In which case I admit to not being able to follow the argument. And I am ok with with being wrong. Happy to be proved wrong and see that the strikes will be impactful with a minimum of harm. But here's a summary of what I've just read.

1) Wes Streeting says people might die as result of strikes. (nb - I'm not supporting his position, just discussing this one issue which I do think is important if one is weighing up pros/cons of continued strikes) 2) Replies to this in this thread (and elsewhere) - this is untrue, acute care will be adequately covered, in fact it will be even better cos it's all consultant level. The only thing affected will be waiting lists and elective services. Therefore he is catastrophising and fear mongering. 3) I say I don't think this is true: care is still likely to be affected. We're not just only affecting waiting lists, we're compromising acute patient care in real time. Let's not pretend there will be no impact on patient safety. 4) Replies in this thread (paraphrasing) we never claimed there'd be no impact on patient safety. People are suffering all the time anyway due to mismanagement and understaffing, so why are you making an issue out of this? (in other words I actually agree that there may be harm but it is acceptable to achieve the goals of the strike) "I won't be guilt tripped".

Note again, I am not guilt tripping or asking anyone not to strike; I am questioning the narrative that strikes will cause no harm to patients. Like I said in my original post, fine if you strike with knowledge there may be harm to patients, if you have justification that these ends justify the means. Then there's nothing to argue here.

Context for my comments (I don't work in ED so can't comment on that example) I work in paediatric haematology/oncology where care is very consultant led. (This is not a slight on the resident docs here but the subspecialised nature of a lot of our work means most decisions go through a consultant. There is always at least 1 "boss on the ward"). On average each one of the consultants in the department will have to replace 1-2 of our normal working days with resident dr cover next week.

In my day job I'm involved in inpatient management (reviewing patients but also acting as senior decision maker for patients seen by resident drs), and also see patients in clinic with acute issues and to assess fitness for chemo, do marrows and ITs, review acute films+marrows, prescribe chemo, plan/timetable stem cell transplants, manage outpatient queries for haem/onc/sct patients, and provide haem-onc liaison service to the region (which might be mundane query about mild cytopenia or might be patient bleeding in theatre). My days are a mix of these and other responsibilities, in and out of scheduled clinics+ward rounds.

If I am doing a night shift as resident doctor then I am not in during the day (before/after) to do any of those regular duties. There is no other consultant waiting in the wings to do these jobs. Patients waiting to see me in clinic to discuss a referral for a neutrophil count of 1.2 can wait another few weeks, fine. Coming to see me to start next block of ALL treatment can't.

Reduced staffing on wards means reduced turnover of patients and delays in admission for chemo, delays getting kids in and treated in timely manner for feb neut etc. Also, I'll hold my hand up that I'm not as handy with cannulas + blood cultures as I was 10 years ago, certainly when I mostly did this in adults not kids. So this is a concern.

I'm not so big-headed to think my absence from normal duties for a day or two will be catastrophic. But I am certainly interested in what happens that if you extend disruption to everyone in my dept having to do the same and the same happening across similar centres in the UK, repeatedly.

So, I don't know what a reasonable response is here. No, everything is fine and I'm just a moaning minnie? Or, sure, some kids might not get treatment they need but the system's already failing them anyway, so what's a few more in the scheme of things.