Resident doctors begin sixth strike in bitter NHS pay dispute

Resident doctors in England have started their sixth strike in a contentious row over pay, with the strike action starting at 07:00 BST on Tuesday morning. The six-day strike, the 15th to affect the NHS since the row started in March 2023, is expected to cause considerable disruption to NHS services across the country. Around half of the NHS medical workforce is made up of resident doctors, meaning senior clinicians are being brought in to provide emergency cover whilst some pre-planned treatments and appointments are cancelled. The strike follows talks between the government and the British Medical Association broke down in March, with both sides accusing each other of departing from a negotiated settlement.

The strike commences: extent and instant effects

The strike action by BMA members is set to create significant disruption throughout NHS services, with junior doctors accounting for around half of the medical workforce in England. Senior consultants and other experienced clinicians have been drafted in to offer cover in emergency settings, but the shortage of junior doctors has compelled hospitals to make difficult decisions about which services can remain operational. The NHS is urging patients to avoid delaying accessing care if needed, with those requiring emergency or urgent care instructed to contact 999 and 111 services as normal. Health Minister Wes Streeting claimed that 95 per cent of appointments continue as scheduled, though he recognised that cancellations have occurred and expressed regret to those affected.

GP services have mostly escaped disruption, with most general practice proceeding as planned. The government calculates that the ongoing industrial action is expending NHS resources at approximately £50 million daily, accumulating to around £3 billion since strikes began in March 2023. However, a comprehensive analysis of these costs has not been publicly released. Patients with scheduled appointments and treatments are instructed to keep their appointments unless they receive notification otherwise. The NHS has stressed that those with real health concerns should promptly access care, stressing that emergency services remain operational despite the industrial action affecting planned care capacity.

• Senior consultants called upon to staff accident and emergency units and critical care units
• Scheduled procedures and regular consultations suspended throughout NHS hospitals
• GP services mostly unimpacted by the six-day walkout
• NHS encourages patients to use emergency services normally if required

Why discussions have collapsed

The state’s position on pay

The government has stressed its dedication to fair pay negotiations, with Health Secretary Wes Streeting insisting that officials worked “in good faith” with the British Medical Association. The Department of Health points to substantial pay rises awarded to resident doctors across the previous four years, totalling 33 per cent. Streeting has described resident doctors as “by a country mile the best beneficiaries of the entire public sector workforce when it comes to pay increases,” suggesting that additional requests are excessive given present financial pressures and competing priorities across public services.

Despite these assertions of goodwill, negotiations between the government and the BMA broke down in March after weeks of discussions failed to produce an agreeable resolution. The government’s latest offer was rejected by union representatives, who contended that the administration had changed the conditions at the eleventh hour. According to the BMA, this last-minute shift entailed cutting the amount of funding the government was willing to provide, rendering the new proposal unacceptable for union members to support and prompting the move to resume strike action.

Medical professionals’ position on genuine fall

The BMA disputes the government’s portrayal about pay improvements, contending that when inflation is properly accounted for, resident doctors have undergone a considerable decline in genuine income. Despite securing a 33 per cent nominal pay increase over four years, the union calculates that doctors are currently earning approximately one-fifth less than they were in 2008 when adjusted for inflation. This real-terms pay cut has eroded living standards for junior doctors, many of whom are carrying substantial student debt and face growing cost pressures across the United Kingdom.

Dr Emma Runswick, deputy chair of the BMA Council, emphasised that talks were nearly reaching a viable deal before the administration changed its position. She noted that the revised offer fell short of what staff representatives would accept and was not recommended for ratification. The BMA maintains that meaningful progress requires substantial funding in junior doctor pay that reflects both the cost of living and the essential contribution these professionals play in delivering healthcare provision, rather than modest raises that do not restore historical pay levels.

• Resident doctors receiving 20 per cent below 2008 levels after adjusting for inflation
• Government claims 33 per cent pay rise over four years; BMA disputes real-terms value
• Talks broke down following government cut investment commitment at final stage

What individuals should understand

The NHS has advised patients to remain engaged with services if needed during the strike lasting six days, emphasising that emergency and urgent care will continue to be accessible. Those requiring immediate assistance should use 999 for serious life-threatening situations and 111 for urgent issues that aren’t emergencies, which will be operating normally. The NHS has made clear that these provisions will continue without disruption, with senior doctors deployed to provide cover in critical settings. Patients with booked treatment slots should attend unless explicitly told otherwise by their healthcare provider.

Health Secretary Wes Streeting recognised the disruptions resulting from cancellations, offering apologies to affected patients and saying they “deserve better”. He pointed out that approximately 95 per cent of appointments stay scheduled despite the strike action. General practice services are largely unaffected by the strike, allowing patients to keep accessing frontline care through their GPs. The NHS has cautioned against postponing necessary medical attention and encouraged those with concerns to contact their local health services for guidance on their specific circumstances.

The personal toll of strike action

The prolonged dispute has had a considerable impact on patient care and the broader NHS staff. Dr Jack Fletcher, head of the BMA’s resident doctor committee, expressed genuine regret about postponed treatments, recognising the hardship caused to patients seeking treatment. However, he pointed out that such delays are not unique to strike periods, noting that specialist and GP shortages create ongoing service disruptions independent of industrial action. The fundamental issue, he argued, centres on achieving a lasting solution through meaningful dialogue rather than continuing a pattern of industrial action that ultimately harm those depending on the health service.

Beyond direct patient disruption, the financial impact on the NHS has been significant, with the government claiming strikes have cost the health service £50 million daily since March 2023—totalling roughly £3 billion. This figure represents resources that could otherwise fund patient care, staff recruitment, and service improvements. The prolonged disagreement has also created tension within the medical community itself, with senior doctors repeatedly drafted in to cover emergency services, potentially affecting their own schedules and welfare. Both sides recognise the unsustainability of the present circumstances, yet fundamental disagreements over restoration of pay and government commitment continue to obstruct resolution.

What follows from here

The six-day strike is set to end on Sunday, but there persists significant doubt about whether further industrial action will occur. The BMA has indicated that the route forward depends entirely on the government’s commitment to return to substantive talks. Dr Emma Runswick highlighted that the union had nearly reaching a deal before the government changed its negotiating stance, indicating that a settlement is achievable if the two parties can discover shared understanding. The ball now sits squarely in the government’s corner to show fresh commitment to talks.

Health Secretary Wes Streeting has defended the government’s negotiating stance, insisting officials operated with integrity and offered a substantial proposal that resident doctors turned down. However, the BMA maintains the offer fell short of what members would endorse, especially given the decline in physician earnings compared to rising costs since 2008. With no planned negotiations right now planned and both sides entrenched in their positions, the possibility of ongoing walkouts looms large. Patient services will stay in uncertainty until genuine negotiations resumes and a resolution is reached.

• The 6-day strike continues through Sunday, with no further action currently announced but possible
• Government and BMA remain far apart on salary recovery and funding pledges
• NHS services will progressively return to normal when the strike ends, provided no further escalation takes place