• More than 100,000 operations and appointments may be cancelled from strike
• Walkouts will be repeated next month to coincide with Tory party conference 

By Kate Pickles Health Editor

Published: 19:57 EDT, 19 September 2023 | Updated: 02:47 EDT, 20 September 2023

Consultants have taken to picket lines today in their ongoing row with the Government over pay.

The senior medics walked out of hospitals across England at 7am this morning as part of a 48-hour strike and are providing a stripped-back ‘Christmas Day’ level of service — meaning routine appointments and operations are set to be significantly disrupted. 

Junior doctors will then stage a joint strike with consultants tomorrow — for the first time in the health service’s 75 year history — marking an escalation in the dispute.

Striking medics claim their salary has been slashed over the last 15 years but officials say their have already made their final pay offer and patients are at risk. 

Here, MailOnline details all you need to know about the action and how it could affect you.  

Who is striking this week and when?

Consultants and junior doctors in England are taking industrial action this week, coordinated by the British Medical Association (BMA).

Senior doctors will walk out from 7am today to 7am on Thursday.

This includes 24 hours of joint action with junior doctors from 7am on Wednesday to 7am on Thursday.

The junior medics will take to picket lines from 7am on Wednesday to 7am on Saturday.

What services will be hit? 

Many routine hospital appointments and treatments, including cancer care, have been postponed as a result of both junior doctor and consultant strikes.

Some hospitals have had to halve their normal levels of activity on strike days. 

However, patients have been urged to still attend their appointment if they have not been told it is cancelled — as some doctors are still working.

There will be ‘Christmas Day’ cover throughout hospitals on Tuesday and Wednesday, with emergency units staffed and a basic level of cover on wards. 

On Thursday and Friday — during the junior doctor strike — there will be a ‘full strike’ meaning consultants will be used to provide cover in hospitals.

GP services and pharmacies are expected to operate normally during the strikes, though some junior doctors work at GP surgeries, so some practices may be affected from Wednesday.  

Professor Sir Stephen Powis, national medical director at NHS England, said: ‘The NHS has simply never seen this kind of industrial action in its history. It poses an enormous challenge.’ 

Professor Powis urged the public to use NHS ‘wisely’ to ensure care is delivered to those who need it most.

He said to only call 999 or attend A&E for life-threatening emergencies and otherwise contact NHS 111 for non-urgent needs.

Why are they striking?

The BMA argues that junior doctors and consultants have seen their pay be eroded over the last 15 years, meaning it hasn’t kept up with inflation.

As a result, the medics’ pay has fallen by around 35 per cent, the union claims.

Junior doctors have called for a full 35 per cent pay uplift, while consultants set their pay demand at 11 per cent. 

For comparison, the Government has offered junior doctors a pay rise between 8.1 and 10.3 per cent, depending on what level they are at.

The average junior doctor in their first year of training will see their salary rise from £29,300 to £32,300, while a medic with three years’ experience will get a boost from £40,200 to £43,900. 

Meanwhile, pay for consultants will increase by six per cent. It means starting basic pay has increased from £88,300 to £93,600. The average consultants’ earnings are expected to be £134,000 a year, after including overtime and on-call payouts. 

Why are health leaders more worried about these strikes? 

NHS bosses have long warned that strikes mean disruption for patients, with nearly 1million appointments and operations cancelled over nine months of walkouts.

For this round of action, health chiefs are warning that increasing numbers of patients who have already had their operation cancelled due to industrial action are having their rescheduled appointments cancelled again.

This includes a growing numbers of cancer patients. 

NHS Confederation warned that the BMA is now putting ‘more patients at risk than ever’ and describe the situation as ‘dangerous’.

What impact will the strikes have on patients?

Hospitals are reporting that some patients have now had their appointments cancelled up to three times because of strike action.

Health leaders say there is a ‘clear risk’ that the health of some patients will deteriorate the longer they are left to wait. 

While NHS bosses report that around 1million apportionments have been rescheduled because of strikes, the true toll is thought to be much higher. 

This is because hospitals are now routinely not booking in patients for strike days, meaning the true scale of the impact won’t be reflected in the official data.

Is there any end in sight for the NHS strikes? 

