12/01/2016 Victoria Derbyshire

Hello it's Tuesday, it's 9.15, I'm Joanna Gosling in for Victoria,

The first strike by junior doctors in 40 years;

thousands of NHS patients in England have their routine operations

and appointments cancelled as the dispute over changes to pay

We think that though we do need change to the contract, this isn't

the prescription the NHS needs so junior doctors really have the short

end of the strick. That's not what we want to see.

We want to hear from you if you're a patient who's affected or you work

in a hospital and we'll hear from our audience of viewers -

some of whom work in the health service -

about whether the doctors are right to strike.

I'm Sabrina and this new proposal is not safe for doctors. I'm for

doctors but against the strike. Also today, hundreds of Syrians

in the besieged town of Madaya must be moved so they can get life-saving

medical care according We'll have the latest

from those on the ground. Hello and welcome to the programme,

we're on BBC 2 and the BBC We'll have reports from around

England on how today's doctors strike is affected services

and we want to hear from you if you're affected,

especially if you or one of your relatives has had

an operation cancelled. We are getting reports of an

explosion in central Istanbul. More on that as we get it. Plus the rest

of the day's news and sport. You can subscribe to all our

features on the news app, by going to add topics and searching

Victoria Derbyshire. Thousands of NHS patients in England

will have their operations or hospital appointments cancelled

today because of a strike The industrial action -

which is over pay and working hours - began at 8 o'clock this morning

and will last 24 hours. NHS England says all hospitals have

plans in place to deal with the disruption and emergency

care will still be provided. But more than 4,000 routine

operations and procedures have been cancelled and many non-urgent

appointments will also be postponed. Scotland, Wales and Northern

Ireland are not affected. Our reporter Jim Reed has been

looking at why the doctors Ior Save our NHS, save our NHS, save

our NHS, save our NHS... The priority at the moment is the

thousands of people that we think die unnecessarily because we don't

have proper cover for urgent and emergency care at weekends. Save our

NHS, save our NHS... They are trying to cut our pay when

we are already overworked and underpaid.

There are 55,000 junior doctors in England.

These are not just students leaving medical school but anyone below

That can mean someone with nine years experience in charge

They're the person you will see clerking you in when you go

into A, they are the person you might see in your GP practice.

Often they will be the person that comes round on the ward

They are often also the people that will be doing surgery in theatre,

they will be assisting the consultant when they do

The starting salary is just under 23,000.

Add in overtime and unsocial hours, average pay in the first two

Those in higher training can earn 53,000, rising up to 70,000

How does that compare with other jobs?

It is hard to measure and depends on where you live but take

the average pay for a junior doctor in those first two years.

That is more than a teacher or a police officer

but about the same as the starting salary for a banker and less

One big part of this is hours worked.

The Government wants to raise basic wages but change the way it pays

At the moment, regular hours are set at 7-7 Monday to Friday,

The Government wants to extend those core hours till 10pm in the week

and into Saturday for the first time.

This contract does not seem to value the hard work of junior doctors.

The trouble with that is, the doctors that are working some

of the most difficult hours, the ones that are working some

of the hardest rotas, working through the night

and weekends, etc, these are the people who really lose out

They are the people this affects the most.

In the last general election, the Conservatives promised to bring

Illness does not respect working hours.

Heart attacks, accidents, babies, these things do not just

It has been known for years it is more dangerous to get sick

A recent study found the odds of dying in hospital 10% higher

Doctors say these changes will strip back the safeguards meant to stop

them working excessive hours and make life less

Junior doctors in England only are now on strike for 24 hours

Two more strikes are planned for the end of January and February,

unless there is a breakthrough in the talks.

Let's go now to Royal Devon and Exeter Hospital,

They are out on picket, tell us what is happening? Junior doctors left

the ward to come out and stand on the picket line a short time ago.

This is a south-west hospital. You can hear lots of car horns beeping.

There appears to be a lot of support for the junior doctors, today

cataract operations, knee and hip replacement operations should have

been carried out, instead 177 letters were sent out cancelling

out-patient appointments and also 28 operations were cancelled, so how is

the hospital coping and what is going on inside the hospital says

patient safety of course is a priority. Senior staff have been

brought in to provide cover where possible, but today, as you can see,

they are standing out here with their banners protesting about it.

There are 390 junior doctors here at this hospital, more than half of the

staff here, so the impact really will be felt here.

Junior Doctors aren't only picketing hospitals today.

Some of them are out at stations and other commuter hotspots around

England this morning running "Meet the Doctors" events

because they want to personally explain why they are on strike

and what impact it's having at hospitals around the country.

We've sent our reporter Jim Reed down to meet the doctors himself

Euston station really busy. This might look like a picket line but

these are junior doctors here to explain to the general public why

they have taken the action they have. We are joined by two. This is

Marie and Francesca. Explain why you are doing it and what the reaction

has been so far? Were going on strike because we feel the contracts

are not safe for our patients. Because this is all about the

public, the NHS works for the public, we wanted to explain to them

why we are taking this unprecedented action today. Marie, explain what

you would say to someone, one of the thousands of people that's had

treatment cancelled today? Firstly we'd like to apologise to any

individuals who've had operations cancelled today or rearranged. We

have been fighting for months to try to explain to the public what is

going on and to try to prevent the strike action today which is a last

resort. We have been pushed into a corner by Jeremy Hunt and the

Government. It's the responsibility of them what is happening today. The

average wage in the UK, ?26,000 to ?27,000. A lot of people here will

be earning that, the starting salary for a junior doctor is ?36,000.

People might say it's not bad going wage-wise? At no point have doctors

asked for an increase in pay and the Government and the Union agreed the

pay packet overall would be the same. What we are concerned about is

how that pay is divided up amongst the doctors and some of the

Government proposals will mean some doctors on call will be earning less

than the minimum wage. So that is deeply concerning. Why would doctors

go into those specialities? We are concerned. Thanks very much both of

you. The doctors will be here all day. Two more strike days planned,

one or two more days at the end of January and one at the start of

February. Back to you. Let's talk about this now

with Dr Dagan Lonsdale, who is in full support

of the strikes and Dr Jon Stanley, another junior doctor

but he doesn't support the strike. Jon, tell us why you don't support

the strike? Good morning and thank you for having me on the programme.

There are three main reasons. First, I have issues with the validity of

the ballot. The ballot was called several months ago in conditions

that are very different than they are today. The second is, I have

concerns over the general welfare and safety of patients. The

emergency cover that is going to be provided during the week is provided

at the same level as the weekend, yet some of the demands in hospital

are much higher during the week, so that emergency cover won't be as

good as is promised. Secondly, many parts of the country you will know

have been very severely affected by flooding. Operations in clinics have

been cancelled in some areas already and I'm very disappointed that the

BMA's chosen to extend its strike action to these areas. At a very

minimum, areas affected by flooding should have been excused from this

strike. Dagan, why are you striking? Again, thank you for having me on

the programme. No doctor in the country wants to take industrial

action. We have been forced into this position by a Government who've

refused to negotiate fully and openly with us. I'm striking because

I believe that this contract, were it to be implemented as it stands,

would be unsafe for my patients, as well as being unfair to junior

doctors. Explain a bit more, when you say it would be unsafe, what

would be unsafe because the hours are more restricted than currently

under the new contracts? Well, when I look at pieces of evidence, I

really get down and unpick what is there. Whilst Jeremy Hunt and NHS

England are saying that the number of hours will be reduced, when you

look at the safeguards, the policing of that part of the contract, there

are no safeguards in place to make sure that actually happens. And you

don't trust the employers? I certainly don't trust Jeremy Hunt.

He's consistently attacked junior doctors, made us out to be

militants, suggested that we lack vocation. But if it's in the

contract to say the hours cannot be broken, do you not trust that 1234

Not without robust safeguards. We are a hospital to routinely overwork

its doctors, there are financial penalties in place that would mean

our Trust would be fined. Those penalties are being removed in the

way they currently act such that if a Trust routinely overworks doctors,

it fines itself, ie the fine goes back to the Trust, the hospital, and

I don't see that as a disincentive. I think we are going to see a

stretching of the service in an environment where the NHS is in its

tightest financial position it's ever been in its existence. The only

outcome therefore in a contract that has loose policing will be meaning

that doctors are overworked. That is a perspective and fear about things

further down the line. As things stand if it were properly policed,

would you be OK? If the contract were written with appropriate

policing, with appropriate safeguards in place, then we would

not be taking industrial action. It's one of the fundamental points

the BMA disagrees with Government on, so you are absolutely right, if

the contract is written and we have robust safeguards for working

practices, then it would be fine, there would be no problem.

