will take you up to roughly £a0,000. after five years of being a junior doctor that does increase quite dramatically, so you will be more likely to be earning a basic salary of roughly £60,000, and you will get 10% to 20% extra unsocial hours. how does that compare internationally? it is sometimes difficult to know depending on which country you pick because of the weather doctors are categorised as very different across different countries. generally, fully qualified doctor will get paid significantly more in a country like australia, which has been an issue because a large number ofjunior doctors had been working abroad recently, and that is one argument that the bma has to increase wages. in the united states, germany, to pay off a fully qualified doctor is greater than it would be in the united kingdom. however, looking at

other countries, like spain or france, the pay of doctors there is either slightly below that you would expect in the united kingdom or ruffling on that level. it does depend which country you pick if you're at comparisons. fix, depend which country you pick if you're at comparisons. a, lot depend which country you pick if you're at comparisons.— you're at comparisons. a lot of --eole you're at comparisons. a lot of peeple might _ you're at comparisons. a lot of people might have _ you're at comparisons. a lot of people might have sympathy l you're at comparisons. a lot of. people might have sympathy with you're at comparisons. a lot of- people might have sympathy with the government position that 35%, even if it is going back in time and trying to bring them back to the level they should be out, it is not affordable in a cost of living crisis and they can submit to these demands because if they do then we have wage inflation as well. the government make the argument that there has been a separate reduction across england, wales and northern ireland from different members of the medical profession. so we have had ambulance workers and nurses on strike. there, a deal, certain to extent, has been done. so the final deal that was done on a number certain to extent, has been done. so the final deal that was done on a number of certain to extent, has been done. so the final deal that was done on a number of strikes certain to extent, has been done. so the final deal that was done on a number of strikes was certain to extent, has been done. so the final deal that was done on a number of strikes was roughly certain to extent, has been done. so the final deal that was done on a number of strikes was roughly a certain to extent, has been done. so the final deal that was done on a number of strikes was roughly a 5% pay increase for this financial year

in england and then a top up for the last financial year of roughly £1600. so that is the kind of deal i think the government will probably be looking for here. junior doctors reject that for a number of reasons. when you look at the statistics, it does show that over the last 15 years, the pay of doctors, consultants and junior doctors, consultants and junior doctors, consultants being the more senior doctors in hospitals, pay has fallen at a rate that eschew upper than ambulance workers and nurses. so all three of those groups will have seen real terms pay for to a certain extent. but doctors have seen it for more and the bma's and junior doctors' argument is that they need to see this 35% pay increase to restore junior doctors' pay to where it was 15 to 20 years ago. part of the problem here is thatjunior doctors are sticking strongly to that demand. they argue that there are staffing pressures on the nhs at the moment and unlessjunior

doctors' pay is brought up to the level we saw 15 years ago, that will lead to higher vacancy rates and could lead to more doctors deciding to qualify here but then go and work abroad. that of course leads to the pressure on the workforce. it makes working less attractive in the nhs and therefore lead to the spiral where you have more doctors and more people who work in the medical profession decided to leave or retire early. so is a complicated situation for the government. they would argue that a 35% increase would argue that a 35% increase would be unaffordable.- would argue that a 35% increase would be unaffordable. thank you very much- _ while junior doctors strike, their employers, such as health trusts, are busy trying to plug

the gaps and keep the nhs going. dr layla mccay, policy director at nhs confederation, a membership organisation which speaks for health care systems in england, wales and northern ireland. the strikes are going to have a significant impact. our members and health leaders up and down the country are telling us how concerned they are about the disruption that this is going to cause and the lack of capacity across the health service, which is going to mean that in order to focus on urgent and emergency care, many people across the country are hearing that their appointments and operations are having to be postponed. so very fraught at the moment as everybody tries to figure out how much capacity there is and what needs to be done to maintain patient safety. the bma has refused to exempt any services, but says it has plans to protect patients. are you worried that people will die? well, at the moment, everybody has been putting in hours and hours of work to figure out what other mitigations and the best ways to keep people safe. that is what they will be doing throughout the strike

