Crucial cancer surgeries have been cancelled during the doctors’ strike, The Independent understands, amid claims the union demanded “extortionate” pay rates for staff to leave picket lines to respond to patients in need.
Cancer patients were among those to have their operations shelved this week, despite hospitals attempting to maintain planned care during the five-day walkout, which ends on Wednesday and has seen thousands of resident doctors take action in an ongoing dispute over pay.
The revelation comes after NHS England chief Sir Jim Mackey wrote to staff on Tuesday saying that previous strikes had shown that “harm was being caused to patients” when emergency care was prioritised over planned operations.
He also claimed that the British Medical Association (BMA) had asked for “extortionate pay rates” for striking doctors to return to work to address patient safety concerns.
The Independent understands the union had demanded that consultants who were asked to step in be paid thousands of pounds to cover a single night shift.
But the BMA hit back, saying the allegations by the NHS England chief were “unfounded and untrue”, claiming resident doctors do not get enhanced rates to go back into work for what would be a usual shift.
The union has said Sir Jim’s claims are “wholly wrong” and has asked him to apologise.
On Monday, NHS England confirmed it had made 58 requests to the BMA for doctors to work at hospitals where it believed patients could be at risk. It said 18 were rejected, and half of these were because the BMA would approve “only if extortionate pay rates were offered to striking doctors”.
In his message to staff on Tuesday, Sir Jim said: “It has been incredibly impressive to see and hear how hundreds of thousands of staff, including many resident doctors, have pulled together to manage the disruption, protect patients, and ensure the NHS has remained open for care.
“We have learned from the last few rounds of industrial action that harm was being caused to patients by the BMA insisting on just prioritising urgent and emergency care.
“We have all worked hard to avoid that this time, and while there is still some distance to go, the early indications suggest that the planning has worked. That is not to say that services haven’t come under real pressure.
“We have worked with you to overhaul the process for patient safety mitigations (PSMs), and that has yielded results as well, with nine approved as of Sunday night.
“Unfortunately, despite all requests being made and verified by senior medics, 18 have been rejected by the BMA, with half of those rejections saying the BMA would support only if extortionate pay rates were offered to striking doctors.”
He also claimed some resident doctors came into work during the strike, and some staff had stepped in even when the BMA rejected safety requests.
A BMA spokesperson said in response: “These claims by Sir James – that if ‘Extortionate pay rates were offered to striking doctors,’ then nine of the 18 derogations that were not granted, would have been granted – are untrue and unfounded.”
“When a derogation is agreed between the BMA and NHS England and which requires a resident doctor to return to work, they do not receive any kind of enhanced payment because those resident doctors are going back to their ward or department to do their usual work. Sir James is clearly quite confused about the derogation process if he is suggesting anything different.”
It added under its agreement with NHS England before any derogation is granted a trust is expected to demonstrate they have done everything possible to “incentivise” non-striking doctors to cover the vacant shifts.
This can include paying enhanced rates of pay, the BMA said, and that this is usual practice when asking doctors to take on extra contractual work, over and above normal hours.
The BMA added: “However, the claim that the BMA requires increased payments to striking doctors is wholly wrong and Sir James Mackie should withdraw these comments and apologise for the misleading impression they are creating.”
The BMA said on Monday that patients had been put at risk by hospitals that had continued to carry out routine care rather than prioritising emergency care.
Resident doctors began a five-day walkout on Friday, 25 July, after the BMA rejected a 5.4 per cent pay increase offer for 2025-26.
Doctors have instead demanded a 29 per cent pay rise to address what the BMA has said is a 20.9 per cent erosion of pay since 2008.
However, the health secretary, Wes Streeting, has insisted the government will not move on pay, claiming that doctors have received a 28 per cent increase since Labour came into power.
Health chiefs were told by NHS England to maintain as much routine care as possible amid concerns that patients were harmed over cancellations during the 2023 and 2024 doctors’ strikes.
The BMA and NHS trusts have previously clashed over pay rates that the union has advised doctors to ask for to cover strikes.
For consultants, the BMA suggested 2025 pay rates of £188 per hour for a weekday daytime shift, £250 for a weekend day shift or weekday evening shift and £313 for an overnight shift.
The BMA has been approached for comment.