The Health Secretary Steve Barclay and the BMA, which is coordinating the consultant and junior doctor strikes, have not met in more than three months.

Prime Minister Rishi Sunak has said that they pay offer the Government has granted is fair and final.

But BMA leaders have said they will only call off action if presented with a higher pay uplift and ‘cannot cancel strikes to simply enter talks’.

This suggests that there is no end in sight, with the union warning that without an agreement, strikes will continue into winter. 

• Consultation considers minimum service levels that covering urgent care 
• Junior doctors have so far held 19 days of industrial action in hospitals this year 

By Shaun Wooler Health Editor

Published: 19:01 EDT, 18 September 2023 | Updated: 02:34 EDT, 19 September 2023

The United Auto Workers strike against the ‘Big Three’ Detroit carmakers entered its second day on Saturday, and some union members are questioning whether President Joe Biden has done enough to back their cause.

The strike involves 13,000 workers so far, less than a tenth of the union’s total membership, but UAW’s strike fund has enough cash to support a full 150,000-member walkout for up to three months. 

The union representing workers at General Motors, Ford and Stellantis is seeking a 40 percent raise for its workers. The walkout is limited for now to three assembly plants: a GM factory in Wentzville, Missouri, a Ford plant near Detroit, and a Jeep plant run by Stellantis in Toledo, Ohio. 

In Kokomo, Indiana, the hometown of UAW boss Shawn Fain, Local 685 President Garry Quirk told Politico that Biden, the self-described ‘most pro-union president in American history,’ had not done enough to prevent a strike.

‘I don’t know what he’s done,’ Quirk said. ‘Ask him. I don’t think he knows what he’s done. Seriously. I’m not trying to be mean.’

Quirk, 60, told the outlet he voted for Hillary Clinton in 2016, and then Donald Trump in 2020.

Fellow local member Denny Butler, 52, also expressed frustration at the White House’s perceived lack of action.

‘We haven’t had a president in there for years, with the exception of Trump, that was really for the people, all the way back to the Reagan days,’ he told Politico.

He noted that unions were once tightly aligned with the Democratic Party, but said that was no longer the case.

‘Democrats were for the working people. That s**t has changed. I’m telling you what, the Democratic Party was not what it was 20, 30 years ago.’ 

On Thursday, Biden spoke with Fain and the three auto company CEOs in a futile last-ditch bid to avoid a strike. 

The chair of Biden’s Council of Economic Advisers cited Biden’s record of backing unions and collective bargaining, saying the president had been ‘very much engaged’ in the negotiations. 

The union appeared to be digging in for a potential protracted strike, even as Ford quickly announced that ripple effects from the walkouts meant temporary layoffs of 600 jobs.

UAW President Fain said late Friday that it wasn’t true ‘negotiations have broken down.’

However, he added that ‘our members and allies are standing strong at the picket lines. Anyone who wants to stand with us can grab a sign and hold the line.’

‘Tomorrow, we expect to be at the bargaining table,’ he said. ‘All three companies have received a comprehensive counteroffer from our union, and we await their response.’

For Biden, the strike represents a collision of two of the president’s top goals – fighting climate change and expanding the middle class by supporting unions. 

Biden is trying to turbocharge the market for electric vehicles to reduce greenhouse gas emissions and prevent China from solidifying its grip on the growing industry. 

His signature legislation, known as the Inflation Reduction Act, includes billions of dollars in incentives to get more clean cars on the roads.

However, many autoworkers fear the transition away from gas-powered cars will cost jobs, because electric vehicles require fewer people to assemble. 

Although there will be new jobs in the production of high-capacity batteries, there’s no guarantee that those factories will be unionized, and they’re often being planned in states more hostile to organized labor.

‘The president is in a really tough position,’ said Erik Gordon, a professor at the University of Michigan’s Ross School of Business. ‘What he needs to be the most pro-labor president ever and the greenest president ever is a magic wand.’

The union is demanding steep raises and better benefits, and it’s escalating the pressure with its targeted strike. 

Brittany Eason, who has worked for 11 years at the Ford Assembly Plant in Wayne, Michigan, said workers are worried that they’ll ‘be pushed out by computers and electric vehicles.’

‘How do you expect people to work with ease if they’re in fear of losing their jobs?’ said Eason, who planned to walk the picket line this weekend. 

