. Hundreds of extra officers have been drafted in to help protect the president as part of the £7 million operation.

Police are on high alert after an armoured Land Rover was firebombed in Londonderry during a march linked to the New IRA, now being investigated by counter-terror police.

The pipe bombs were discovered close to where the colour party wearing paramilitary style clothing leading the illegal march burnt their outfits. 

Bobby Singleton, the Police Service of Northern Ireland’s Assistant Chief Constable, said that the force's warning last week that disorder would be used “to launch terrorist attacks on police” and officers were again attacked with petrol bombs as they investigated the devices.

The cemetery where the suspected pipe bomnbs were found was only accessible to facilitate burials on Tuesday Credit: Liam McBurney/PA

“The discovery of these devices was a further sinister and worrying development. The actions of those responsible are reprehensible and show a complete disregard and utter contempt for the community. These suspected pipe bombs were left in a cemetery, a place where people lay loved ones to rest and visit to pay their respects. That is absolutely shameful.”

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2023-04-12 01:21:00Z
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‘Joining the picket line is a last stand’: junior doctors on the four-day strike - The Guardian

The four-day junior doctors’ strike beginning on Monday across England will result in an estimated 350,000 appointments, including operations, being cancelled, with experts raising fears for patient safety.

Three junior doctors share their views on the strike and whether they will join the picket line or not.

‘I look after 70 patients per shift for £10.71 per hour’

I am a Foundation Year 1 doctor working in Greater London. I’m in my first year of work following six years training at medical school, from which I gained over £84,000 of debt with an interest rate of 6.9%, and two degrees.

Last month, my average hourly take-home pay, including additional pay for nights, weekends and evenings, but after deductions for tax, student loan, NI, and pension, was £10.71 an hour. In London. My hourly daytime rate before deductions is £14.09. I get a payment of £12.42 per month to offset the cost of living in London. For context, my rent is £19,500 per annum excluding bills for a small one-bedroom flat, which I split with my husband.

This weekend I was the sole doctor looking after around 70 patients – and that is at full staffing levels without any rota gaps or colleagues calling in sick – both very common occurrences. I assessed an elderly, frail patient and made the difficult call to stop their active treatment and put them on an end-of-life pathway. I read ECGs, assessed patients with low and high heart rates, new shortness of breath, aches and pains. I put in cannulas and took bloods, requested X-rays and interpreted the results. I prescribed all the medications and fluids needed for my 70 patients.

A more experienced junior doctor, a registrar, was available to advise me over the phone if I had any issues or needed confirmation that my plans for patients were sensible, but largely the work was done independently. I didn’t see or speak to a consultant all weekend.

Being a junior doctor is a huge responsibility with huge consequences if you make a mistake. Despite the love I have for my job, I don’t think it’s a fair wage. Next year my pay will go up by £2.22 per hour, before tax and other deductions, and with it will come a further increase in responsibility. Joining the picket line is a last stand. We just have to hope that the government listens.
Sarah, a junior doctor from London

‘I fear doctors risk harming the respect their profession has built up over so long’

I have not, and will not, strike with my colleagues. The [British Medical Association’s] claims don’t stand up to scrutiny. Its headline figure of a 26% fall in pay since 2008-09, which builds the basis for the demand for a 35% pay rise, is based on implausible assumptions.

The Nuffield Trust calculates a fall in pay closer to the region of 8% up to 2021-22 based on analysis of actual earnings on more plausible assumptions. It also doesn’t account for the fact that so many junior doctors are now given the option to – and do – work less than full-time, often taking up virtually boundless opportunities to pick up additional shifts at relatively high locum rates.

Even if the BMA’s claims had merit, I cannot ignore that in two years, in the sixth year of my career and before I turn 30, I can readily earn six-figure sums. This is the trajectory that around half of junior doctors take. Yes, those F1 [the first year of training after finishing medical school] payslips are only just in the region of the national median pay, but I currently earn in the region of £55,000, and that’s before locum shifts.

I cannot in good conscience try to acquire an even greater share of taxpayer money. My work is interesting, fulfilling, well respected, and frequently fun. I would quite willingly do this job for less.