period and beyond. so that patient safety is the primary consideration of health leaders and they are going to be focused on making sure they can do as much as possible. certainly, we have heard from members that they are worried. what would you say to people today who are seeking medical assistance? i would say that if you need medical assistance, you should still go and seek that assistance. if you have other options, for example 111 or going to your gp or pharmacist, you should be aware of all the options that are available and act accordingly. but certainly, services will be there. everybody will be working as hard as they can to deliver that care. continue following the national advice from nhs england. there's already a huge backlog in the nhs, isn't there, after covid? what impact are these strikes going to have on those already lengthy delays for many millions

of people across the country? it is certainly the case that having to postpone hundreds of thousands of appointments is going to have an impact on the waiting lists, and that is incredibly frustrating for everyone involved, not least, obviously, patients themselves. this is obviously hugely stressful whenever your operational appointment has to be postponed. but then, of course, it's very stressful too for health leaders, who will not only be worrying about patients, but also worrying about how they're going to maintain and reduce those waiting lists. and of course, it's stressful for staff as well. nobody wants to see this sort of thing. so it is a very stressful time all round for everyone. with more on this, here's coutney bembridge. let's go through a few figures. firstly, we have 75,000 junior doctors in england. that number represents about half the number of

doctors in hospital, so it is a high representation of that workforce. these are people who have done medical school and then been in the job for ten years. so the label junior is probably not quite accurate there. let's look at what they get paid. as you can see, there are lots of different scales here. this is the first scale. this is when you have just entered the workforce after medical school. the average pay is about £30,000 and and there are extras here. that covers over time and things like working at weekends and unsociable hours. then as you get more qualified, this is years one and two. the pay increases and when we look at band five, that is around year eight, you can see that the pay is around 60,000 with some extras that take it to almost 80,000. this is more of a plea to

come to the negotiating table for the government, but it has had the opposite effect. an update has come into the newsroom in the past hour, quoting a downing street spokesperson saying that the 35% pay demand must be abandoned before the government will come to the table, describing that figure as unreasonable and not affordable for the british taxpayer. they say the strikes must be called off before the government will negotiate. despite that, 4000 members of the british medical association are expected to go on strike this week and this is the impact we will see as a result. at least a quarter of a million appointments and operations affected, but that number could be as high as 350,000 appointments affected. now let's look at the difference between uk in terms of doctors and nurses, compared to other 0ecd nations. so we have got

here austria at the top and the uk at the bottom. when we are looking at the bottom. when we are looking at the bottom. when we are looking at the number of doctors and nurses compared to western europe. of course, this is the uk as a whole, notjust england, but it paints a picture that the uk is at the bottom, also with nurses at the bottom. norway is at the top. the uk is already dealing with a shortage when compared to western european nations. we have also had this warning. this is dated september 2022, and the world health organization described the situation is a ticking time bomb, saying that without action, health and care workforce gaps in the european region could spell disaster. this is from the european federation of public service unions, and it says that the shortage of health care workers is at leasti million. so the situation is not rosy across europe and there have also been

strikes there, so this is a situation that we could see mirrored notjust in england, but across the uk and across the continent. thank you. the strike has put considerable pressure on the system. here is dr keith girling, medical director of the nottingham university hospitals, interviewed by our correspondent rob sissons. he explains how they are trying to guarantee the patients' treatments. we have consultants covering the whole of our organisation, with senior nursing staff, advanced practitioners and other teams that are working to support us. we are pleased to have support from the emergency... passing vehicle honks horn. from the gps and from the ambulance service. so we're doing everything we can to protect patient safety. you can't guarantee it, though, can you? we're doing everything we can to maintain patient safety in a situation where half