Electric vehicles may be inevitable, she said, but changes need to be made ‘so everybody can feel secure about their jobs, their homes and everything else.’

Biden on Friday acknowledged the tension in remarks from the White House , saying the transition to clean energy ‘should be fair and a win-win for auto workers and auto companies.’

He dispatched top aides to Detroit to help push negotiations along, and he prodded management to make more generous offers to the union, saying ‘they should go further to ensure record corporate profits mean record contracts.’

As part of its demands, the UAW wants to represent employees at battery plants, which would send ripple effects through an industry that has seen supply chains upended by technological changes.

‘Batteries are the power trains of the future,’ said Dave Green, a regional director for the union in Ohio and Indiana. ‘Our workers in engine and transmission areas need to be able to move into the new generation.’

Executives, however, are keen to keep a lid on labor costs as their companies prepare to compete in a global market. China is the dominant manufacturer of electric vehicles and batteries.

‘The UAW strike and indeed the `summer of strikes´ is the natural result of the Biden administration´s `whole of government´ approach to promoting unionization at all costs,’ said Suzanne Clark, CEO of the U.S. Chamber of Commerce.

Some environmental groups, conscious of how labor remains crucial to securing support for climate programs, have expressed support for the strike.

‘We’re at a really pivotal moment in the history of the auto industry,’ said Sam Gilchrist, deputy national outreach director at the Natural Resources Defense Council.

Presidential politics have increased the stakes for the strike, which could damage the economy going into an election year, depending on how long it lasts and whether it spreads. It’s also centered in Michigan, a key part of Biden’s 2020 victory and critical to his chances at a second term.

Former President Donald Trump , the frontrunner for the Republican nomination, sees an opportunity to drive a wedge between Biden and workers. 

He issued a statement saying Biden ‘will murder the US auto industry and kill countless union autoworker jobs forever, especially in Michigan and the Midwest. There is no such thing as a ‘fair transition’ to the destruction of these workers’ livelihoods and the obliteration of this cherished American industry.’

In an interview with NBC’s ‘Meet the Press,’ Trump said that ‘electric cars are going to be made in China,’ not the United States, and he said ‘the auto workers are being sold down the river by their leadership.’

Trump’s comments have not earned him any support from UAW president Fain.

‘That’s not someone that represents working-class people,’ he told MSNBC earlier this month. ‘He’s part of the billionaire class. We need to not forget that. And that´s what our members need to think about when they go to vote.’

Ammar Moussa, a spokesman for Biden’s campaign, said Trump ‘will say literally anything to distract from his long record of breaking promises and failing America’s workers.’ 

He noted that Trump would have let auto companies go bankrupt during the financial crisis rather than bail them out as President Barack Obama did at the time.

But there are also disagreements between Biden and workers.

When the Energy Department announced a $9.2 billion loan for battery plants in Tennessee and Kentucky, part of a joint venture by Ford and a South Korean company, Fain said the federal government was ‘actively funding the race to the bottom with billions in public money.’

Madeline Janis, co-executive director of Jobs to Move America, which works on environmental and worker issues, said the White House needs to do more to alleviate labor challenges.

‘We don’t have enough career pathways for people to see themselves in this future and let go of the jobs in industries that are causing our world to be in crisis,’ she said.

Never-ending NHS strikes have sent the waiting list for routine ops to another all-time high as the health service battles its busiest ever summer.

England’s backlog, for procedures like hip and knee replacements, now stands at 7.6million, official figures revealed today. 

It means roughly one in seven people across the country are currently stuck in the system awaiting care. More than 380,000 patients have gone a year without being treated, often in agony.

Months of walk-outs by junior doctors, nurses and other NHS workers demanding inflation-busting pay rises have dented efforts to tackle the record backlogs which built-up during Covid.

Hundreds of thousands of procedures and appointments have had to be cancelled, heaping extra pressure onto struggling hospitals. 

Junior doctors, seeking a salary hike of 35 per cent, will tomorrow stage their fifth strike in the ongoing dispute, walking out for four days from 7am.

Consultants, who earn in excess of £100,000, on average, will take to their own 48-hour picket line from August 24. 

Further action is planned for September if the Government ‘refuses to agree to pay talks’.

