Non-urgent care targeted by doctors' industrial action

The first industrial action by doctors for almost 40 years is under way.

British Medical Association members across the UK are boycotting non-urgent care in a dispute over pensions.

Routine hospital appointments and non-emergency operations will be affected, while GPs are also taking part.

The scale and the extent of the disruption to patients is not yet clear, although doctors have promised not to target emergency care.

Much will depend on how many doctors take part.

Most medics working in the NHS are members of the BMA.

The union balloted 104,000 doctors about industrial action and half responded.

Eight in 10 were in favour of taking action.

Ahead of the action, some NHS trusts were saying fewer than 10% of bookings had been cancelled.

These included appointments with consultants and operations such as knee and hip replacements.

However, it is possible there will be cancellations on the day as doctors do not have to tell their employers whether they are taking part.

Both the government and BMA have been quick to stress that patients should still seek help if they need it.

A&E units and maternity departments will remain open.

GP telephone lines will also be staffed and anyone needing an urgent appointment should get one.

Only routine check-ups have been cancelled by GPs.

However, NHS leaders have warned the disruption to patients could be worse than expected.

NHS Employers director Dean Royles said the industrial action could lead to surges in demand in places such as A&E units.

He added: "We are deeply concerned about the distress it will cause patients."

BMA chairman Dr Hamish Meldrum said: "Our intention is not to have the maximum impact on the public.

Dr Naveem Akram is a partner of a GP surgery in Swansea. He will be handing out flyers to his patients so they understand what is happening.

But he says patients needing care on the day will still be seen. Only the routine follow-up appointments and medicine reviews have been put off.

"I don't want any disruption and inconvenience to patients but I want to do something to show that I am not in favour of the changes.

"From a professional point of view, this is not a nice position to be in. We're hardwired to look after patients so to do something like this is not nice.

"But these changes pretty much double my pension contributions. The argument that the current pension scheme is not sustainable is wrong. "

"Our argument's not with the public. It's with the government.

"Yes people will be inconvenienced but we want to get back to real discussions, sensible discussions about how we can move forward."

The BMA has argued the government is wrong to try to change the current arrangements because a new deal was only agreed in 2008.

It has pointed out that the current scheme is bringing in a surplus of £2bn a year and under the new plans they are being asked to contribute much more than other high earners in the public sector.

Under the plans, doctors will be asked to work for longer - until 68 - and contribute more of their pay.

But ministers have insisted the changes are necessary.

Health Secretary Andrew Lansley said: "The BMA has failed to recognise the economic and political realities.

"We all wish there was more money to go round but there isn't, everyone is having to tighten their belts."

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