The head of NHS England has said the organisation must be more resistant to resident doctors’ pay demands, adding that those going on strike should face significant ‘financial consequences’.
Resident doctors in England will walk out at 7:00am tomorrow, Friday 25 July, for five days after health secretary Wes Streeting was unable to persuade the British Medical Association to continue talks on pay.
In September 2024 resident doctors, then called junior doctors, accepted a 22.3% pay settlement. They had been in dispute since October 2022 and had taken 44 days’ strike action, following more than a decade of real-term pay cuts.
The BMA wants a salary increase of 29.2% to bring salaries back to what it terms “full pay restoration”, or to offset the level at which pay has declined in real terms since 2008, when adjusting for inflation.
Strike action
Doctors vote for return to strike action
Streeting appeals to resident doctors to vote against strikes
Sir Jim Mackey, chief executive of NHS England, yesterday told hospital leaders to continue with scheduled operations – to avoid huge overtime payments to resident doctors further down the line – and said that the NHS would take a “different approach” and be “much more resistant” to the demands of doctors than it has been in the past.
Mackey said that strikes had been “net positive from a financial point of view” for doctors in the past as they had cleared the backlog of patients that had resulted from previous strikes by doing overtime and gaining extra pay. This time their action must not be “consequence-free”, he said. During the period of industrial action of July 2023 to February 2024, more than 500,000 appointments and operations had to be cancelled and rescheduled as hospitals prioritised emergency care.
Mackey told hospital bosses in a call on Wednesday: “We’ve been very, very clear we want to have a different approach this time. You have noticed already we are in a different space compared to where we were last time, much more instructive to the BMA, much more resistant to their demands.
“Frankly, we and you make decisions about safety, not the BMA. Do what you do best, make sensible decisions, and we’ll stick together.”
Streeting told hospital leaders that “we have your backs” if they made contentious calls on spreading staff more thinly, which the BMA said was unsafe. This may mean diverting staff from A&E to ensure more routine surgeries are carried out.
“We do have to think about harm in the broadest sense, and not the conventional ways which we’ve thought about urgent and emergency care,” Streeting said.
Melissa Ryan, the co-chair of the BMA resident doctors committee, said the BMA did not want to see years of strikes but that ministers needed to offer more. “We’ve had a lot of words, we’re still waiting for the actions.”
The Academy of Medical Royal Colleges, which represents the leaders of the medical profession, warned it would be “extremely difficult to maintain safe patient care when they have no idea how many doctors will be absent”.
The academy stated that while it recognised the right to strike, it was “calling on the BMA to suspend its guidance to doctors, which states they should not inform their employers whether they plan to strike or not”.
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