Experts today said the NHS is battling an ‘eternal winter’ and urged for ministers to break the deadlock with unions so the backlog can finally start shrinking. 

Summer months usually offer hospitals a break ahead of the usual busy spell, when seasonal pressures like flu and norovirus typically kick in. 

But NHS England said this summer is ‘on trajectory to be the busiest in NHS history’.

Some 4.42million attendances in A&E were recorded over June and July.

This is a rise of 42,500 on the previous high, when 4.37 million were recorded in 2022. 

Monthly performance data released today shows the overall waiting list has shot up from 7.47million in May. 

It marks the highest total since NHS records began in August 2007. 

Around 4.4million were stuck in the system when the pandemic reached the UK. 

More than 7,000 patients had been waiting for more than 18 months in June – down slightly from 11,000 figure logged the previous month.

The Government had set the target of eliminating this backlog by April, apart from those who have exceptionally complex cases or had chosen to wait longer.

Rishi Sunak made cutting waiting lists one of his 2023 priorities, pledging in January that ‘lists will fall and people will get the care they need more quickly’.

However, he has acknowledged that strikes across the health service are making the task ‘more challenging’.

As part of the plan to tackle the backlog, health chiefs announced yesterday patients will be matched to hospitals further from their home. 

People waiting for diagnosis or treatment on the NHS will be given a profile detailing their symptoms or treatment needs and how far they are prepared to travel.

These would be reviewed by managers at 650 private and NHS providers around the country who can take over their care if they have spare capacity.

Some consultations may be performed remotely by doctors hundreds of miles away from the patient.

Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said: ‘Today’s data is a reminder of the significant pressure on staff with this summer currently on trajectory to be the busiest in NHS history, all while industrial action continues to disrupt services.

‘Despite this, hard-working staff are delivering improvements in urgent and emergency care waiting times while also tackling the backlog by doing more tests and checks than any July on record and seeing record numbers of people with suspected cancer.

‘While tomorrow the NHS will see a fifth round of junior doctor strike action with thousands of appointments and procedures likely to be postponed, the NHS will need to prioritise emergency care once again.

‘So please continue to use 999 if it is a life-threatening emergency and 111 online for any other health concerns, while GPs and pharmacies are also unaffected by strikes.’

Separate A&E performance data for July shows emergency departments faced their second busiest July ever, with 2.1million attendances.

Three-quarters of emergency department attendees (74 per cent) were seen within four hours.

NHS standards set out 95 per cent should be admitted, transferred or discharged within the four-hour window.

Meanwhile, 23,934 patients who sought help in emergency departments were forced to wait more than 12 hours. 

Dr Tim Cooksley, president of the Society for Acute Medicine, said the figures show urgent and emergency care and ‘the NHS as a whole’ remains ‘under immense strain’. 

He added: ‘It is pleasing that the number of patients waiting 12 hours in emergency departments have reduced compared to this time last year. 

‘This all comes at a time of the year previously associated with some respite for staff but, as we have said before, the eternal winter that now exists in the NHS is again putting hard- working staff at risk of exhaustion.

‘Along with the failure of the Government and the BMA to reach a settlement and seeming intransigence that this will be the “final” offer, the situation is deeply alarming.

‘The consequence of this in particular will almost certainly mean a continuation of strikes with inevitable disruption to patient care and an inability to implement urgently needed plans to prevent the similar appalling scenes witnessed last winter being seen again this winter.’ 

He said: ‘There is, without doubt, more trouble ahead in the NHS. It is still possible to change the trajectory for the upcoming winter, but the window of opportunity is growing more narrow by the second.

‘Urgent action is needed to ensure winter plans are implemented effectively and in full. 

‘If not we will inevitably be back in a situation where we face calls for national major incident type plans. We simply cannot wait to hit that scenario again.’

Rory Deighton, director of NHS Confederation’s Acute Network, also said: ‘Given the difficulties the NHS is facing it is unsurprising but regrettable that the overall elective waiting list has increased to 7.57million, with activity levels dropping lower than pre-pandemic levels.’

He added: ‘Imagine where the NHS could be now if industrial action had not been allowed to rumble on.’