of our doctors are on strike. dr claire mitchell is a british doctor, now an emergency consultant, who moved to queenland, australia for work and has now been there for eight years. she said she's stayed because the medical workforce is properly valued, unlike in the uk. i moved to australia for a year's career break and to experience medicine and life in another country, and i am now here eight years later. country, and i am now here eight years later-— country, and i am now here eight ears later. ~ ., ., .,~ ., years later. what do you make of the strikes today? _ years later. what do you make of the strikes today? to _ years later. what do you make of the strikes today? to be _ years later. what do you make of the strikes today? to be honest, - strikes today? to be honest, watchin: strikes today? to be honest, watching it — strikes today? to be honest, watching it from _ strikes today? to be honest, watching it from this - strikes today? to be honest, watching it from this side - strikes today? to be honest, watching it from this side of| strikes today? to be honest, i watching it from this side of the world, it is devastating. my friends and colleagues in the uk, it's their last resort. they don't want to be out of the emergency departments or off the words, and it is a shame it has come to this. but it is playing years of catch up and ultimately playing the long game to protect patients. 50 playing the long game to protect atients. , ., . ., playing the long game to protect atients. . ., , patients. so you decided to stay there after— patients. so you decided to stay there after being _ patients. so you decided to stay there after being there - patients. so you decided to stay there after being there for- patients. so you decided to stay there after being there for one i there after being there for one year. was pay a big factor in that

decision? ~ ., ~' year. was pay a big factor in that decision? ~ ., ~ ., , decision? working conditions was definitely a _ decision? working conditions was definitely a factor. _ decision? working conditions was definitely a factor. pay _ decision? working conditions was definitely a factor. pay is - decision? working conditions was definitely a factor. pay is always i decision? working conditions was| definitely a factor. pay is always a side issue, but it is very wrapped in with working conditions, which is hours and pay. here, staffing is also better, which allow for better supervision and training. and we had access to study leave, access to exam leave, access to annual leave. we got married and were given five weeks off work. it was valued as part of our nonprofessional lives. ultimately, having that wellness within your work culture means that doctors are more rested. we felt valued when we were here, and you then provide better care when you are at work and that improves the whole system and improves patient safety. whole system and improves patient safe . �* ., ., whole system and improves patient safe .�* ., ., ., , safety. and now that you have been there a while _ safety. and now that you have been there a while and _ safety. and now that you have been there a while and worked _ safety. and now that you have been there a while and worked in - safety. and now that you have been there a while and worked in both i there a while and worked in both systems, what would you put the difference is down to? is it down to the huge size of the nhs compared to what must be a much smaller health

system in australia? that what must be a much smaller health system in australia?— system in australia? that is -robabl system in australia? that is probably part _ system in australia? that is probably part of _ system in australia? that is probably part of it, - system in australia? that is probably part of it, but - system in australia? that is probably part of it, but we | system in australia? that is i probably part of it, but we still have very busy tertiary hospitals, busy district hospitals. we still haveissues busy district hospitals. we still have issues with staffing rural hospitals in particular. i think the difference is that there is a culture of valuing the workforce. doctors are paid more. junior doctors also have regulated hours. they are capped at 80 hours a fortnight in some states, with any hours worked over that as over time. and they are regarded as highly skilled, highly professional, trained people who are worthy of having those high salaries. i think having those high salaries. i think having purpose, being allowed to be good at yourjob at work and having autonomy gives professionals the motivation to do theirjob well. and i think being able to pay the bills is the important thing and the cost of living crisis in the uk is a big

factor too. catherine burns is in leicesterfor us. she gave us this update from the picket line there. you can see that they are out there, singing. they are very resolute in what they are saying. we have had lots of this today. it is obviously about pay. i am joined by some of these doctors now. ben, you have been a junior doctor for less than a year. he is thinking about leaving the nhs. talk to me about why? essentially, at the moment, every single _ essentially, at the moment, every single time you go into work, you have _ single time you go into work, you have people off sick. you have staffing — have people off sick. you have staffing which is onlyjust covering what it _ staffing which is onlyjust covering what it needs to in the first place without _ what it needs to in the first place without including sickness, and i don't _ without including sickness, and i don't feel— without including sickness, and i don't feel able to do my best work. and i_ don't feel able to do my best work. and i don't— don't feel able to do my best work. and i don't feel able to manage with the stresses and strains that are put upon —