Jon, are you concerned about the issue of safeguards and the fact

that what is in the contracts could therefore be ignored? Of course

safety is paramount. I'm not going to talk about

safety is paramount. I'm not going because up until a few days ago, the

BMA was in arbitration with the Government and the forum for

discussing the fine details of how safeguards are put in place and who

is policing them should be discussed there. I would take one issue, the

contracts being proposed, the contract being striked on is one

that was offered months ago and since we have had four weeks of

arbitration, that's changed. This is problem, this is what the public

don't realise. The BMA are now effectively striking on an offer

that's already out-of-date. In terms of whether doctors should ever go on

strike, do you agree with the doctors having the right to strike?

I believe any worker in a free society has the right to withhold

their labour. When you are a member of a profession that's given a huge

amount of trust and regard by the public, the threshold of that has to

be extremely high. Particularly for trainees, they are in a privileged

position, there are very few training places in the UK, many

doctors don't enjoy the chance to train herer at all. I think striking

during the training period will be seen as, it won't be held in a very

high regard by some of our non--trained colleagues. What do you

say to that, Dagan? There have been negotiations before Christmas. The

fundamental issues over patient safety and fair working practices

remain the same, remain problematic for junior doctors, and we are not

talking about a small minority of junior doctors who before Christmas

voted for industrial action. 98% of those patient doctors who returned

the ballot voted in favour of industrial action. This isn't a

small minority, this is doctors looking at the evidence for

themselves and saying, this contract's dangerous and it's

completely unfair and, without significant movement for Government,

we have no option but to take action. We have tried every other

avenue, we have tried communicating with Government directly, 20,000

doctors were on the streets of London marching in protest against

this dangerous contract, 98%, tens of thousands voted for industrial

action and still, despite that, the Government haven't listened and

haven't entered into meaningful negotiations with the BMA so we have

been left with no choice. The BMA left the negotiations

They have been in negotiations for three years. At one stage they said

this contract is so bad, so dangerous and you are not engaging

with us that there is no point in us being there and they said that if

you do not start to listen to us, there is no point and we will step

back from the table. From what you say, it sounds like your beef is the

lack of safeguards to make sure the hours are properly monitored and

hospitals are held to account. Is that really what this boils down to?

For me, if we were just talking about a contract change that cut the

pay for doctors, in a time of austerity, everyone is taking this

5% cut, we would not see this level of dismay. But the fact is, the

contract could bring in dangerous conditions and there are issues over

pay and conditions... Holding the line for the future? Doctors have a

moral duty to look after the NHS for the future because if we have no NHS

that respects doctors and Monson working in safe practice, we will

lose the NHS and I think the public want to keep it and that is why I am

taking part today. What about that point that it is protecting the NHS

for the future? In the next few days we will hear every side of this

argument over ownership of the NHS. My issue is that first and foremost

I am a member of a profession and by nature we put patients first. The

one concern I have is that in recent days we have heard more languid from

certain members of the BMA trying to make this a wider issue and trying

to bring in other political groups and areas of the public sector and

trying to make this as part of a larger movement against the

government and I am concerned about that. You all want good health care

in this country and we have the NHS in this country and we want it to

work but I will not lay claim to being the champion of the NHS more

than anyone else. Speaking about comments from viewers, one says that

junior doctors are wrong to strike, people need care and the weekends as

well as a week, what if I'm in and police have the same attitude? VB

will move abroad when she graduates, junior doctors we teach me work

ridiculous rotors and they are exhausted and the NHS is a mess. I

will be sorry to go but this government is hell-bent on

destroying the NHS. And one says, I am a senior doctor, fully in support

of the junior doctors, we want to save the profession. Thank you all

very much. And thank you for your comments at home, keep them coming

in. We will talk more about this. Still to come... The view from

inside the city of Madaya as vital aid begins to arrive.

And how a breakthrough DNA project has finally allowed children

with mystery diseases to be diagnosed.

Keep your points of view coming in. The menus...

Junior doctors in England are beginning a 24 hour strike

in their dispute with ministers about new contracts.

Emergency cover is still being provided but around 4000 scheduled

The Health Secretary Jeremy Hunts says doctors have been offered

a rise in basic pay but wants to see changes so that more staff

It is a last resort, doctors have not been on strike for more than 40

years and we have been pushed into a corner to the government 's

decisions. The responsibility lies with them for what is happening.

Senior health officials in Turkey have told Reuters that ten people

have been killed in an explosion in Istanbul.

It's thought to have happened in the city's historic

Sultanahmet district, an area popular with tourists.

The cause of the explosion is not yet known.

The UN is warning that around 400 people urgently need to be evacuated

from the besieged Syrian town of Madaya or face dying

from starvation or other medical problems.

Residents received their first supply of food and medicine

in months yesterday, when an international aid convoy

Doctors think they've identified genetic mutations which left

a four-year-old girl unable to talk and with damaged kidneys and eyes.

Georgia Walburn-Green is the first person to have her condition

explained by the 100,000 Genomes Project.

The scientists who studied her DNA hope that new treatments will be

Archaeologists working on what's said to be Britain's best preserved

Bronze Age settlement have given a glimpse behind the scenes

Must Farm was home to several Bronze Age families when a fire tore

through it 3000 years ago, causing it to sink

This is almost like getting the opportunity to look through the

curtains and see people actually in their daily moment and as

archaeologists, you just really nosy and that is what we want, to be able

to see what people are doing and this gives us an opportunity unlike

others. The media mogul Rupert Murdoch

and the actress and model Jerry Hall The couple have been together

for four months. The engagement was announced in this

morning's Times newspaper, which is owned by Mr Murdoch's News

Corporation company. Let's catch up with

all the sport now. Good morning. Huge congratulations

this morning to Lionel Messi, who was crowned the winner of the Ballon

d'Or, awarded to the best player in the world for a record fifth year in

a row. He won this consecutively for a long four years between 2009 and

2012 for Cristiano Ronaldo. This year, he picked the Portuguese

player into second place and there was some frosty this when it was

awarded. Let us say that he took his time to congratulate Nalgo. So, the

winner of the men's award, Carly Lloyd, the USA midfielder, winning

for the woman, she scored a hat-trick in the final of the World

Cup. There was British interest on the night, Mark Sampson, the England

women's coach just lost out to Jill Ellis, congratulations to him,

though, he has been given a contract extension. Speaking of managers,

Louis Van Gaal takes his side to Newcastle United tonight and

surprisingly, he says that he also has been bought by his team. But I

grew bored by his team so far this season. Join us at around ten

o'clock for more. -- board. More on the breaking news from Turkey. There

has been a large explosion in central Istanbul with reports of at

least ten people have been killed. It went off in Sultanahmet Square,

next to the Blue Mosque. Our correspondent could hear the

explosion. It was at 9:40am, local time. I heard the explosion despite

the wind being closed and we started looking. -- the windows. There are

reports that more than ten casualties and more people are dead

but as far as we can get from the government, ten people got killed as

a result of this explosion, this blast. There are rumours which have

not been confirmed that it could be a suicide attack in this part of

Istanbul. Deliberately targeting tourists, it would seem? Yes,

Sultanahmet Square is a major point for every kind of tourist group and

it is the major Ottoman area which carries all of the characteristics

of the past so it could target tourists but no one else. Have been

previous attacks like this in Istanbul? Last year, at the

beginning of January, last year, there was another attack in

Istanbul, targeting the police station in Sultanahmet and there

were only a few casualties, including officers and that was a

suicide attack and it is one year on since this. Thank you very much and

we will stay across the latest reports and keep you updated on

that. The UN says around 400 Syrians out

of the besieged town of Madaya are at risk of dying and need

to be urgently moved. Yesterday an international aid

convoy entered the town, where 40,000 people have been

trapped by a government Aid agencies say there are credible

reports of people starving to death, while activists have posted images

claiming to show people eating Here's a quick reminder

of how we got here. We can speak now to Pavel Sheshek,

who was in Madaya yesterday as part of the convoy with the

International Red Cross. He's now back in the Syrian

capital Damascus. On the line is Abdullah Burhan,

a former fighter for the Free Syrian Army who lives

on the outskirts of Madaya. And joining us here in

the studio is Greg Barrow What was it like going into Madaya?