I fear doctors risk harming the respect their profession has built up over so long by using patients as leverage against the government. Even the idea that this is about patient safety seems to have been dropped since the last strikes in 2016. I think it’s inevitable that there is going to be some degree, possibly even a high degree, of unnecessary suffering.
Daniel Hart, 27, a junior doctor in his first year of GP specialty training, from Runcorn

‘I’m striking for those who will come after me’

I’m dreading going on strike. I work in a community mental health team and during the strikes in March I spent the three days on the picket line worrying about the patients who would not be reviewed due to our absence. I had nightmares that the patients’ mental states had deteriorated, leading to them killing themselves or being sectioned. I’ve worked late every day last week to ensure that my patients will be safe.

I know I’m not alone in feeling like this. No one wants to go on strike, but sadly it’s the least bad option in this workforce crisis. Staffing levels are so poor that there have been shifts in my trust where only one out of three rotas has a doctor working. I’ve had colleagues move to Australia, or venture into pharmaceuticals and finance.

I’m striking not so much for myself, because I’ve only got two years until I’m a consultant. It’s because of the people coming after me. I worry that when I’m a consultant I’ll have hardly any junior colleagues because many will have gone abroad if pay and working conditions aren’t improved.

The government talks about increasing the number of medical school places, but basic life support principles dictate that you try to stem bleeding before giving an infusion. They need to stop the NHS haemorrhaging staff, before it’s too late.
Dominic, 31, a specialist registrar in general adult psychiatry, from London

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2023-04-12 06:53:00Z
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Biden arrives in Northern Ireland to mark peace deal anniversary - Reuters

• Summary

• Biden to mark 25 years of peace in Northern Ireland
• Power-sharing government collapsed over a year ago
• President to travel south to celebrate Irish roots

BELFAST, April 11 (Reuters) - U.S. President Joe Biden was welcomed to Northern Ireland by British Prime Minister Rishi Sunak on Tuesday as he flew in for a brief visit to mark the 25th anniversary of a peace deal that largely ended 30 years of bloodshed.

Biden, who is fiercely proud of his Irish heritage, will spend just over half a day in the British-run region before travelling to the Republic of Ireland for almost three days of meetings with officials and distant relatives.

Biden, who was met by Sunak on the runway at a windy Belfast International Airport, arrives at a delicate time in Northern Ireland and will need to tread carefully as the largest pro-British party continues to boycott the devolved power-sharing government, a key part of the 1998 Good Friday Agreement.

The president spoke for a few minutes to officials on the tarmac, flanked by Joseph Kennedy III, of the storied Irish American political family, whom he appointed as the U.S. special envoy to Northern Ireland for economic affairs in December.

Biden and Sunak will hold a meeting early on Wednesday, and Biden will also engage with each of the leaders of Northern Ireland's five main political parties ahead of his speech at a Belfast university.

Speaking to reporters before boarding Air Force One, Biden said supporting the recent Windsor Framework deal agreed by the European Union and Britain to ease post-Brexit trade barriers in Northern Ireland was one of his top priorities.

"Make sure the Irish accords and the Windsor Agreement stay in place. Keep the peace. That's the main thing." he said. "Keep your fingers crossed."

Northern Ireland's Democratic Unionist Party (DUP) has said Biden's visit - the first by a U.S. president in 10 years - will not pressure it to end its protest at post-Brexit trade rules that treat the province differently to the rest of the UK.

The DUP wants further changes to the revised post-Brexit deal for the province but London has said that is not possible.

Biden, who clashed with the British government at times during the Brexit talks, drawing ire from DUP lawmakers, will float the possibility of closer investment ties between the U.S. and Northern Ireland to try to encourage an end to the impasse.

Security concerns were also highlighted on Tuesday by the discovery of four pipe bombs, small improvised explosive devices, in Londonderry, a city 110 km (70 miles) from where Biden is to stay. Police in a statement linked the devices to Irish nationalist rioters who attacked police there on Monday.

'WE DO NEED HELP'

The latest political stalemate - which followed a three-year collapse of the devolved government from 2017 to 2020 - is set to overshadow the visit and the anniversary of the peace deal the U.S. helped broker between Irish nationalists seeking a united Ireland and pro-British unionists wanting to remain part of the UK.

"It might spur things along and maybe things will be taken a bit more seriously," said Niamh McNutt, a 21-year-old student adviser in Belfast, where security was tight ahead of the visit. "We do need help right now to get things in order and maybe this will give people the push that they need."

There is still some sporadic violence by small groups opposed to the peace process. In February, an off-duty police officer was seriously injured after he was shot by two gunmen in front of his son.