the stresses and strains that are put upon me in the nhs. you were sa in: put upon me in the nhs. you were saying you — put upon me in the nhs. you were saying you have — put upon me in the nhs. you were saying you have had _ put upon me in the nhs. you were saying you have had to _ put upon me in the nhs. you were saying you have had to take - put upon me in the nhs. you were saying you have had to take time l put upon me in the nhs. you were i saying you have had to take time off because the stress and burn—out of the job. because the stress and burn—out of thejob. do you mind talking because the stress and burn—out of the job. do you mind talking about that? , , ., , the job. do you mind talking about that? , , ., ., ., that? during my last rotation, i was havin: that? during my last rotation, i was having moments _ that? during my last rotation, i was having moments at _ that? during my last rotation, i was having moments at work _ that? during my last rotation, i was having moments at work where - that? during my last rotation, i was having moments at work where i . that? during my last rotation, i was| having moments at work where i was getting _ having moments at work where i was getting panic attacks because each day, i— getting panic attacks because each day, i was — getting panic attacks because each day, i wasjust exhausted getting panic attacks because each day, i was just exhausted and that getting panic attacks because each day, i wasjust exhausted and that i was being _ day, i wasjust exhausted and that i was being lumbered with so much responsibility. and as i had only 'ust responsibility. and as i had only just left— responsibility. and as i had only just left medical school eight months — just left medical school eight months ago, i felt unable to cope. and it _ months ago, i felt unable to cope. and it got — months ago, i felt unable to cope. and it got to a point where my partner, — and it got to a point where my partner, she did the best thing for me which— partner, she did the best thing for me which was to say, you need to take _ me which was to say, you need to take time — me which was to say, you need to take time off. and i'm thankful to have _ take time off. and i'm thankful to have a _ take time off. and i'm thankful to have a saying that, because i don't think— have a saying that, because i don't think i_ have a saying that, because i don't think i would be able to be in work for the _ think i would be able to be in work for the last— think i would be able to be in work for the last few months if that hasn't — for the last few months if that hasn't been the case. you for the last few months if that hasn't been the case.- for the last few months if that hasn't been the case. you are at the start of your — hasn't been the case. you are at the start of your career. _ hasn't been the case. you are at the start of your career. do _ hasn't been the case. you are at the start of your career. do you - hasn't been the case. you are at the start of your career. do you think. start of your career. do you think this is something you are going to stick within the nhs? i this is something you are going to stick within the nhs?— this is something you are going to stick within the nhs? i really hope so, stick within the nhs? i really hope so. because _ stick within the nhs? i really hope so, because when _ stick within the nhs? i really hope so, because when this _ stick within the nhs? i really hope so, because when this job - stick within the nhs? i really hope so, because when this job is - stick within the nhs? i really hopej so, because when this job is good, so, because when thisjob is good, it is fantastic. it's a privilege to serve _ it is fantastic. it's a privilege to serve patients and their families make _ serve patients and their families