I would say it was like going with very mixed feelings and those

feelings accompanied us to the very end of the operation so on the one

hand we had this huge sigh of relief from the people, you could see

smiling and cheering, the people thanking us for coming, did you

bring food and medicine? We did not have either. Nothing to eat for a

very long time. On the other hand, what they were telling us, what we

have seen in the medical structures, it was just heartbreaking. The

people are in a very desperate condition. We have seen several

cases, several people very severely malnourished, the people telling us

that for the past few days, when the food ran extremely low, they had to

eat water with spices. They showed us pictures of leaves and grass. The

most shocking thing, leaving -- living and working here, is pretty

much every single person who came to me asked as the first question, did

you bring any bread? Or biscuits. I am hungry. What did you bring them?

We brought, together with the UN and the Red Crescent, 44 drugs of

humanitarian aid, the UN was responsible for the food supplies

which are very desperately needed. The Red Crescent brought similar,

life-saving and essential medical supplies to keep the health

structures running. Those guys were doing a great job, not only in

Madaya but North, with a similar convoy, they brought also the baby

unit. It is not only a matter of food that is not available, the

health structures and the conditions in a very basic dispensary I've just

tragic. Many people need further, specialist assistance and we are

quite sure that this is not only the case in Madaya but other besieged

places in Syria but we must access as soon as possible. Tell us more

about those people in desperate need, the aid agencies have

identified around 400 who really should get out of Madaya to access

that sort of care. What is your prospective? -- perspective. We

identified eight agencies, with the UN, together we are working hard

with those cases so certain people need to be taken out but right now

we each need to follow basic procedures to negotiate that and all

of his preparations are under way so I cannot tell you more than that. So

we can reach some substantial result there. Greg Barrow from the World

Food Programme, the aid will only last a finite amount of time. What

would you like to see happening? We want free and unhindered access on a

regular basis. One of the most tragic messages we had from people

yesterday was the one that's it, we may not see you again. People

genuinely thought that after the first convoy went in, this could be

the last they see a few monetary and agencies. We cannot have a situation

like that, we cannot have children suffering the kind of problems that

were just described. And the situation there is absolutely

appalling. We have stories of people paying ?130 for the kilogram of

rice. One family told us they had to sell the family car to get three

kilos of rice. And giving away gold jewellery, the children gathering

pirouette in saying give us anything to eat. We want biscuits and bread.

This is not what should be happening in this day. It goes against all

humanitarian principles. Should there be aid drops into

places like Madaya? We hear this argument all the time. You can't

drop food into a city. It's just too problematic. The simplest solutions

are the best solutions, we just need to be able to drive food into the

city. That way, we can meet the needs of 40,000 people on a regular

basis. What are your concerns now that the aid has gone in but these

people are left, albeit with a bit of extra help, but left until if and

when there is more aid on the way? Well, I think the only logical

solution for us, for all humanitarian activists is to get

this regular access, not only to Madaya, but to other besieged places

in Syria. We can confirm that all the places are going through

extremely difficult and tragic didn't. Their lives are in danger

and we really need to be able to help them. In order to do that, we

have to keep coming back with the humanitarian aid. There is no

long-term solution for the time being. Greg, Madaya is the name in

the head lierns, there's been a lot of focus on Madaya, but there are

other places just like Madaya, what is the situation in those places,

are they getting assistance -- headlines Simultaneously yesterday

we distributed food aid in two different locations to the north,

surrounded by opposition forces. Across the country, we estimate that

up to 400,000 people are stuck in those either besieged or

hard-to-reach places. So this is a feature of our work and has been so

for many years now. It's an unfortunate feature and we have to

send a very, very clear message to the people with guns, you have to

let the humanitarian agencies through. How difficult is it for the

agencies working in these conditions? It's probably one of the

most challenging and complex operations in the world right now.

Despite that, I should say the World Food Programme is reaching around

four million programme every month inside area alongside the 1.5

million refugees we are feeding. But it's a very, very complex operation

and it would be a lot easier if those groups on the ground

cooperated more. Thank you both very much for joining us. Let's bring you

some breaking news on the junior doctor's strike. Sandwell Hospital

has declared a level four incident and has told their junior doctors

they must attend work. The Trust has said, we have got no more details

about that level four incident and why it is happening that doctors are

being told they must attend work at Sandwell in West Bromwich, but we'll

check that out and get more as we get it. More political reaction now

from Norman Smith in Westminster. Westminster you are actually at a

hospital, away from your normal stomping ground? I'm at St Thomas',

Westminster's Hospital, I suppose, where MPs have to come if they have

scrapes or cuts, though probably not if you are a Tory minister, I doubt

you will be coming here today. A fair number of pickets have already

gathered. The strange thing about today's industrial action though is,

no word really from the Government. Now, this is curious in the sense

that, here we have the first doctors' strike since the '70s. It's

a long time since we have had such a strike, something like 4,000

operations expected to be cancelled, you have about 40,000 junior doctors

out on the strike, but the Government's chosen not to say

anything today, turning down all requests for interviews. In fact,

they've put up a clinician chap by the name of Norman Williams, an

eminent consultant, to speak on behalf of Jeremy Hunt last night.

This is what happened. REPORTER: Where is Jeremy Hunt

tonight? He's in the department at his desk working hard. And do you

feel it's good that doctors on the eve of a national strike and indeed

the people who use the NHS aren't able to hear from... Hang on a

second, we are not doing all this nonsense... We are recording all

this, so there you go. We agree add series of questions... I didn't

agree any questions with anyone, so there you go. We are here in an

interview, you are the person the Department of Health put up for

interview. I'm a clinical adviser. But you are the person the

Department of Health put up. We are in a democracy, I think I'm allowed

to ask you the questions... Well, not to be deterred, we sent

one of our reporters off to Mr Hunt's house this morning just to

see whether he'd have time to say a few words, give us the Government's

view on the junior doctors' strike. This is what happened.

REPORTER: Do the proposals threaten the future of the NHS? That's why we

want to speak to you. Is there enough money to create a 24-7 NHS.

There is. What is your message to junior doctors?

The Government is adopting a low profile I suspect because of the

battle for public opinion. There is awareness in Government circles of

having a Government minister pitching up on the telly, then in

the next shot having junior doctors because perhaps inevitably, people's

sympathy is going to gravitate more to the doctors than the politician.

That said, ministers are determined not to back down. They say they have

a mandate in their manifesto to introduce a 24-hour NHS, that is

what this is all about, they say, and Mr Hunt argues that he's

offering an 11% pay rise. We heard Mr Cameron just yesterday saying

that most doctors will be better off. But will they? I'm joined by

the BMA representative of the junior doctors and, is that what this is

really all about, money? The fact is that junior doctors want a safe,

fair contract. The last thing they want to ever do is to take

industrial action. What we want is to be protected in our working

lives, to make sure we don't put patients at risk in making

fundamental decisions. What is your problem though with

having a 24-hour NHS as Mr Hunt wants to introduce? We have

currently a 24-hour NHS, your viewers will know that. I work as an

obstetrician, we deliver babies 24 hours a day, seven days a week. The

fact is the Government's completely mishandled this situation and has

betrayed junior -- portrayed junior doctors as the problem when the

Government is frankly. Mr Hunt says many hospitals are deterred from

employing junior doctors at the weekend because it costs them more

money so he wants to reduce the amount of cash you get for that

evening and weekend work? Interesting that that is the issue

when actually the Prime Minister said yesterday everyone would be

better off. The fact is that junior doctors already work weekends,

nights and evenings, this is nothing to do with junior doctors and your

viewers will know that. Junior doctors are there 24 hours a day,

seven days a week, it's a pity the Government doesn't recognise that.

Are you really going to go through with a threat, not just to hold

another day of strikes but also to hold one that would close down A

too? The fact is that before December, we offered the

Government's talks, the Government took us up but then didn't engage

with us in a meaningful way. We hope the Government does address the

concerns of all these doctors that have come out today and have

demonstrated that they are absolutely unhappy with the

Government proposals. If you are right and it's already a

24-hour NHS and it's not just about money, are we basically in

face-saving country, that if some sort of compromise can be put

together which saves Jeremy Hunt's face and enables you to claim

victory, that's it, that's what we are about now? Well, the fact is, we

tried to put together a deal that actually helped junior doctors to be

re-Rail Maritime and Transport Union negotiated appropriately, protected

them, -- renumerated them. We have to take the concerns of 55,000

doctors seriously. 99.6% of doctors do not vote for this kind of action

unless they are deeply unhappy with the Government proposals.