Saffron Cordery, deputy chief executive at NHS Providers, added: ‘Trust leaders’ efforts to recover urgent and emergency care – and to bring down the waiting list – must be backed nationally with proper support. 

‘This includes better government funding in workforce and capital, including beds and vital equipment, and a solution for the challenges in social care. 

She added: ‘The strikes divert trusts’ resources from bearing down on backlogs to managing the disruption they cause. 

‘It’s vital the government and unions talk to find a resolution to the pay dispute. There can be no delay.’

NHS data on cancer waiting times also showed just six in ten cancer patients were seen within the two-month target. 

Almost 6,600 patients were left waiting more than 62 days to start treatment for surgery, chemo and radiotherapy, after an urgent referral from their GP. 

NHS guidelines state 85 per cent of cancer patients should be seen within this time-frame. This target has not been met nationally since December 2015. 

Professor Pat Price, leading oncologist and founder of the #CatchUpWithCancer campaign, said: ‘These figures confirm that cancer treatment performance remains around record low levels and that deadly delays remain baked into cancer treatment with over four in 10 cancer patients waiting far too long. 

‘The Government need to break this drumbeat of monthly and quarterly failure and take decisive action to boost treatment capacity. 

‘It’s ominous that in the vital cancer treatment area of radiotherapy, performance actually worsened. 

‘This isn’t just a red flag for cancer, it’s a siren blaring the need for immediate action to tackle the crisis.’

Latest ambulance figures for July also show waiting times fell significantly. 

This is despite ambulances services facing their busiest month since May 2022, with 707,000 calls last month.

Heart attack and stroke patients in England, known as category two callers, had to wait an average of 31 minutes and 50 seconds for paramedics to arrive, shaving five minutes off the previous month. 

The NHS target is 18 minutes, however.

Ambulances took an average of eight minutes and 21 seconds to attend the most life-threatening category one calls, such as cardiac arrests. The NHS target stands at seven minutes. 

Hospital consultants were tonight accused of giving patients ‘a kick in the teeth’ after it emerged they can do lucrative private work while on strike.

It means the senior doctors – on average NHS incomes of £128,000 – can profit from the misery caused by their two-day walkout next month.

The British Medical Association (BMA) today said its members would be free to earn extra money by carrying out private surgery and consultations during the strike. Patient groups described the BMA’s stance as ‘unconscionable’.

Health leaders have warned a ‘double whammy’ of industrial action by consultants and junior doctors will cause disruption to ‘many thousands’ of patients and is a ‘huge risk’ for the NHS to manage.

Junior doctors will strike for five days from July 13 to 18, in the longest walkout in the history of the NHS, before consultants walk out on July 20 and 21.

Both groups are seeking an inflation-busting pay rise of 35 per cent. The combined action is likely to lead to the cancellation of more than 300,000 appointments, hampering efforts to clear record waiting lists of more than 7.4 million.

The BMA said consultants will be ‘perfectly able’ to do private practice if they are not contracted to do NHS work on strike days.

Those who are rostered to do routine NHS work, such as outpatient appointments and elective operations, can decide to ‘withdraw their labour’ and choose to provide private care instead.

However, those who are due to be ‘on call’ cannot do private work as they must remain available for emergencies, as part of the BMA’s agreement to provide a ‘Christmas Day’ service.

Tory MP Paul Bristow, who sits on the Commons health and social care committee, said: ‘How can it be right that in a middle of a strike, some consultants will be cashing in? This is a kick in the teeth for patients waiting for life-changing surgery.

‘The BMA need to get round the table and negotiate on behalf of their members.’

Fellow Conservative MP Ben Bradley added: ‘This is rank hypocrisy. It’s about time the BMA put patients first and called off the strikes.’

Consultants already do more than 800,000 private procedures each year, official figures show, with many cashing in on the rising demand for private healthcare fuelled by record NHS waiting lists.

They typically charge £2,500 for the likes of hip and knee replacements or cataract surgery, £250 for an initial consultation and £150 for follow-up checks, according to the Private Healthcare Information Network (PHIN). Some charge much more.

Patients have to pay the consultants’ fees plus extra charges to the hospitals where their procedures take place.

The statutory body, which collates data on private healthcare, said 12,200 consultants conducted private procedures last year. There were 820,000 private in-patient and day-case admissions in 2022, which is more than any year since it began collecting data.