make people better. but it is so frustrating and so difficult when the job— frustrating and so difficult when the job is— frustrating and so difficult when the job is made impossible by the system _ the job is made impossible by the system you are working in. so i hope i system you are working in. so i hope i can— system you are working in. so i hope i can be _ system you are working in. so i hope i can be here — system you are working in. so i hope i can be here again in five years, butl— i can be here again in five years, but i don't — i can be here again in five years, but i don't know if i can say that with— but i don't know if i can say that with certainty. it but i don't know if i can say that with certainty.— with certainty. it was a difficult decision for _ with certainty. it was a difficult decision for me, _ with certainty. it was a difficult decision for me, because - with certainty. it was a difficult decision for me, because i - with certainty. it was a difficult decision for me, because i am | with certainty. it was a difficult| decision for me, because i am a doctor— decision for me, because i am a doctor and — decision for me, because i am a doctor and i_ decision for me, because i am a doctor and i want— decision for me, because i am a doctor and i want to _ decision for me, because i am a doctor and i want to give - decision for me, because i am a doctor and i want to give my. doctor and i want to give my patients— doctor and i want to give my patients the _ doctor and i want to give my patients the care _ doctor and i want to give my patients the care they- doctor and i want to give my patients the care they need, doctor and i want to give my. patients the care they need, but doctor and i want to give my- patients the care they need, but we 'ust patients the care they need, but we just cant— patients the care they need, but we just can't do — patients the care they need, but we just can't do that. _ patients the care they need, but we just can't do that. the _ patients the care they need, but we just can't do that. the whole - patients the care they need, but we| just can't do that. the whole system is broken. _ just can't do that. the whole system is broken. and — just can't do that. the whole system is broken, and it— just can't do that. the whole system is broken, and it has— just can't do that. the whole system is broken, and it has broken- just can't do that. the whole system is broken, and it has broken us- just can't do that. the whole system is broken, and it has broken us as l is broken, and it has broken us as welt _ is broken, and it has broken us as wait i_ is broken, and it has broken us as well. i graduated _ is broken, and it has broken us as well. i graduated in _ is broken, and it has broken us as well. i graduated in 2019, - is broken, and it has broken us as well. i graduated in 2019, beforel well. i graduated in 2019, before covid~ _ well. i graduated in 2019, before covid~ since— well. i graduated in 2019, before covid. since then, _ well. i graduated in 2019, before covid. since then, i— well. i graduated in 2019, before covid. since then, i know- well. i graduated in 2019, before covid. since then, i know at- well. i graduated in 2019, before| covid. since then, i know at least two people — covid. since then, i know at least two people from _ covid. since then, i know at least two people from my _ covid. since then, i know at least two people from my graduating l covid. since then, i know at least- two people from my graduating class who have _ two people from my graduating class who have stepped _ two people from my graduating class who have stepped aside _ two people from my graduating class who have stepped aside and - two people from my graduating class who have stepped aside and many. two people from my graduating class i who have stepped aside and many have left medicine, — who have stepped aside and many have left medicine, including _ who have stepped aside and many have left medicine, including friends- who have stepped aside and many have left medicine, including friends of- left medicine, including friends of mine _ left medicine, including friends of mine because _ left medicine, including friends of mine because they— left medicine, including friends of mine because theyjust _ left medicine, including friends of mine because theyjust can't - left medicine, including friends ofj mine because theyjust can't carry on like _ mine because theyjust can't carry on like this — mine because theyjust can't carry on like this. they— mine because theyjust can't carry on like this. they treat _ mine because theyjust can't carry on like this. they treat us - mine because theyjust can't carry on like this. they treat us like - mine because theyjust can't carry on like this. they treat us like we | on like this. they treat us like we are expendable. _ on like this. they treat us like we are expendable.— on like this. they treat us like we are expendable. catherine burns, talkin: to are expendable. catherine burns, talking to doctors _ are expendable. catherine burns, talking to doctors on _ are expendable. catherine burns, talking to doctors on the - are expendable. catherine burns, talking to doctors on the picket i talking to doctors on the picket line in leicester.

the bbc�*s regional reporters across england have been talking tojunior doctors who have been taking action today. let's head to devon next — kirk england is in exeter. thesejunior doctors these junior doctors have been thesejunior doctors have been on the picket line since around seven o'clock this morning. the main impact of the industrial action is expected to be on hospitals like this, the royal devon and exeter. dr nick bellamy is a junior doctor. we hear concerns about cancelled operations. what would you say to people who would say that this isn't 0k? ., , , , ., ., 0k? undoubtedly, there is going to be some disruption _ 0k? undoubtedly, there is going to be some disruption through - 0k? undoubtedly, there is going to be some disruption through these i be some disruption through these strikes. _ be some disruption through these strikes, but this is really down to the government. we have been in conversation with the government for over six— conversation with the government for over six months, sending letters and trying _ over six months, sending letters and trying to— over six months, sending letters and trying to be — over six months, sending letters and trying to be reasonable, and it has come _ trying to be reasonable, and it has come to— trying to be reasonable, and it has come to this and it is a shame. a 35% come to this and it is a shame. 35% pay demand, the government says thatis 35% pay demand, the government says that is not affordable. what would you say? that is not affordable. what would ou sa ? , , that is not affordable. what would ousa? ,., that is not affordable. what would ousa? , ., ., you say? this comes down to the fact that our pay — you say? this comes down to the fact that our pay has _ you say? this comes down to the fact that our pay has been _ you say? this comes down to the fact