Thank you so much for your time. Joanna, it's worth just pointing out

the stakes here for the Government really, because you only have to go

back a few years and remember the plight of Andrew Lansley who also

found himself locked in confrontation with many people in

the NHS over his NHS reforms and that didn't turn out so well for

him. So the stakes are high for Jeremy Hunt, albeit he insists he

has a manifesto mandate to make the sort of changes he wants to make.

Pixie has been in touch to say she has been affected but supports the

doctors. Steven says junior doctors think too much of themselves. Police

and Fire Service work nights, weekends with no extra pay. More on

the strike and we do want to know how you have been affected so get in

touch. After 10, we'll be talking with our viewers to tell us what

they think and our audience. Be part of that discussion by getting in

touch in all the usual ways. Let's get a weather

update with Matt. You will probably agree it's

starting to feel a bit more like winter now. Yes, it is. We had a

ridiculously warm December. The weather is lacking the picture

perfect quality of what you can see here. Look at China, the lovely

white deposits on the trees. It's water vapour in the atmosphere that

freezes when it hits any object. Usually happens by night when you

see fog around, when the fog clears, you leave these beautiful pictures.

It's called Rime. A nice version of that, this is footage from the

United States. Look at this car encased in ice. Rough seas whipped

up over the lake, the waves crashed on to to shore, lots of frozen

vapour. Imagine trying to get your car open with that! They are

suffering with extreme weather in the US, black out conditions in and

around the Great Lakes. The snow will come day after day after day.

When this happens, we are talking about two, three, four feet of snow

falling within the space of 24 hours. Crikey. Not quite like the

winter we are having at the moment but it will get colder. Let us get

back to what is happening at the moment because it's chilly at the

moment. While some started with sunshine, others have seen the

showers and we'll see more develop more widely as we go through the day

but still quite a chilly wind as well.

At the moment, we have plenty of cloud across the east of Scotland,

bringing in rain and hill snow. It will drift to northern England. This

hook of cloud as well feeding the showers to north-west England and

northern and western parts of Wales. Gale force winds here will push the

showers to areas where so far you have been dry and sunny. As they

push south and east, it means the west should have a brighter

afternoon. Cornwall should be fine this afternoon. A good deal of

sunshine. The winds will ease down. A noticeable wind chill for many,

especially across the west. Brightening up towards Pembrokeshire

and Carmarthenshire. Wintry over the hills and after a brief respite in

the north, more cloud, rain and hill snow will develop.

Into Northern Ireland, pretty wet. This afternoon looking much, much

better with a few showers around. We'll continue to see sunny spells

in the far west of Scotland throughout the day, but eastern

Scotland, grey and gloomy, hill snow persisting and working its way into

north-east England. A few showers south of that. After a sunny

morning, East Anglia and the south-east, here we'll see some

heavy showers to end the day. If you have got to work with conditions

dry, you may not on the way home, because lots of outbreaks of rain. A

cold wind as well. It eases away, dying back to the eastern coasts

toward the end of the night and, with clear skies widely, a

widespread frost away from towns and city centres. Could get as low to

minus eight in pars of Scotland, just about staying frost free down

the eastern districts but a risk of ice tomorrow. Tomorrow morning, a

lot more waking up to sunshine, with a frosty start, and some across

eastern England will stay dry throughout.

The showers spreading to Northern Ireland, northern England, Scotland,

a mixture of hail, sleet and snow and thunder, a bit of everything and

it will still feel chilly. Tomorrow night, the showers take over a bit

more widely across England, Wales, southern Scotland. A bit more white

on the charts, increasing chance of the showers turning wintry. A bit of

sleet and snow into Thursday. As that system clears, it opens the

door to north to north-westerly winds and a plunge of colder air to

end the week. A bit of sunshine, a few wintry flurries and also

overnight widespread frost. That's it.

Hello, it's Tuesday, it's 10 o'clock, I'm Joanna Gosling

If you've just joined us, coming up before 11am...

The first strike by junior doctors in 40 years.

There's major disruption to thousands of NHS patients England

as routine operations and appointments cancelled

as the row over changes to pay and conditions escalates.

We'll hear from our studio audience about their thoughts

on the industrial action - and we also want to hear

from you and whether you agree with the strike.

A large explosion in the old town of Istanbul, ten people are dead. We

will bring you the latest. The migrant camp at Calais is getting

bigger and bigger, our reporter has been looking at what is being built

there and whether that will tempt more people to head there.

The main news this morning: Junior doctors in England have begun a 24

hour strike in their dispute with ministers about new contracts.

Emergency cover is still being provided but around 4000 scheduled

One hospital in Birmingham have has declared a level four incident,

winning junior doctors must go into work.

The Health Secretary Jeremy Hunt says doctors have been offered

a rise in basic pay but wants to see changes, so that more

It is a last resort, doctors have not been on strike

for more than 40 years and we have been pushed into a corner

The responsibility lies with them for what is happening.

The Governor's Office in Istanbul say that at least 10 people people

have been killed in a large explosion in the city.

It's thought to have happened in the city's historic Sultanahmet

district, an area popular with tourists.

The cause of the explosion is not yet known.

We now have an editor from the EDC Turkish service. We can confirm this

was a suicide attack, a bomb attack. It was definitely a bomb attack,

this is what we've heard from the governor. It happened early in the

morning, but before jurors groups were gathered in the square to visit

the attractions, the historic attractions of the square. What

we're hearing is that this was quite a large explosion, it was heard from

the Asian side of Istanbul as well, a couple of kilometres away from the

explosion site and also, you hearing from the hospital that there were

numerous wounded people getting treatment in hospital, several of

them seriously injured. The police officers are still contacting the

investigation and the area is sealed off and we are monitoring the

situation. Thank you very much. The UN is warning that around 400

people urgently need to be evacuated from the besieged Syrian town

of Madaya or face dying from starvation or other

medical problems. Residents received their first

supply of food and medicine in months yesterday,

when an international aid convoy Doctors think they've identified

genetic mutations which left a four-year-old girl unable to talk

and with damaged kidneys and eyes. Georgia Walburn-Green is the first

person to have her condition explained by the 100,000

Genomes Project. The scientists who studied her DNA

hope that new treatments will be Archaeologists working on what's

said to be Britain's best preserved Bronze Age settlement have given

a glimpse behind the scenes Must Farm was home to several

Bronze Age families when a fire tore through it 3000 years

ago, causing it to sink This is almost like getting

the opportunity to peek through the curtains and see people

actually in their daily moment, and as archaeologists,

you're just really nosy and that is what we want,

to be able to see what people are doing and this gives us

an opportunity unlike others. The media mogul Rupert Murdoch

and the actress and model Jerry Hall The couple have been together

for four months. The engagement was announced in this

morning's Times newspaper, which is owned by Mr Murdoch's News

Corporation company. Let's catch up with

all the sport now. We're talking about a man we have

ran out of superlatives for. Special, incredible and more than

anything he dreamed of as a child - that was Lionel Messi's reaction to

winning Fifa's Ballon d'Or for a record fifth time. He beat his

Barcelona team-mate Neymar and Real Madrid's Cristiano Ronaldo to the

prize. Messi's nickname is 'La Pulga Atomica' - the Atomic Flea - fitting

for a man who stands just five foot seven tall and has proved a constant

pest to every opposition. Last season, Messi helped Barcelona win

the league, the Copa del Rey and Champions League, plus the Uefa

Super Cup and Fifa Club World Cup. England's Mark Sampson missed out on

the Women's Coach of the Year award - that went to the USA manager Jill

Ellis, who was born and bred in Portsmouth. But Sampson did extend

his contract as England Head Coach, to include the 2019 World Cup

campaign, after guiding the Lionesses to third place in Canada

last summer. We believed in his team and that was one of the motivations

for signing the contract. I want to work with winners and to know we

have a team capable of winning the European Championships and hopefully

go one to 2019 and win that tournament. We know we will be

judged as a group one, can we eventually win a major tournament?