Consultants announced the strike on Tuesday after 86 per cent backed the move in a ballot, on a turnout of 71 per cent. They will provide only a bare-bones ‘Christmas Day’ service, meaning they will deliver emergency care but most routine treatment will be cancelled.

Dennis Reed, director of Silver Voices, which campaigns for the elderly, said: ‘For consultants to use a strike as an opportunity to increase private practice is unconscionable.

‘Consultants are not hard up and a lot of elderly people are on a pension that is a small fraction of these doctors’ income, so will be less supportive of them than they were of nurses.’

The BMA said: ‘If a consultant is not contracted to work for the NHS on strike days, then they can either support the strike – via picket lines or a locally organised rally – or if they are among the minority of consultants who have a private practice or a private patient list elsewhere on that day, they are able to go and do that work.

‘For consultants who are contracted to work for the NHS on strike days, only those who are on call will be expected to be available to provide the level of cover agreed – the ‘Christmas Day’ cover.

‘Consultants who are contracted to do NHS work, but not provide cover, have the ability to work in a private setting on strike days if they wish.

‘However, we’d recommend they support the industrial action and remain available to the NHS in case the strike is called off due to the Government returning with a credible offer.’

NHS doctor who helped to drive strike action has been selling a drug used for skin whitening

• Glutathione, which is used as a skin whitener was described as a ‘dangerous fad’ 
• It may have ‘toxic effects on the liver, kidneys and nervous system’

By Glen Owen and Abul Taher

Updated: 19:39 EDT, 17 June 2023

Lin-Manuel Miranda and Tina Fey spoke out on behalf of screenwriters and TV writers everywhere, and were joined by some of Broadway’s best and brightest.

The 43-year-old Miranda – who recently attended the Tony Awards – and 53-year-old Fey were among the more prominent speakers during the WGA Strike Broadway Day Rally in Times Square on Thursday.

They were joined by Sara Bareilles, Sharon Catherine Brown, Lauren Patten, Paula Pell, Christine Pedi, Alex Edelman and Nicole Parker, along with Rent stars Norbert Leo Butz, Adam Pascal.

Miranda was wearing a black baseball cap that read ‘Words’ three times, along with a dark grey t-shirt for the Broadway musical Hadestown.

After his time on stage, he was seen petting Sara Bareilles’ dog, a schnauzer named Louie, at the event.

Fey was spotted wearing a black t-shirt and blue jeans along with black sunglasses for the rally.

She also had a brown purse slung from her shoulders, and was seen with John Lutz and Paula Pell during the rally.

The 30 Rock creator was also seen giving Miranda a hug during the rally, which attracted writers and supporters from all over to Manhattan. 

Bareilles also took to the stage donning a white and violet striped shirt during the rally for writers everywhere.

Sharon Catherine Brown donned a grey WGA strike t-shirt plus a black baseball cap and black sunglasses. 

Actress Nicole Parker also wore the same grey WGA strike t-shirt while she took the stage as well. 

Alex Edelman opted for a light grey suit while taking to the stage during the WGA strike rally. 

Christine Pedi opted for a black ensemble with a black and white scarf while speaking on stage. 

Rent stars Norbert Leo Butz and Adam Pascal also both took the stage on Thursday, decades after starring in the hit Broadway musical.

Lauren Patten also belted out a few tunes while taking the stage in a sleeveless black tank top and a black baseball hat. 

Paula Pell also took to the stage in a black ensemble, sharing one of her old headshots with the crowd. 

The Writers Guild of America strike is wrapping up its seventh full week, with picket lines and rallies taking place in various locations in New York and Los Angeles and many other places in between.

Russia has suffered a major explosion at an oil refinery in a suspected drone or sabotage attack, just 80 miles from Vladimir Putin‘s Black Sea palace.

The blast came as yet another Russian general was killed in Moscow’s on-going war against Ukraine, this time in a missile strike.

The double blow for Putin came as Ukraine stepped up its counteroffensive, with Kyiv’s forces claiming they have liberated at least four front-line villages – amid reports that Russian troops are being killed fleeing through their own minefields.

