Consultant doctors in England have decided that the best way to get the government's attention is to stop working for two days next month, in a dispute over pay and working conditions. The walkout will begin on 25 November at 06:59 GMT, with consultants staffing emergency care only - a setup known as Christmas Day cover, which is likely to have a major impact on most routine and elective or planned services. Because nothing says "we care about patients" like giving them the same service they'd get on a public holiday.

The announcement comes after talks had been taking place with the government over the past month, following the vote in favour of strike action by British Medical Association members in July. Consultants - the most senior doctors in the NHS - were given a 3.5% pay increase this year. But the BMA argues pay has fallen by a quarter over the past 17 years, once inflation is taken into account. The union also wants a reduction in the standard working week, from 40 to 35 hours, and higher pay for out-of-hours work, alongside changes to pensions, including greater flexibility over when they can be taken.

In a joint statement, BMA consultants committee co-chairs Dr Helen Neary and Dr Shanu Datta, said they had tried to negotiate with the government in "good faith", but "time-and-time again ministers have kicked the can down the road". "Unfortunately, that road has now run out, and we have been forced to announce strikes. Consultants take their responsibilities incredibly seriously, and striking does not come naturally, but we are hearing loud and clear from the profession that they have had enough."

Average earnings for consultants top £150,000 a year. Basic pay starts at £113,500, with the most experienced getting £150,500. But many earn tens of thousands in extra payments and awards. In the strike ballot, 76% of consultants who took part voted in favour of strike action, with just over half of eligible BMA members taking part. The government says this represents only around one in five consultants employed by the NHS in England voting for strike action, as nearly half are not BMA members.

Health Secretary Yvette Cooper said the government had been in "constructive discussions" with the BMA so it was "disappointing" the strike dates had been announced. She said taking strike action would be "irresponsible" and "place the health service under even greater pressure". The strike announcement comes as consultants and other doctors are taking part in strike action during November in Northern Ireland. Consultants last took strike action in England in 2023. The long-running dispute involving resident doctors in England came to an end earlier this year after more than three years of on-and-off strike action.

So, to sum up: highly paid doctors are striking over pay, the government is disappointed, and patients are caught in the middle. It's the circle of life, NHS edition.