That is the aim for 2017 and 2019. Eastleigh manager Chris Todd said it

was unbelievable for his side to be mentioned in the same breath as

Leeds United after they were drawn together in the fourth round of the

FA Cup. Non-league Eastleigh have a replay with Bolton to negotiate

first, after they drew 1-all at the weekend - but if they come through

that, they'll have a home tie against the 1972 cup winners to look

forward to. It's taken over half a season, but

it seems manager Louis van Gaal is finally at one with the Manchester

United fans - the Dutchman has admitted he too has been bored by

his side this season. . United were booed off at half-time during

Saturday's 1-nil FA Cup win over Sheffield United, with thousands of

home fans leaving before Wayne Rooney's last minute winner. Van

Gaal speculated the Manchester traffic may have had something to do

with the early exodus. But he believes the team can improve. There

are also matches but I am also very broad or angry with because we're

not taking apart the defence of our opponents. But at this moment, we

have created a two. But they have done it. So they can do it. We will

see if they can in the Premier League tonight against Newcastle and

that match is live on Five Live. Thank you for joining us this

morning, welcome to the programme We're on BBC Two and the BBC News

Channel until 11am this morning. Thank you from -- thank you for all

of your comments. Email from Sidney -

fully support striking doctors. Very confident they will have been

given little option. They are not slaves and so can

withdraw their labour. I thank them for trying

to protect our NHS. Tweet from Mike: My mother's

operation has been cancelled. She has to remain in

agony until Friday. Your contributions to this programme

and your expertise really is key. Texts will be charged

at the standard network rate. And of course you can watch

the programme online wherever you are - via the BBC

News App or our website. And you can also subscribe

to all our features on the News App by going to add topics and searching

'Victoria Derbyshire'. As we've been telling you,

junior doctors went on strike across England at 8am this morning

in a row with the government Thousands of appointments have been

cancelled. Some hospitals are feeling the pressure, Sandwell

Hospital in West rummage. They must attend work after declaring what has

been described as a level four incident. No further details or not.

We will talk to a group of viewers, some of whom work in the Health

Service and others have experience of using it. Before that, a reminder

of what this strike is about. Junior doctors are on strike

as they're unhappy with the way their pay and conditions

are being changed. There are 55,000 junior doctors -

over a third of medical workforce - from those just out

of medical school to doctors Average earnings in the first two

years are ?36,000, but those in higher training can earn ?53,000

rising to ?70,000 for The Government wants an 11% rise

in basic pay, but this would be offset by 25% cut

in what are classed as unsociable hours -

which get extra payments. This includes classing Saturday

as a normal working day. The BMA, over time, say it

could lead to a large pay cut and mean they're forced to work more

evenings and weekends 98% of BMA members voted

yes for strike action - How will patients be affected

by the action? NHS England estimates nearly 4,000

operations and procedures out In a moment we'll speak

to our correspondent Smitha Mundasad who is at

Harrogate District Hospital but first Elaine Dunkley is outside

the Royal Devon and Exeter Hospital. They're on the picket line. Over to

you. We're on the front line, two hours ago junior doctors walked away

from the wards and came onto picket line and there are more common out

to support this strike. We have heard lots of car horns beeping,

there appears to be lots of support in the south-west for junior doctors

and I have got to them. Louise and Matt Jones, you have been a junior

doctor for 20 years. How did you feel, not? This is not something we

wanted to do. We don't want to take care away from the patients. -- for

non-2 years. We feel forced into this. It is unsafe for patients and

unfair for doctors and we feel we have been forced into having to take

this to industrial action today. You are at the start of your career.

Yes, it is a big decision because as doctors we set out to do the best

for patients and care for our patients and to take that caraway

and not turn up for work is not a decision we take lightly. We do this

for the future of the NHS and the future of patients. Why was so

important for you to be here, Louise? We have significant concerns

about the safety of the new contract and the suggestion is to take away

current safeguards to stop was working too many hours and without

those I am worried that the shifts mean that we will not be able to do

our job properly. The government says this is about improving

standards across the NHS. Today in Devon, 360 junior doctors are at

this hospital and the majority will be on strike. We can go to Harrogate

night. What is the situation there? -- now. You can hear lots of public

support, members of the public have been coming up here all morning and

shaking the hands of junior doctors and saying well done. Lots of junior

doctors joining the strike all morning. There has been a lot of

support coming in at the situation is less severe, perhaps, than other

parts of England. For operations have been cancelled across England

and here, no planned operations have been cancelled because senior

doctors have come in to help. Just 40 outpatient appointments have been

cancelled. I enjoyed by Doctor goldfields. There have been some

cancellations and disruption to patients. How do you feel? We feel

horrified that we have to strike, we feel very sorry if this has caused

problems for patients and we feel very strongly about the future of

the NHS and patient care. Some people will say that public sector

workers across the board have had pay cuts and pay freezes. Should

doctors not go through the same thing? I think we feel we are not

special people, but we feel we have to stand up for all of our

colleagues in the public sector, nurses, pharmacists, refuse

collectors, we have to say that enough is enough, we're looking at a

30% pay cut and that is simply not fair. But this argument is deeper,

it is about patient safety. Some patients will have health concerns

today. What about emergency services? Today is exactly as a

weekend, it is also the same as a bank holiday. There is enough

emergency care for patients. We would say, please come to the

hospital or your GP if you feel unwell, do not stop coming in, it is

safe to come to hospital today. Thank you for speaking to us.

Emergency services will continue today so patients should come in

they need to. Thank you very much indeed. Those were the picket lines

at different hospitals. We're joined this morning

by group of viewers - some of whom work in

the health service. Others, like many of you,

have experience of using it. They all have very different

views on the strike Straight to Nicky, you are a mental

health nurse and have experience as a patient. What is your perspective

on this? I completely agree that the doctors deserve better treatment but

I don't think striking is the right way to go about it because I'm an

activist myself for mental health charities and stuff and I know

that's different, but I have managed to raise the profile of issues

without doing strikes and stuff. I'm studying to be a mental health nurse

and I understand that sometimes steps like this are necessary, I

just don't think that striking is going to achieve more than it would

risk. Sabrina, you are a junior doctor working in a maternity unit

in East London. Why are you going out on strike? I really feel pushed

into this and this is the last thing me and my colleagues want to do. We

do not want to strike. We would have hoped that since the threat of

strike in December the negotiations would have come further along and we

would have reached agreement and hoped that the Government would have

engaged truly in a meaningful discussion, but unfortunately that's

not the case. That is why we have been pushed to strike and withdraw

services today. Since the strike mandate went ahead though, there

have been changes and an 11% pay increase has been put forward by the

Government? The 11% is only in the basic salary, a large proportion of

our salary is based on the out-of-hours work we do as well. If

you look at the basic salary, it's not enough money really for a

professional that's been working - I've been working in the NHS for 11

years and if you count my basic salary, it wouldn't be enough to pay

for my mortgage and tolike after my children. Andrew Brown, you are a

Conservative health spokesperson for Hammersmith and Fulham Council and

studied medicine yourself. Do you see a justification for doctors

striking? Yes. Because of my background, I have huge sympathy for

the doctors but I do not agree that strike is the right way forward. Why

not? As you already mentioned, there's been a lot of progress since

the negotiations started properly at ACAS in December, but over the last

six months, that's been the only negotiations between the BMA and the

Department of Health and the Government. I think the fault lies

both with the BMA and also with the Department of Health. I want to see

everyone get back around the table, talk about how the contract can

improve things for junior doctors and also patients - the most

important people in this. Dr Sarah Hallett, you are another junior

doctor working in a Ne-Yo natal intensive care unit. It seems the

areas of disagreement are actually not as great as they were at the

dispute. Are they still great enough to justify a strike? Absolutely. I

think Jeremy Hunt's comments about the areas of disagreement, a lot of

what he said was completely inaccurate. There are significant

areas we disagree on. Spell them out? So one of the main areas that

we are having issues with are safeguards in the contract. The

current contract has safe forwards to ensure junior doctors are not

overworked and not worked to unsafe levels unsafe for us and our

patients. What they are proposing in new contract, the safeguards do not

exist and, as a result we are really quite concerned that the impact this

will have on us and our patients and the amount of hours that we are

going to have to work. That is one area of disagreement but there are

many more as well. Does it boil down to pay? No. Pay is the very bottom

of our agenda. When you become a doctor, you become a doctor because

you want to help people. The reason you go to medical school is to help

people. Nobody would go into medicine to earn lots of money. It

would be the wrong career choice if that is what you are looking to do.