Meanwhile, Russia launched a ‘massive missile’ attack overnight on the central Ukrainian city of Kryvyi Rih, killing at least ten people and damaging civilian infrastructure, Ukrainian officials said early on Tuesday.

Video emerged this morning of the oil refinery in Krasnodar, showing flames and thick noxious black smoke pouring from the facility after the attack.

Krasnodar city is capital of a region of the same name which is linked to annexed Crimea across the Kerch Strait.

Putin’s £1 billion clifftop palace and Gelendzhik – with an underground bunker, pole-dancing boudoir, and vineyard – is less than 80 miles away from the blast.

The city is a key link in Putin’s war effort and a hub for supplying occupied Crimea.

The blaze was at Krasnodar Oil Refinery, in a diesel processing facility, said local Kuban News. More than 130 firefighters were called to the scene.

Attacks inside Russia’s borders have become more frequent in recent months. It is believed that Ukraine, or pro-Ukrainian groups, are using drones to strike key infrastructure such as oil refineries or military bases.

There was no initial claim of responsibility for the Krasnodar attack. The city is around 200 miles away from the front lines in Ukraine.

Krasnodar region also suffered a radio hack this week from anti-Putin partisan group Freedom of Russia Legion.

The message threatened to destroy Putin’s ‘war criminals’ in Crimea but would not pose a threat to the civilian population.

The attack came as Major-General Sergey Goryachev, 52, died in a missile attack in Zaporizhzhia region – adding to Putin’s war woes.

He was Chief of Staff of the Russian 35th Combined Arms Army, and is one of at least 11 generals reported to have died in the war – the first this year.

His death was revealed after Putin had awarded medals to wounded soldiers in a Moscow hospital, accompanied by Defence Minister Sergei Shoigu.

In personally presenting their medals, he acknowledged the heavy toll Russia has suffered in the war.

Earlier the Russian leader had been at a Champagne reception in the Kremlin at a state honours ceremony.

The death of the general was revealed by pro-war military channels who admitted that Russian forces were under pressure due to Ukraine’s counter offensive.

The Russian Defence Ministry has not commented, as is normal with high-ranking deaths among its forces.

‘War takes the best,’ reported war correspondent Yuri Kotenok. 

‘As a result of an enemy missile attack, Major General Sergey Goryachev, Chief of Staff of the 35th Combined Arms Army, was killed,’ Kotenok said.

‘The army today lost one of the brightest and most effective military leaders, who combined the highest professionalism with personal courage. Combat friends express their condolences to the family and friends of the deceased.’

Gorbachev had been promoted to general during the war.

Kotenok said Russian forces were facing ‘heavy fighting’ on ‘almost along the entire line of military contact’. He admitted: ‘The situation is difficult in the defence zone of the 60th and 37th motorised rifle brigades.’

News of Goryachev’s death came as Russia launched a ‘massive’ missile attack on the central Ukrainian city of Kryvyi Rih overnight.

Ten people were killed and more were wounded in a Russian missile strike on the central Ukrainian city of Kryvyi Rih early Tuesday, the regional governor said, as air attacks were reported in Kyiv and other cities.

‘A five-storey building got destroyed. According to initial reports, three of its residents died. 25 people were injured,’ Serhiy Lysak, governor of Dnipropetrovsk region, said on Telegram. ‘There are still people under the rubble.’

Kryvyi Rih mayor Oleksandr Vilkul said that said that one person is still believed to be trapped under the rubble and 28 others were wounded.

The devastation in President Volodymyr Zelensky’s home town is the latest bloodshed in Russia’s war in Ukraine, now in its 16th month.

Pictures from the scene showed emergency crews working at the bunt-out building, a sight that has become all-too common in the 15-months of war. 

Survivors were seen wrapping in blankets, looking on in disbelief. 

Seven other people were wounded in strikes on two other locations, he added.

Lysak said three cruise missiles were shot down but others got through.

The Ukrainian capital and the northeast city of Kharkiv also came under missile and drone attack.

‘According to initial reports, the enemy used Kh-101/555 cruise missiles,’ Kyiv city military administration said.

‘All enemy targets in the airspace around Kyiv were detected and successfully destroyed by the forces and means of air defence,’ it said, adding there was no immediate information on any casualties or damage.

