Why are hospital consultants on £90k+ a year going on strike?

• Consultant Opthamologist Randeep Sharma explains why he and his colleagues are taking industrial action today.

Thousands of NHS consultants in England are on strike for two days until 7am on Saturday (22 July).

It's expected to cause mass disruption and could end up costing hospitals "many billions" of pounds, the NHS Confederation has warned, as it urged the Government and unions to reach a deal.

The starting salary for a consultant is around £90,000, which has left many people who are struggling with the cost of living, questioning the justification for their actions.

Here is what consultants on the picket line told ITV News today.

• Housing costs

Ben Hockenhull is a consultant at St Mary's hospital in London but he commutes 80 minutes every day from the West Midlands because he says that is more affordable than living in the capital.

He says the London-weighting aspect of his pay has not changed since 1994, and at around £100 a month it doesn't cover working and living in London.

"In fact, it doesn't cover it to the extent that I actually live in the West Midlands, and I commute on a daily basis to London, because that is cheaper, and more manageable for me on my salary than to move to London, and have somewhere to live by myself.

"I couldn't afford to pay for a single studio apartment on my current salary in London, within 15 to 20 minutes of the hospital, which is what we are contractually obliged to have"

"It does mean that when I'm on call, I have to stay in a hotel. I have to pay that out of my own pocket. That is still cheaper than me paying for a flat within 15 to 20 minutes of Paddington."

• Loss of doctors abroad

One consultant on the picket line outside the Queen Elizabeth Hospital in Birmingham said his biggest concern for the health service was the loss of talent to other countries.

Mark Openshaw has worked in New Zealand and says pay and conditions are better abroad. Many doctors he's now training are moving abroad permanently - and they need to be retained.

He says he's not saying that consultants are badly paid, but there are other reasons why people are leaving the country.

"We're not saying that consultants aren't receiving a good salary, what we're worried about is people are still leaving despite this, these things need to be looked at. I think there's insufficient doctors, people leaving training, people not getting all the way to being consultants."

• Pay

Randeep Sharma, a consultant ophthalmologist at Russell's Hall hospital in Dudley says that consultant pay has eroded by a third over the last 14 years, and "this is detrimental to the medical profession and patient care."

He argues, "When you are starting as a consultant you've gone through seven to ten years of training, and before that six years of medical school, and so at that point in your life having gone through vigorous training and student loans I think that salary is justifiable.

"Consider the value consultants provide in terms of patient care - which is almost 24/7, and the volume of patients we care for.

Mike Hendley, from the BMA consultants' committee says he was 37 before he became a consultant and he started training at the age of 18.

He says the salary works out at about £45 an hour to do tasks like brain surgery.

With the recent pay rise, people start on £93,000 in the UK, but in Ireland people start on £185,000 a year and even higher in Australia and Canada - where doctors trained here can choose to work.

• Supporting junior colleagues

Alex Moss, a cardiology consultant in Birmingham, was out on strike today to show support for colleagues like nurses and junior doctors who are paid less, but who she says have seen cuts to their pay and working conditions.

She also wants to keep them motivated and to see consultancy as a job they would like to work towards.

More than 24,000 consultants voted in the British Medical Association (BMA) ballot for industrial action last month, with the vast majority (20,741 or 86%) voting in favour.

The government has told consultants they will receive a 6% pay rise, but the BMA has called this “derisory” and said doctors have seen real-term take-home pay fall by more than a third over the last 14 years.

NHS trusts have been planning how to manage without their most senior doctors, with Christmas Day cover meaning, in many cases, that consultants will be “on call” throughout Thursday and Friday.