What this comes down to is concern about our patients.

Let's bring in a medicine student, a fourth-year student on placement at

Guys St Thomas' Hospital. So you are at the start of your career

path, how do you see it, is money a factor because you will be leaving

with debt, but for medical students the debt gets racked up over a

number of years? Sure. For me and a lot of medical students, the issue

is that we are worried about entering a system where we are

basically being set up to fail, where we are going to have to work

longer hours, there'll be less support staff during the week, less

colleagues around to help us make clinical decisions that are

essentially very difficult in an ageing population with very

complicated health needs. We don't want to be in a position where we

are making mistakes, and if this contract is unfair and unsafe, which

I think it is, I think most of us would agree it is, we are worried.

What is it specifically that is unsafe, the fact that safeguards

aren't in it? Yes, that would be the main thing. The total number of

hours junior doctors can work under contracts are limited so they are

fewer than currently? That's assuming the safeguards they want to

put in place work. However, I think it's very hard to believe that would

be the case. Abbie Cooper, a hospital nurse in

second year recently joined an intensive care team. Do you have

sympathy with the junior doctors you work with? Absolutely. The NHS is

such a huge team and it's not just doctor that provide the care. I have

the biggest sympathy with the strike and I completely support it, but at

the end of the day it's not just down to them, there are so many more

problems need addressing. It's not just about the doctors needing to

work more or less hours and earning less, it's about supporting the

health care professionals that are caring for patients at their most

vulnerable state. What is morale like on medical

teams? In my personal opinion I think it's fantastic but that's

obviously my own experience that I've had. I mean, I feel within the

NHS, doctors, nurses, physiotherapists, pharmacists,

radiographers work fantastically well as a team and that's what the

NHS is about, that is what I feel needs to be recognised.

Anne, your daughter died being treated in an NHS hospital. She'd

been treated for some time but it was over the weekend when she was

being treated that she died. The Government says this is about

getting good 24-7 care rolled out across the NHS. What is your

perspective on this? Its seems at the moment it was Monday to Friday

and unfortunately my daughter got the moment it was Monday to Friday

ill on a Friday evening and there just wasn't the cover available over

the weekend, there was no communication and she actually died

on the Wednesday afterwards. You work in a hospital as well don't

you? Yes. So you have that perspective on the dynamic across

the week and at weekends. Do you see a difference? I'm a ward clerk so

obviously I don't work weekends, but it's really scared us, you know, the

experience we had with our daughter to think if we were ill at the

weekend what would happen. What is your perspective on the strike?

Obviously you can see the doctors work lots of hours and it's not good

for them and it's certainly not good for the patients.

Sarah and Sabrina, just respond to that, because by striking, some

might say it looks like you are against the patients when the

Government says it's doing this because it wants 24-7

Government says it's doing this sure every patient has the best

possible quality of care whenever they go into a hospital? I

absolutely want every patient to have the best possible care whenever

they go into a hospital. However, I know because I work at least one in

four weekends, at least one weekend every month I'm at work on a

Saturday and Sunday, I know the struggles that we face at the

weekend. We have a lack of admin staff because the ward clerks don't

work at the weekends, we have a lack of pathology staff so the lab

results don't come, a lack of imagery staff, so the images we need

to come through to treat patients in the best possible way, they are just

not there and this idea that you can deliver a seven day NHS and top

class emergency services 24 hours a day without investing ex-that money

in an already struggling system is just absolutely ludicrous. I want

the Government to put the money where their mouth is and truly

deliver a seven-day NHS. Andrew are the doctors being scapegoated for

the problems at the weekends? I don't think so, but I agree that

they need the support of radiographers, radiology and admin

staff and porters, as well as from a council perspective, from social

services, to help patients get discharged from hospital in the

first place. I also think the Government is investing a lot of

money in the NHS and all the faults and problems and challenges that the

NHS is facing, a lot is due to demand and we need to do things to

tackle demand by investing more in public health, helping people live

healthier lifestyles as well. Alastair, you are a student. When we

see a debate where doctors and the Government are pitted against each

other effectively, does it become a debate about who really has the best

interests of patients at heart and, is it therefore a very edifying

debate, I suppose you could say, when you look at what is best for

the NHS in an impartial way as possible going forward? I think

that's why the debate's become so poisonous and skewed because it's

become about, it's moved beyond the technical issues about whether

doctors are better working out-of-hours which are issues we

can't talk about without knowing a lot about how productive junior

doctors are at their particular level of training. The reason is

because it's been skewed by the way the BMA has approached this and

called on strike action. The elephant in the room is, if you call

for strike action, you are invoking affirmative action politics which is

kind of not speaking to people in this country which is why the

strikes are a very bad idea in practical terms because people don't

respond to that kind of language and that means we can't talk about the

technical issues. On that point, let us bring in Theresa, a teacher,

teachers strike many times, what do you think about the doctors striking

today? I'm not a teacher at the moment but I think it's, as we can

see, all of the polls have shown the support for this strike is

incredibly high. I think this is a problem that we have that somehow

strike action is, as you say from a by gone era, you have to remember

when push comes to shove, you don't have, I mean if you try to negotiate

and can't get anywhere with that negotiation, there is very little

that is left to you and withdrawing your labour is a fundamental right

and something that you should be able to do. The doctors striking

today, it's got incredible support from the public and it's raised this

issue in a way it wasn't being raised until the talk of strike

action came into being. This is people now understanding in a way

that they wouldn't have done because these thingses don't obviously get

the same kind of attention that it has at the moment. I think that's

incredibly important. We know how important the NHS is to the public,

you know, just looking at things like the Olympics and how proud

people were when they saw Danny Boyle's thing on the NHS there, the

choir coming to number one, you know, these are things that show the

affection and importance that people place on the NHS. I think that

people absolutely understand that the doctors are not taking this

action because it's just about, we want to have lots of money and we

want to go on the golf course, you know, that's not how it is any more

for doctors, it hasn't been for a very long time and they understand

that doctors are saying, if we don't do something now, the NHS as we know

it will cease to exist and that cannot be allowed to happen. Leena,

you are an employer in the private sector, what is your view on the

right of doctors or anyone else to strike? There are 5.4 million small

businesses in this country and 48% of all jobs created in private

sector are created by companies like mine, small businesses. I do not

support the strike. I understand where doctors come from, but to run

a small business, to run the NHS is not different really, it's just

complexity and budget. So if something doesn't work, a small

business hooks into it and tries to find a solution. We've got the

Federation of Small Businesses who lobby on behalf of small businesses.

If tomorrow they say, hey guys let's strike, a small business owner will

go to the office and work because if you don't work, it doesn't mean you

don't earn money, we lose money and we can't pay our employees. My

opinion is it's a failure of leaders of NHS and unions and they should

come back to the table and negotiate and get the result. It's not what

they have done, it's what results they have achieve and they haven't

achieved the result. Sarah, answer that? The truth of the matter is

that we've now been discussing this contract for months, over a year in

fact. We have repeatedly raised the concerns and we feel we have not

been listened to. No junior wants to have to take industrial action, it's

an absolute last resort for us and I feel really sad we have come to

this. It doesn't feel like you are that far apart any more, it feels

like this strike was going ahead because it was in train but... No.

You are shaking your head, Sabrina? If you look at the sticking points,

we have already talked about the issue of the safeguards, but I mean

we have not really talked so much about how just unfair it is. I have

a seven-year-old and when she asks me why we were going on strike, I

said to her, the Government wants mummy to work more weekends and she

said, you already work lots of weekends and I said yes, but the

Government want mess to work more weekends which means less time with

you and in return they are not going to give me anything extra. In terms

of a financial point of view, I've got to arrange childcare ona

Saturday that costs more money. You can't get a nursery on a Saturday,

schools are not open so it costs me more money to go into work on a

Saturday but I'm not getting anything to help me cover that cost.

That is just not fair. Junior doctors, consultants, health workers

across-the-board will vote with their feet and they'll leave.