that our pay has been decreased - you say? this comes down to the fact that our pay has been decreased by i that our pay has been decreased by 26% since _ that our pay has been decreased by 26% since 2008, so we are just asking — 26% since 2008, so we are just asking for— 26% since 2008, so we are just asking for this to be restored to the same — asking for this to be restored to the same levels in 2008 to address the same levels in 2008 to address the workforce crisis we witness every _ the workforce crisis we witness every single day. the workforce crisis we witness every single day-— the workforce crisis we witness every single day. thank you for talkin: every single day. thank you for talking to _ every single day. thank you for talking to us. _ every single day. thank you for talking to us. nhs _ every single day. thank you for talking to us. nhs bosses - every single day. thank you for talking to us. nhs bosses say i every single day. thank you for. talking to us. nhs bosses say they will prioritise things like accident and emergency departments and maternity services, but people are being urged to go to 111 as a first port of call and to only call 999 if it really is a life—threatening emergency. $5 it really is a life-threatening emergency-— it really is a life-threatening emergency. it really is a life-threatening emeruen . a , emergency. as well as picket lines across the country, _ emergency. as well as picket lines across the country, there - emergency. as well as picket lines across the country, there is - emergency. as well as picket lines across the country, there is a - emergency. as well as picket lines| across the country, there is a huge demonstration taking place in trafalgar square in central london. there are hundreds if not thousands with their placards also taking part in thisjunior doctor with their placards also taking part in this junior doctor strike with demands for a 35% pay rise and better patient safety. the government have said there will be no pay talks with the bma union and that it abandons its starting position of this 35%.

the health secretary says this is unreasonable, but the bma says the health secretary needs to come to the table. let's get more on the political reaction to this story. our correspondent david wallace lockhartjoins us now. tell us what the health secretary has been saying?— tell us what the health secretary has been saying? well, both sides need to get _ has been saying? well, both sides need to get around _ has been saying? well, both sides need to get around the _ has been saying? well, both sides need to get around the table - has been saying? well, both sides need to get around the table and i need to get around the table and come to an agreement but it feels like both sides are in completely different ball parks when it comes to even a starting point for these talks. as you mentioned, there bma were looking for a 35% pay rise. steve barclay, the health secretary, says his door is open to talks come but he says he is open to talking about a fair and reasonable settlement and we know the government does not think that 35% figure is fair to even begin those

talks. the government has faced many industrial disputes over the past few months and they have always brought up the fact that they are mindful about inflation and worried about excessive, as they see it, pay rises fuelling that. therefore, that seems where both sides are so far apart. so while steve barclay says his door is open for talks, it sounds like it is only really open if there bma is willing to modify that figure of 35%. of course, plenty of other political reaction is coming out at the moment. labour shadow health secretary wes streeting has accused the government of an abysmal failure to avert these strikes. the labour party do not want to get to engaged about what exact figure they would be offering junior doctors if they were in government. but they are critical of the government being unable to facilitate talks and they are tying that into their general message. we are hearing a lot at the moment about 13 years of conservative

government and labour questioning how the country is operating off the back of that. the lib dems are also standing critical about the fact that no talks are taking place and both sides are not around the table. their leader, sir ed davey, says things have got so serious when it comes tojunior doctors things have got so serious when it comes to junior doctors that parliament should be recalled so that mps can debate this. of course, we are in the easter recess at the moment. the green party sayjunior doctors are right to be calling for their pay to be restored to pre—austerity levels, very supportive of the strikes. the backdrop to all of this, which i'm sure the political parties have in their mind, is that we have local elections in many parts of england, local elections in northern ireland next month. councillors don't have input intojunior next month. councillors don't have input into junior doctors and the pay deals they are being offered each year, but of course, local elections can be broader than local issues. it can be about how they

