LONDON (Reuters) - Britain is in turmoil over a second 96-hour strike of junior doctors, amid fears it could threaten patient safety and compound the crisis on patient queues.

The strike comes amid demands by junior doctors for a 35% wage increase after years of no increases, in addition to inflation that has led to a decline in the purchasing power of their salaries to 26% compared to 10 years ago.

Junior doctors in the UK start annually at £29,36 (about $41,60), compared to £<>,<> for their counterparts in the US and £<>,<> in Australia.

According to the financial website "Wise", a family of 4 needs 38,98 pounds to cover the costs of average living in the United Kingdom, prompting junior doctors to approve by a <>% majority the strike organized by the British Medical Association (BMA) representing doctors.

Salaries for junior doctors in Britain annually start from 29,41 pounds, compared to about <>,<> for their counterparts in America (Al Jazeera)

Expected catastrophic effects

The strike will lead to the cancellation of caesarean sections and an increase in the number of patients incarcerated, delays at funerals as doctors will no longer be available to issue death certificates, hospital heads estimate that at least 350,<> routine operations are likely to be canceled, and hospitals expect half of the consultants to cover the shortage of junior doctors' shifts, leading to unprecedented disruption in specialty clinics.

The NHS said the strike would have an impact for months to come on waiting lists of 8.3 million patients, while some medical specialties wait up to 18 weeks.

NHS recorded the worst waiting time for heart attack patients (about 90 minutes), while the average wait for stroke and heart attack patients in Britain is supposed to be 32 minutes, while patients who do not face a threat to life have reached 4 hours in emergency rooms during normal working days that do not witness any strikes.

In order to ease the impact of the strike on patients, a warning was published to citizens on Monday to avoid unnecessary hospital visits and emergencies and to avoid emergency visits, except in life-threatening cases to reduce pressure on emergency rooms.

In leaks published by the British newspaper "Independent", the government's Department of Health and Community Care (DHSC) warned last week of low levels of employment, and the impact on critical care services for both adults and children, as patients will not receive medicines and periodic evaluations on time, especially hospitals in the southwest that are experiencing a severe shortage of medical staff.

NHS chief executive Matthew Taylor expects up to 350,<> appointments and operations to be cancelled as a result of the strike, adding that there is no point in hiding the fact that it would be risks to patient safety and dignity.

Last month's strike led to the postponement of 175,<> appointments and medical operations in Britain (Reuters)

Patient Safety Precautions

Latifa Patel, head of the British Medical Association's workforce, said patients were experiencing a substandard experience, with the NHS suffering from stress and severe shortages of equipment and medical staff, separate from the strike.

Speaking to Al Jazeera Net, Patel added that during the previous strike, the National Health Authority, in cooperation with health unions in England, assessed the readiness of hospitals for the planned strike, and explained that there is an agreed system to ensure patient safety in case of extreme and unforeseen circumstances.

"We met four times a day during the recent strikes to monitor the situation and ensure patient safety, but there were no requests for an exemption to study stopping the strike, so we will implement the same arrangements that proved useful last time," Patel said.

She stressed that junior doctors do not want to strike, and that the government's long-term inaction is what prompted them to strike, noting that they want to end this dispute as soon as possible, and that the association hopes that the Minister of Health will come to the table immediately with a realistic offer so that doctors can avoid further strike and return to the care of their patients.

Government attempts

Health Minister Steve Barclay described the demands of junior doctors as unrealistic, and that these strikes were planned to destabilize the security and stability of the country, while the government submitted a draft law on punitive measures for strikers if emergency institutions do not comply with the minimum operating limits for emergency sectors.

For their part, the union institutions considered the strike law an insult to human rights in Britain, but this opposition did not prevent Parliament from moving forward with activating the law, which reached its penultimate stage before starting its implementation, demanding the need to balance the rights of workers in the strike and the ability of citizens to access vital services.

On March 16, the government made an offer, after lengthy talks with health unions, to more than one million NHS medical staff to receive an additional 6% pay increase.

Speaking to Al Jazeera Net, the media officer in the Department of Communications and Policies of the British Medical Association, Fred Maynard, said that these negotiations did not include doctors in the college as "beginners, specialists, consultants and general practitioners," and what was presented was a presentation to the nursing and ambulance crews, and the Medical Association was not included in any serious negotiations until the moment.

I came across this. It is entirely untrue. Junior doctors who are IMGs are not at risk. JDC will not run strike action that puts IMGs at risk of visa issues. Actual advice here https://t.co/mMkemWbvlX Please retweet to correct this outrageous nonsense. pic.twitter.com/a1d5gkhcvg

— Mike Henley 🤨 (@trentconsultant) April 3, 2023

Threat to international doctors

The crisis also escalated on the fourth of April, when a text message was leaked warning international doctors working for the Lewisham and Greenwich NHS Trust against participating in the strike, and threatening them not to renew their contracts and visas, which angered large sectors of doctors and the Medical Association in Britain.

For his part, the media office of the British Medical Association (BMA) for Al Jazeera Net that this is unacceptable, and that they have issued a statement reassuring international doctors who may be worried, and urged doctors to inform the Medical Association to take the necessary legal action to protect them.

On the other hand, the official account of the "Loshiam and Greenwich" Federation, one of 219 associations and funds in the National Health Authority in the United Kingdom, denied that the letter represents the official opinion, explaining that it is an individual message launched by an employee personally on an informal WhatsApp group of employees, and called on doctors not to worry about their position on the strike.