Gary says he fully supports the doctors in their battle with this

horrible government. Mark says junior doctors on duty at the

weekend by rapid problem, weekend issues are not enough, senior or

Houseman, there are no consultants on duty at the weekend. By law, a

bus driver works for hours maximum without a break because of

concentration issues and no more than a ten hour shift. How does the

new contract provide better weekend coverage? It rewards anti-social

hours and working less. Eamonn McCann, you are the final year

student and you have decided not to go into the profession? Why? I am

still on the fence but I am considering not doing medicine and

it is truly sad that after six years, all of this money I put into

this and all of that work, and at the last hurdle to think, it is not

worth it any more. Why not? It is the last hurdle to think, it is not

not appealing. It is not that... I knew I was not going to make it

about money or anything like that, I was not thinking I would earn lots

of money. I genuinely thought I wanted to help people. I wanted to

make a difference. And now, just thinking about having to work in

this environment with the government attacking us, smearing us, they

don't care about what we want to say, it is... Is at this

specifically that has changed your mind? It is one of the things, it

does not feel like it is worth it any more. I meant to be starting

work in six months I am dreading it and all of the medical disputes

around the UK, they have such low morale, we have had e-mail from

lecturers to keep faith and even they know we're not looking forward

to it any more. You just treading it and so many students, I am one of

many who want to do something else, go somewhere else, leave England.

Martin, the audit paramedic. What is your view? -- review archive. My

concern is the seven-day week NHS and when you listen to patients, the

experience where they have the NHS filling is when things go wrong,

acute medical complaints, emergency care. -- failing. And predominantly

that is in the community, provided by fellow professionals like nurses

and paramedics. What we really need to do is look at how we can provide

care in the community, we need more highly trained

care in the community, we need more professionals to provide patients

with the care they need in their own homes and in the community and only

take the most severe patients to the hospital so that doctors working at

the weekend can provide the care they need safely but we need to look

at community care and we talk about seven days a week and this is not

just about doctors, it is about all health care professionals. Andrew

says it is a disgrace that junior doctors or on strike over working at

beginners, patients are dying at weekends because the luck of the is.

-- because of a lack of doctors. Another says that doctors are

becoming more demoralised. Even though I am waiting for an

operation. The issue is being discussed with this strike and

obviously there is a lot of focus, but to any others feel like you

understand better this debate about the NHS and 20 47 caring and how

things should go forward? I think so. That is why it has been so

positive, we have been able to discuss these things and I think the

issue we have touched upon, wages and medicine as a vocation, it is

important. My grandfather was a GP in the north of Scotland, he had a

seven-day working week. He took afternoons off, it was not because

of remuneration, it was because of his calling and vocation and I am

not commenting on junior doctors because they are fantastic. But

maybe the debate is becoming more about wages and what you can get out

because we live in Mideast bridge is context and the public debate takes

place, not in the same post-war context that those discussions took

place churning the creation of the NHS. But we are that kind of

society, I work for 24 hours, seven days a week. To have a 24/7 NHS, the

government has not defined what they mean when they call for a seven-day

NHS. As junior doctors were already stretched with what we currently are

doing so the government might say, we're not going to provide any more

junior doctors, we will not change the pay. And yet we're going to have

more junior doctors working at weekends. We say, where are you

getting these junior doctors from? At the moment, it just does not add

up and it seems like this is political spin, unfortunately. If

we're going to talk about wages, the safe delivery of professionals in

hospitals, the mistake we have made is to talk about one group. It is

more than just doctors working in hospitals, we need to talk about the

conditions of everyone who works in the NHS together and only by doing

that can be create a nHS provides the care that we need 24/7. Couple

more comments from viewers, Mike Luffield boy has a lump in his

chests in September and was going to be checked yesterday but it has been

postponed. The only solution for these services is to have more staff

employed, not changing the contract. Thank you for joining us. And please

do keep in touch. We'll have a special report

from Calais where new shelters to house migrants

have been installed. And how a groundbreaking DNA project

has finally allowed children with mystery diseases

to be diagnosed. Junior doctors in England have

begun a 24 hour strike in their dispute with ministers

about new contracts. 4000 scheduled operations

have been postponed, although one hospital in Birmingham

has declared a level four incident, meaning junior doctors must go

into work because of The Health Secretary Jeremy Hunt

says doctors have been offered a rise in basic pay

but wants to see changes It is a last resort,

doctors have not been on strike for more than 40 years and we have

been pushed into a corner The responsibility lies with them

for what is happening. A bomb explosion in Istanbul has

killed at least 10 people people Latest reports say tourists

from Germany and Norway The blast happened in the historic

Sultanahmet district. Local media reports suggest it may

have been a suicide attack. The UN is warning that around 400

people urgently need to be evacuated from the besieged Syrian town

of Madaya or face dying from starvation or other

medical problems. Residents received their first

supply of food and medicine in months yesterday,

when an international aid convoy Doctors think they've identified

genetic mutations which left a four-year-old girl unable to talk

and with damaged kidneys and eyes. Georgia Walburn-Green is the first

person to have her condition explained by the 100,000

Genomes Project. The scientists who studied her DNA

hope that new treatments will be We will talk more about that in a

moment. The media mogul Rupert Murdoch

and the actress and model Jerry Hall The couple have been together

for four months. The engagement was announced in this

morning's Times newspaper, which is owned by Mr Murdoch's News

Corporation company. New containers to house migrants

have been installed at Calais - the first semi-permanent structures

to be built in the area since 2002. The buildings have raised concerns

that more people wanting to make it to the UK will be tempted to do

so because the temporary accommodation was thought to be

an incentive to force Our reporter James Longman

is in Calais and has been having The new face of Calais' jungle

looms over its residents. For the first time since 2002,

semipermanent homes have been built Certainly not luxury

but better than this. These are the new containers

here in Calais, which the French have installed to house migrants

currently living in the jungle, There will be enough space

for 1500 eventually. There are three larger

containers, giving migrants Is all this going to tempt more

people here and then on to Britain? It was tighter border controls that

actually made the difference. TRANSLATION: Since 22nd of October,

no-one has been caught in the UK It is actually that that

stops people coming. Peering through at this new world,

residents in the camp remain determined as ever and some

do not want to move Go outside every night,

going to try England. Even those who do want the shelter

aim to make it to the UK. Mohammed Shafiq and his family

of eight have been at the camp They may have some dry beds now but,

when the weather clears, Mohammed says he will

be trying again. My dad, my mum, five

sisters, three brother. There will not be enough space

here for everyone but the bottom line is the French want

the jungle cleared. What happens to those who do not get

or want a place is anyone's guess. We are yet to know what effect these

containers will have on people What is clear is that migrants

still living in the jungle A four-year-old girl

with a previously unknown medical condition has been diagnosed

after volunteering to take part in a groundbreaking DNA

sequencing project. Georgia Walburn-Green,

a patient at Great Ormond Street hospital in London, suffered

from a rare gene mutation. She's the first person

to have her condition explained The scientists who studied her DNA

hope that new treatments will be With me now is Professor Mark

Caulfield, Chief Scientist Just tell us first of all what the

project is. The 100,000 Genomes Project is about understanding the

causes of rare inherited disease and what drives cancer and to infection.

Today we're sharing diagnoses where we have read through the 3.3 billion

letters in our genetic code that make us the individuals that we are

but also carry a tendency to have disease and in these cases, we are

able to feed for the first time answers to the mothers and fathers

of these children and that is what they crave. It is an important

milestone. What difference does it make for someone like Georgia

Walburn-Green? She is able to have this diagnosis. When George was

born, there was evidence of thing was wrong but the NHS through

conventional tests could not find the cause and what Georgia

Walburn-Green had was something amongst 7000 people in Britain, a

syndrome without any name so we did not know what the diagnosis or the

causes and a very do not know that, we cannot understand the biology and

we have limited chance of getting treatment or any preventative

strategy. For Georgia Walburn-Green and her parents, she has an answer

and if you talk to affected families, above all else, they want

to understand why their child is like what they are and they want to

pave the way for treatments but in many cases it may not. So in

practical terms, doesn't make much difference? In some cases it will

and hopefully in the second case, which is where a child has a defect

of the transport of glucose in the brain and this child at 13 months

had recurring fits a lot of the time and that develop mental delays,

another syndrome without any name, and in that case, then modifying the

diet to eat a high-fat diet you can reduce the effects on the seizure

and we hope that will bring benefit to the family. In some cases we can

work out what helps. And in some cases will be a direct material

benefit. Obviously, understanding the biology gives us the chance to

begin to unravel how we might approach treatment and I think the

great thing for the family of Georgia and other families affected

by these diseases is that they neither have others with the same

disease and support framework and network and I think the loneliness

that people feel when they don't have any answer to why the child is

like they are, that is profound. If you meet the parents of these

children, they are so heroic and the love they give the children Ex

Machina very humble, having two daughters myself. I believe the

answer is very important. Even if it is only the beginning of the search.

