Resident Doctors (RD) in England are once again taking industrial action as part of their long-running campaign for pay restoration to 2008 levels.
They will strike from 7 am on 25th July to 7 am on 30th July and are demanding a staged 29% pay rise. Analysis by the Institute for Government of NHS staff earnings by group show that RD have experienced the largest erosion in spending power over recent years, with Consultants a close second.
BMA members voted 90% in favour of striking, with a 55% turnout; their mandate for strikes will last until January 2026. It is expected that tens of thousands of RD will take part in the five-day strike. Details of picket lines at selected hospitals can be found here
Current dispute
The current dispute comes after the BMA agreement with Wes Streeting in the summer of 2024 that resulted in a 22% pay rise over two years. However, this increase was quickly eroded by the impact of inflation, which had hit a high of 11% following the Truss government. The last round of strikes therefore concluded with a deal that was well short of what was needed. Crucially, Wes Streeting acknowledged at the time that pay restoration was a valid goal, describing it as ‘a journey rather than an event’. RD are now concerned that the journey has in fact been abandoned.
The new chair of the BMA council, Dr Tom Dolphin, stated that a 29% pay increase is ‘non-negotiable’ as it simply represents the spending power lost by RD since 2008. The BMA stresses this is not a demand for a pay rise above inflation, but for restoration of pay to historic levels before the erosion caused by over a decade of below-inflation increases and wage freezes. It is calling for a credible commitment together with an agreement for getting there, over perhaps 3 to 5 years.
Meanwhile, Health Secretary Wes Streeting is already preparing to scapegoat RD for the lacklustre pace of improvement in NHS performance over the first year of this government. He has stated that: ‘The NHS recovery is hanging by a thread, and the BMA are threatening to pull it… The BMA should abandon their rush to strike and work with us to improve resident doctors’ working lives instead’, calling the strikes ‘completely unreasonable’. No doubt the Government is also concerned that a ‘renewed series of strikes could encourage other NHS staff and public sector workers to submit claims for large salary rises, creating havoc in the NHS’, as reported in the Guardian. Dr Dolphin told this newspaper that Streeting is to blame for the strikes, not the BMA, and that the Government could afford to give RD a pay rise.
Government and press are also whipping up division and moral outrage over ‘greedy consultants’ claiming thousands of pounds for taking on RD weekend shifts. What must be remembered here is that consultants have no contractual obligation to cover for striking junior colleagues, and many are already doing 11-14 hours a week unpaid overtime to keep on top of increasing workload. In addition, their pay has been eroded almost to the same degree as that of RD. Given that Government has stated it wants normal NHS work to continue as far as possible during the strike, it is reasonable for employers to offer higher locum rates as an inducement for consultant staff to take on this work in addition to their usual commitments to hospitals and family.
Short term costs to the NHS emphasise the need for constructive engagement
RD have many grievances about their working conditions that need addressing in addition to low pay. These factors, including training bottlenecks and a feeling of being undervalued, have resulted in an estimated 15,000–23,000 leaving the NHS between September 2022–23 at a cost to the NHS of around £2 billion (potentially rising to £5 bn/year without intervention). Providing clinical cover in the last strike is estimated to have cost hospitals around £1 billion.These figures highlight not only the value of RD but the need for a positive approach to talks by Wes Streeting in order for an urgent resolution of the dispute.
The BMA is right – given the political will the Government could keep its promise and find the means to pay restoration. Poor NHS performance and haemorrhageing away of staff must be addressed through proper funding, filling vacancies and improving working conditions. Desperately hoping that a solution lies in focusing on prevention, technology, Artificial Intelligence and shift to community care does not alter this reality. Neither is greater involvement of the private sector a solution, even when it is wrongly seen as a partner and not a competitor. Rather than demonise doctors and feign outrage over staff taking industrial action or demanding adequate financial compensation for taking on extra work, Government should reflect on its own role in the current disastrous state of the NHS, including the 16,000 or so people dying each year from being stuck in Emergency Departments.
Time to forget moral outrage and show some leadership
Strikes must be seen as an indication of systemic weaknesses in the NHS that demand attention. This dispute will only end after meaningful discussions between Wes Streeting and RD representatives. Fixing pay, addressing morale by improving working conditions and filling staff vacancies require necessary investment and are essential for a more resilient and healthier future service. KONP stands in solidarity with striking RD and all NHS staff and urges Streeting to enter into negotiations with RD in good faith. The aim should be both to agree the promised road map to pay restoration and by doing so, take an important step in rebuilding the NHS.
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