think the political parties are performing. iam think the political parties are performing. i am sure the parties will be aware that they have to face those elections next month and that will be factoring into their response to the strike. there is one thin that response to the strike. there is one thing that seems _ response to the strike. there is one thing that seems to _ response to the strike. there is one thing that seems to be _ response to the strike. there is one thing that seems to be angering - response to the strike. there is one j thing that seems to be angering the bma when we have heard from them on the picket line. they say in the last few talks, steve barclay, the health secretary, didn't come up with any counteroffer. they say, how can we negotiate if there is no negotiating position from the government?— negotiating position from the covernment? ~ ., government? well, the government seems to be — government? well, the government seems to be saying _ government? well, the government seems to be saying that _ government? well, the government seems to be saying that while - government? well, the government seems to be saying that while they i seems to be saying that while they are open to the ideas of getting around the table and talking to junior doctor leaders, the fact that they are hearing about that 35% being what the doctors would like just means they are not willing to engage. it is perhaps not dissimilar to what happened with the rcn, the

nurses' union, when they wanted to talk about improved pay offer is. they had a high figure initially. they had a high figure initially. the government refused to engage, they dropped the figure down and even at that point, the government kept refusing to be engaged on what their offer would be. so what we have seen with the many industrial disputes over the past few months is the government not necessarily wanting to throw about figures to start negotiating in public regarding offer and counteroffer, they prefer to do that behind closed doors in proper talks. they are very concerned about trying to get inflation down and they have that fear that feeding into pay rises can feed into inflation. there are of course those who say that pay rises for public sector workers would not be the straw that breaks the camel's back when talking about inflation.

but it seems like the government are willing to negotiate behind closed doors, but they say at this point, unless the bma comes down on that 35% starting figure, those talks aren't even going to happen. i have had one suggestion _ aren't even going to happen. i have had one suggestion from _ aren't even going to happen. i have had one suggestion from someone | aren't even going to happen. i have | had one suggestion from someone i interviewed today. why not get both sides around the table with acas, who can mediate? what would have to happen to make that happen if both sides refused to meet in the middle to have an independent mediator to help move this process forward? that would be an — help move this process forward? trust would be an interesting tactic. it would be an interesting tactic. it would be a difficultjob when we think about how far apart these sides sound at the moment. but i think the stamps of government ministers at this point, it should be pointed out that there will be people across the political spectrum

who think that there bma demand is not a pay offer that is realistically going to happen. even close to that 35% pay offer is not going to happen. these sides are so far apart at this point, and it does sound like the government will be potentially open to talking about pay and perhaps, as we have seen in other industrial disputes, coming up with a better offer than they were willing to a matter of weeks or months ago. i think the government is wanting to be quite firm on that starting offer and send the message that it starting offer and send the message thatitis starting offer and send the message that it is a nonstarter for them. that figure has to come down before they would even engage in those talks. whether or not there is an independent mediator, i still think that would be the position of government ministers, but of course, there bma are making the point that they have faced problems since austerity. they have faced long—term

below inflation pay rises and junior doctors are not being paid enough. so it feels like both sides are still very far apart on this issue. david wallace lockhart, thank you. live now to london's trafalgar square, where we can speak to nickjohnson, who's at the rally there. yes, much busier now in trafalgar square. this is the ground zero for thejunior square. this is the ground zero for the junior doctor protests in england. as you mentioned, the second time thatjunior doctors in england have gone on strike in a month. they are not going to budge on that 35% figure they have asked the government for. as you have been alluding to, the government says it will not budge either. i will give you more from the statement from downing street. they say that 35% figure is unreasonable and it is not affordable for the british taxpayer. they say it is completely out of step with pay settlements in other parts of the public sector and would cost around £2 billion. they say