Britain's MI5 intelligence agency increased the threat level in Northern Ireland from domestic terrorism to "severe" following the shooting - meaning an attack is highly likely. It has been mostly at that level since its introduction in 2010.

In Ireland, Biden, who speaks proudly of his Irish roots and frequently quotes Irish poets such as Seamus Heaney, will address the parliament in Dublin, meet Prime Minister Leo Varadkar and visit his ancestral homes on either coast.

The president will travel to County Louth on Wednesday, where his great-grandfather James Finnegan was born, and end his visit with a public address in the western county of Mayo, where his great-great-grandfather Edward Blewitt grew up.

"Since (John F.) Kennedy there hasn't been as Irish American a president as Joe Biden and we're really looking forward to welcoming him home," Varadkar said on Sunday.

Additional reporting by Amanda Ferguson and Aiden Nulty in Belfast; Writing by Padraic Halpin in Dublin; Editing by Alistair Bell and Rosalba O'Brien

Our Standards: The Thomson Reuters Trust Principles.

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2023-04-11 22:25:00Z
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CBI head Tony Danker sacked after misconduct claims - Financial Times

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2023-04-11 17:27:16Z
1901801713

‘I’m here because I care’: junior doctors on NHS picket lines - The Guardian

Having grown up in Romania and spent some time in hospital as a child, Dr Cristina Costache thinks she has seen the future of the NHS if the government does not urgently invest in its staff and services.

The kind of specialist paediatric work Costache does across two hospitals in Leeds is done by voluntary organisations in Romania and resources are thin on the ground, which is why she began working in the UK seven years ago.

On Tuesday, she was joined by dozens of colleagues – and large piles of donated snacks – outside Leeds General Infirmary, some of the thousands of junior doctors taking part across England in a 96-hour walkout over pay and conditions.

“It’s sad to see the NHS going that way,” she said. “I’ve experienced that and I don’t want anyone here to see that. It’s scary. I’ve seen how bad it can be and I’m on the picket to prevent things from going that badly.”

Costache said she has seen the NHS decline significantly over the last decade.

She added: “I teach students adult medicine and some of them who don’t have hospital experience ask, ‘is it usually this bad?’. And I say ‘sorry, but it is’.

“For example, there are patients finding out they have diabetes from their discharge notes because there’s nobody to chat to them. And yet, healthcare is a right.”

“I love this job so much. I wanted to give the care that children deserve. Some children end up spending their whole lives in hospital.

“Emotionally, this job has a big toll. You see things that are hard to see. If you have a child die, you have to switch and not pass on the sadness to the next child.

“What I really like about the UK is compassionate care. My fiance is trying to get me to leave because he sees me coming home exhausted and getting ill. I left a country once and I could leave again, but it’s because I care that I’m here.”

Outside University College hospital in central London, supportive drivers were honking, sound systems were blaring and demands were being chanted as junior doctors picketed.

Rebecca Lissmann, 29, a junior doctor, said she felt “sick in her stomach” when the strikes were announced.

“I don’t want to be on strike, but I hope patients can see that this action is also about keeping doctors in the NHS and to save the service.”

Lissmann is a trainee in obstetrics and gynaecology. “I absolutely love my job but it is a really hard job. People’s lives are genuinely at risk.

“In obstetrics, you deal with people having some of the best or the hardest days of their life. You have big conversations with people having miscarriages.

“To do that in a service that is chronically underfunded, where there are gaps in the rota being filled last minute, all the time, where I’m missing lunch and staying late. I think a lot of junior doctors feel they are not able to provide the care they would like to see for their patients because of the current situation.”

At Addenbrooke’s hospital in Cambridge, cars honked in support of a 10-person picket line that had been holding placards and thanking passersby for their support since 8am.

For Tanmay Anand, 26, a junior doctor in his second foundation year currently working on trauma and orthopaedics, the decision to strike comes from concern for patient care and to improve conditions for future junior doctors.

“The system is now so under-resourced that [they] do not have the capacity to train me.” Anand said this affects his ability to care for his patients and become the doctor he always dreamed of being.

He said overtime is also a given. “You’re contracted to work an average of 48 hours a week but there was not a single week in my first rotation where I worked 48 hours. The average was at least 60 hours. Those 12 extra hours are unpaid.

“There was one week that I counted because I was so tired, where I worked 114 hours. Across those four months in that first rotation, I lost half a stone in weight.”

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2023-04-11 20:47:00Z
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