In Kharkiv, civilian infrastructure was hit in a drone attack, said the city’s mayor Ihor Terekhov.

‘According to initial reports, a utility company in the Kyivskyi district, as well as a warehouse in Saltivskyi district got damaged. A fire broke out as a result of the explosion on the latter,’ he said.

Air alerts were also sounded in the Dnipropetrovsk oblast and the neighbouring Donetsk and Poltava regions.

The fresh wave of air attacks came after Ukraine claimed to have retaken several villages and made advances in its counter-offensive against Russian forces.

‘The fighting is tough, but we are moving forward, this is very important,’ Ukrainian President Volodymyr Zelensky said Monday in his daily evening address.      

A charity worker who survived a 950 million volt lightning strike opposite the White House that killed three others has spoken out about her horrific injuries – and grueling road to recovery.  

Amber Escudero-Kontostathis, 28, was in Washington DC for her birthday when six bolts of lightning hammered the spot she was standing on in the space of half a second, giving out an electrical output of roughly 950 million volts.

The freak weather event on August 4 fried her nerves, melted her watch to her wrist, and stopped her heart – and her recovery has also been marred with chronic pain and survivor’s guilt.  

The strike killed Brooks Lambertson, 29, a Vice President at City National Bank, and James and Donna Mueller, 76 and 75, who were visiting the capital for their 56th wedding anniversary. 

The group hid under a tree during a summer storm, which was subsequently hit by a bolt and flash of lightning that was caught on camera. 

Amber survived, but suffered appalling injuries which left her using a walker. She was forced to take three hour showers to soothe her wounds – but would still scream with pain throughout.  

Speaking about her recovery, Amber told the Washington Post: ‘Everyone’s been optimistic. But I just want to know if any of my nerves are, like, dead-dead. Like not coming back. Is there any way to test that?’ 

When she watched a clip of the first responders giving her CPR at the scene, she said: ‘They were putting so much force on me. They were practically jumping on my chest.’

Without watching the videos, she said she has no recollection of what happened. 

When they started resuscitating her, Amber recovered just long enough to squeeze one nurse’s hand and lock eyes with an agent – but her heart stopped again for 13 minutes.  

And talking about her painstaking recovery, she added: ‘Whatever I’m experiencing that day, however much pain I’m in, I try to hold on to the fact that I’m the lucky one.

‘The one who gets to feel anything at all.

‘I didn’t survive because of a miracle. I survived because good people, complete strangers, ran toward danger in the middle of a storm to save me.’

Amber said that her injuries were so intense, and her pain was so great, that in the first few weeks after the event she would spend hours just simply screaming.

But after a while, she would follow each scream with a whisper: ‘But I’m grateful.’  

Nearly a year after the event, Amber revealed she still has no feeling from the lower part of her back to her upper thigh and she can’t sense where her legs are going.

She said: ‘It’s like I’m floating on a box on my tailbone. I feel pressure pushing up on the box, but nothing else.’ 

Five months into her recovery, she told her doctors that she was experiencing bewildering sensations thanks to the way that the intense lightening strike had affected her nervous system.

She told them she felt a ‘grinding pain, like sand grains’ that were trying to squeeze through the pores of her skin. 

Amber experienced consistent hot and cold feelings – with the sensations of burning and freezing striking at random times of the day. She felt piercing needles in her toenails, bruising bone aches, and a twisting in her right foot.

She said it felt as if a mechanical gear was spinning inside her ankle – the direct point where the initial split-second lightening strike entered her body. 

Her iPad, which had been sitting near her stomach during the strike, exploded – causing severe burns on that area of her body. 

In the early days, she would have to sit in the shower for three hours every day to scrub the wounds to avoid infection. 

And on her chest, the lightning left intricate red marks which have been likened to the roots of a tree, marking the intricate system of veins and arteries in her body. 

She said she was waiting for her husband to pick her up so they could celebrate her birthday as she canvassed near at Lafayette Square for non-profit Threshold Giving. 

Last year, the charity worker said she thought her shoes may have been the decisive factor in her survival as they were platform sandals with large rubber soles made by Doc Martens. 

Still, the flash of lightning traveled through the ground and shocked her body, resulting in her being rushed to hospital in critical condition as she struggled to breathe and suffered from severe burns.