rishi sunak is being kept abreast of the developments. and also, the key issue of disruption that this is having on the nhs, the manager said that this week's action is causing unparalleled levels of disruption. it is thought more than a quarter of a million routine appointments, elective surgeries and even some cancer appointments might have to be rescheduled. with me, i have got muddy bell, who was a junior doctor from south—east london. —— mad the bell. tell me what it is like to be a junior doctor at the moment? i am relatively newly _ a junior doctor at the moment? i am relatively newly qualified. i love the job — relatively newly qualified. i love the job i— relatively newly qualified. i love thejob. i like my relatively newly qualified. i love the job. i like my colleagues in the work— the job. i like my colleagues in the work atmosphere is incredible. but obviously. — work atmosphere is incredible. but obviously, the conditions are less than _ obviously, the conditions are less than ideal~ — obviously, the conditions are less than ideal. it is not the same service — than ideal. it is not the same service we _ than ideal. it is not the same service we were 15, 20 years ago. my first rotation _ service we were 15, 20 years ago. my first rotation this year was in a&e and obviously, the waiting lists

have _ and obviously, the waiting lists have lengthened and lengthened. it was only— have lengthened and lengthened. it was only seven years ago that we were _ was only seven years ago that we were regularly, if not completely compliant with the four hour waiting target, _ compliant with the four hour waiting target, now it would be a miracle for that— target, now it would be a miracle for that to — target, now it would be a miracle for that to happen. that is notjust space _ for that to happen. that is notjust space or— for that to happen. that is notjust space or demand, that is a case of people _ space or demand, that is a case of people not— space or demand, that is a case of people not being able to find any time or— people not being able to find any time or privacy to speak to these patients— time or privacy to speak to these patients for what can be up to an hour~ _ patients for what can be up to an hour. ., . ~' patients for what can be up to an hour. ., ., ,, ., patients for what can be up to an hour. ., ., ~ ., .., ., , hour. you talked about conditions and that they _ hour. you talked about conditions and that they have _ hour. you talked about conditions and that they have worsened - hour. you talked about conditions and that they have worsened in i hour. you talked about conditions. and that they have worsened in the last few years. but a lot of this is about pay, and that must be one of the reasons you are here as well? pay is easily understandable to the general— pay is easily understandable to the general public, but in reality, people — general public, but in reality, people are deserting the nhs and going _ people are deserting the nhs and going abroad. people are leaving the profession— going abroad. people are leaving the profession and these are people who have thought about working in medicine _ have thought about working in medicine for their whole lives. that is not _ medicine for their whole lives. that is not because they have fallen out

of love _ is not because they have fallen out of love with medicine itself, it is because — of love with medicine itself, it is because the working life is no longer— because the working life is no longer sustainable.— because the working life is no longer sustainable. maddy bell, thank ou longer sustainable. maddy bell, thank you very _ longer sustainable. maddy bell, thank you very much. _ longer sustainable. maddy bell, thank you very much. so - longer sustainable. maddy bell, | thank you very much. so doctors longer sustainable. maddy bell, - thank you very much. so doctors are being attracted elsewhere. a common misconception is thatjunior doctors are freshfaced graduates. that is not strictly true. there are some who fit that bracket, but a lot have up who fit that bracket, but a lot have up to a decade of experience and it is thought around 40% of the medical workforce in england arejunior doctors. samantha, you mentioned beforehand that the conciliation service acas might have to get involved if the government are not budging and thejunior involved if the government are not budging and the junior doctors are not budging. budging and the “unior doctors are not budging.— not budging. doesn't sound like an bod not budging. doesn't sound like anybody is _ not budging. doesn't sound like anybody is budging _ not budging. doesn't sound like anybody is budging at _ not budging. doesn't sound like anybody is budging at the - not budging. doesn't sound like - anybody is budging at the moment. nick, thank you. this halfway through big day one of these junior doctor strikes. through big day one of these junior doctorstrikes. it through big day one of these junior doctor strikes. it is reported that 50,000 junior doctors are out on strike today. there are no guarantees from the bma that lives

won't be lost because of this industrial action. won't be lost because of this industrialaction. it's won't be lost because of this industrial action. it's estimated that some 350,000 operations and procedures have had to be cancelled. we will have plenty more on this. now, it's time for the world business report. the imf warns of weak economic growth for the next five years, uk set to be the worst performing advanced economy this year. i am live in washington _ advanced economy this year. jan live in washington where those meetings are taking place and conversations will take place on what the weak growth means for global interest rates. also in the programme, a prominent forecaster in india warns of a deficient monsoon season, threatening crop yields in this

farm—driven economy.