After nearly two years serving as a resident doctor within the NHS, Heather Gunn is preparing for the possibility of unemployment. Like many of her peers, she was eager to obtain one of the additional 4,500 training positions that the government had promised to create in England over the next three years to facilitate doctors’ advancement into specialized areas.
These positions were pledged during negotiations between the British Medical Association (BMA), representing doctors, and the government amidst an ongoing dispute concerning the pay and job security of resident doctors.
However, last week, amid unresolved pay disputes, the first 1,000 of these training positions were rescinded. Talks between the involved parties had once again faltered, leading the BMA to proceed with its 15th strike since 2023, which is set to commence on Tuesday and continue for six days. Health Secretary Wes Streeting communicated to the BMA via a letter on social media that it was “operationally or financially impossible” to offer these positions while NHS providers are dealing with the repercussions of industrial action.
At 27 years old, Gunn had aspirations of entering either pediatrics or emergency medicine. As resident doctors, previously referred to as junior doctors, are typically in the early stages of their careers with many on temporary contracts, the retraction of these new roles leaves Gunn without employment when her current position concludes in August. Nevertheless, she remains in favor of the strike and has confirmed her intention to participate.
“I was quite appalled that the government thought it could jeopardize patient safety and care,” remarked Gunn, who resides in Oxford. “Ultimately, it is the patients who suffer. My inability to secure a training position means there is one less doctor available to care for these patients.”
“When families are anxious about their sick children and cannot consult a doctor, or when patients endure twelve-hour waits in A&E, I’m at home unable to work and assist these individuals. It’s disgraceful that the government views this as a bargaining chip.”
The government asserted that a transition to permanent contracts was on the agenda prior to the breakdown of discussions. “The proposed reforms were exactly what the offer aimed to achieve, provided that disruptive strike actions were avoided,” stated a source familiar with the negotiations.
Nonetheless, salary remains the primary issue of contention. The government claims that resident doctors would have effectively received a 35% salary increase over the past four years had the BMA accepted the latest proposal. This year, most doctors were offered a 3.5% raise, which is higher than the 3.3% increase proposed for some other NHS personnel. Streeting emphasized in his correspondence to the BMA that the lowest-paid resident doctors were presented with a pay rise of up to 7.1%.
Conversely, the BMA is advocating for the restoration of salaries to 2008 levels, which would necessitate an additional 26% increase after accounting for inflation. Gunn and her colleagues believe this issue has become increasingly urgent in light of global economic pressures exacerbated by the ongoing conflict in Iran. The government has criticized the BMA for relying on the retail prices index (RPI) to calculate pay erosion, arguing that it is outdated and inaccurate. The BMA defends its use of this method, citing its application in calculating student loan interest.
In addition to a real-terms pay cut, the union emphasizes the deterioration of working conditions for doctors. It has issued warnings that unresolved issues may prompt more doctors to leave the UK.
Gunn expressed, “Whenever the government claims there aren’t sufficient funds for pay restoration, NHS trusts are spending millions on locum staff at inflated rates to cover strikes. There is certainly money available. People believed the government had the funds to support those extra 1,000 positions. For them to retract their commitment at the last moment is an unacceptable excuse.”
Another government representative indicated confusion regarding the sudden collapse of negotiations. “It seemed we were making progress, but everything fell apart at the last minute, and we are unsure why,” they noted. Streeting has contended that resident doctors have been extended the highest pay increase in the public sector.
This situation has led to discontent among trade union leaders representing other NHS staff, with reports indicating that some unions have been offered less favorable pay deals. “The agreements we can present to our members have become significantly harder to justify,” one union leader stated.
The second government source further clarified that the training positions were more a request from the BMA than an urgent necessity for the NHS. They stated, “While increasing the number of doctors in the workforce and providing these advancement opportunities is beneficial, the NHS would not collapse without these 1,000 positions.” The government has labeled claims suggesting that patient safety would be compromised by the withdrawal of training positions as “grossly misleading.”
Public support for the strikes appears limited. A recent YouGov poll involving nearly 7,000 individuals revealed that 53% opposed the latest industrial action, with 31% strongly against it. During the strikes, certain elective and non-urgent services are postponed, leading to longer wait times for patients, although the NHS claims efforts are made to minimize disruption.
“It’s incredibly frustrating when elective procedures are canceled,” acknowledged Gunn. “However, I believe that once the public realizes that the government is using job security as leverage and risking their care, they will understand the rationale behind our strikes; it is ultimately for their benefit. We aspire to be experts in our fields to provide them with the highest quality care.”
A representative from the health department commented on the ongoing situation.