Tell us about some cases that you have been involved with where you

have found that relief because someone's got a bit of clarity? One

example of another case we had back this Newcastle has been a family

affected by kidney disease where the father, uncle and brother of the

affected man in his 50s had a severe kidney disease and he'd had to have

two kidney transplants. Unfortunately, he transmitted that

to his daughter but she is well because she had also got good blood

pressure control and her kidneys didn't fail so that's excellent. But

her daughter had a daughter herself and they've been worried for years,

the daughter is a teenager, that she would be affected by the disorder,

so a palpable example of what can be done is that by getting a diagnosis,

answering why the grandfather had his kidney failure and why the

daughter has the same condition but hasn't gone into kidney failure, we

have been able to test in the NHS that daughter, granddaughter of this

family and find that she doesn't have it. A huge relief? Yes. She has

to have check force protein loss and blood pressure. Sometimes it doesn't

change the disability people have but when you understand the cause

you can begin to start to search for treatment. How labour intensive is

it to find out where the sequencing goes awry? You mentioned 3.3 billion

sequencing letters? Absolutely. There are areas that regulate bits

that make the protein so there is a lot to read through. It's like

reading a complex book and periodically we have to reread it to

make sense of it and bring the answers out. In geonomick, we are

developing with parter ins automated ways of doing this, so we can bring

die know seize to patients in the Health Service -- geonomics.

We hope to transform this. Thank you very much.

Breaking news to bring you about defence. We are just hearing from

Jonathan Beale, our correspondent, that 131 British military personnel

have died during training since 2000 according to statistics released by

the Ministry of Defence. It represents 5.5% of all military

deaths on duty over the period from January 2000 to October 2015, so

that is about one in 20 deaths during training. 88 of those who

died in training or on exercise were in the army, eight in the Royal

Marines, 21 in the RAF. Junior doctors are on strike in England in

a row with the Government over new contracts. They are only working in

emergency departments today. It's a dispute which politicians remain

divided on. In a moment we'll speak to two of them. Jim Reed has been

looking at why the doctors are striking.

The priority at the moment is the thousands of people we thinnk

die unnecessarily because we do not have proper cover for urgent

We're already overworked, underpaid, demoralised.

There are 55,000 junior doctors in England.

These are not just students leaving medical school but anyone below

That can mean someone with nine years experience in charge

They're the person you will see clerking you in when you go

into A, they are the person you might see in your GP practice.

Often they will be the person that comes round on the ward

They are often also the people that will be doing surgery in theatre,

they will be assisting the consultant when they do

The starting salary is just under 23,000.

Add in overtime and unsocial hours, average pay in the first two

Those in higher training can earn 53,000, rising up to 70,000

How does that compare with other jobs?

It is hard to measure and depends on where you live but take

the average pay for a junior doctor in those first two years.

That is more than a teacher or a police officer

but about the same as the starting salary for a banker and less

One big part of this is hours worked.

The Government wants to raise basic wages but change the way it pays

At the moment, regular hours are set at 7-7 Monday to Friday,

The Government wants to extend those core hours till 10pm in the week

and into Saturday for the first time.

This contract does not seem to value the hard work of junior doctors.

The trouble with that is, the doctors that are working some

of the most difficult hours, the ones that are working some

of the hardest rotas, working through the night

and weekends, etc, these are the people who really lose

They are the people this affects the most.

In the last general election, the Conservatives promised to bring

Illness does not respect working hours.

Heart attacks, major accidents, babies, these things do not just

It has been known for years it is more dangerous to get

A recent study found the odds of dying in hospital are 10% higher

Doctors say these changes will strip back the safeguards meant to stop

them working excessive hours and make life less

Junior doctors in England only are now on strike for 24 hours

Two more strikes are planned for the end of January and February,

unless there is a breakthrough in the talks.

Louise Hague is heading to the picket line later and David Morris

is disappointed that the strike has gone ahead. Thank you both for

joining us. Louise, why will you be off to the picket line? I've already

been on my way here this morning just outside St Thomas' to talk to

junior doctors there. I've spoken to many in my own constituency. We are

really concerned about if contracts being imposed on them, but also they

are concerned about the way they are being spoken about. The Government

is taking them on as a political battle, rather than trying to work

with them to make sure patient safety is improved and as we have

heard, that weekend working is improved as well so people aren't

put at risk. There's been an awful lot of misinformation on this, not

least from Jeremy Hunt who is refusing to talk about the

industrial action today, about weekend deaths, about the contract

that is being imposed on junior doctors, and these are very, very

caring people. The last thing they want to do today is strike, they

want to make things work and improve safety for patients. David? I

disagree totally. The BMA have handled this totally wrong. If you

look at the hierarchy, they are all Labour-wanna be candidates, all of

them and some stood against noted Conservatives for Parliament. The

electorate have given the Conservative Government a mandate to

give a full NHS seven days a week. But it's junior doctors who've

voted. On 98%. On 74%. 9ving 87%. You are talking in the region of 20%

not voting. It's the majority, so they have the mandate? But it's how

it's been put across. You look at what's been offered, more money for

less hours. You have seen what is happening today, this is what is

happening. There is a furore at the moment saying we are not covered at

the weekend. We are covered but this is what is happening every weekend.

What Jeremy Hunt wants to bring in is a seven-day NHS where doctors are

being paid right, being monitored correctly and, more to the point,

any overtime they do is being put into their pension which it isn't

now. The pay rise offered is 11%, originally it was 15% but that

doesn't begin to compensate for the 26%... Let's top stop you on that

point. You are saying antisocial hours, I've been listening to some

doctors on this programme saying it's antisocial hours working

Saturdays, but they don't want to be penalised nor forgot working

Saturdays, so let's clear that up. They want to work Saturdays but get

paid more, this package gives them that. It's a 26% cut for the hours

they'll be asked to work over an above the hours they are can'tly

working. At the end of the day, this isn't about pay for a lot of the

junior doctors, it's safety for patients, I don't want to be

operated on by a doctor that's been working 80-90 hours a week. That is

why the hours are going down. 91 hours down to 72. This will return

us to the bad old days of 90-hour working week. How can they? This is

the ultimate negotiation. This is a basis for the contract that NHS,

health education England's put out. The final negotiation with the BMA

put forward have shown the major points of disagreement left are

working hour weeks, rest breaks and night shifts. Those are the final

things the Government won't negotiate on. The chief negotiator

says we have to topple this Government, don't forget the last

election was won by a Conservative Government with a mandate to sort

this problem out and that's what we are doing. What the Government is

doing, this is going to disincentivise people applying to

antisocial hours. We have seen specialities like paediatricians. 91

to 72 hours. 70% of junior doctors surveyed said they would consider

leaving the NHS if the contract is imposed. We are facing a massive

recruitment and retention crisis in the NHS, we have lost a third of A

doctors in five years overseas and nothing being put in here will

tackle any of those problems. They are overstretched because they are

working longer hours, they say, they are working 91 down to 72 hour,

monitored better, better pay and it's safer for the patients and that

is the important thing. The safeguards are being removed. The

indisincentive for Trusts to award excess hours, unsafe hours for

junior doctors, that is being removed and they are putting in

place voluntary special guardian. I want to come in because you have

both run through all of the arguments very effectively there. In

terms of the strike today, are you concerned about patient safety?

Personally I would rather see everyone get around the table and be

grown up about it and sort it out for the future. From what I can

gather, most hospitals are covered. I've looked on the Twitter feed from

my local hospital in Lancaster, there are no doctors on the strike

line s just opposition politicians, whether they be the Greens or

council candidates or whoever are Labour. This is what we see every

Saturday and weekend where we have less staff on, we want to see that

being monitored better and have more staff on at the weekend. Emergency

care is being well covered today but the idea that this is a political

strike exercised by militants which is what several colleagues have

called junior doctors is appalling. That's exactly what it is. This is

an enormous mandate for junior doctors. We are out of time, you

two. Thank you very much and we'll wrap up with a couple of viewers'

comments. Doctors have every right to strike as do the Tube drivers.

Janet, it's Government's responsibility to make sure

contracts are safe for doctors. Thank you so much for your views,

your company today. See you same time tomorrow. Have a good

afternoon. Bye. So, no-one pays tax here?

No-one pays taxes.