PARLIAMENTARY DEBATE
Resident Doctors: Industrial Action - 10 July 2025 (Commons/Commons Chamber)
Debate Detail
Today’s waiting list figures show that after 14 years of decline, the NHS is finally moving in the right direction. Since July, we have cut waiting lists by 260,000. We promised to deliver an extra 2 million appointments in our first year, and have more than doubled that figure, delivering 4.6 million more appointments. For the first time in 17 years, waiting lists fell in the month of May, and they now stand at their lowest level in more than two years. That is what can happen when NHS staff and a Labour Government work together. We have put the NHS on the road to recovery, but we all know that it is still hanging by a thread, and that the BMA is threatening to pull that thread.
On Tuesday this week, I met the co-chairs of the BMA’s resident doctors committee to discuss the results of its ballot for industrial action. In that meeting, and in a letter I sent yesterday, I offered to meet the BMA’s full resident doctors committee and work with it to improve its members’ working lives. Since the start of this year, I have offered repeatedly to meet the entire committee, but it still has not taken up my offer. Instead of agreeing to talk, the BMA responded by announcing five days of strike action. Its planned strike action will run from 7 am on Friday 25 July to 7 am on Wednesday 30 July. These strikes are unnecessary, given this Government’s willingness and eagerness to work together to improve resident doctors’ working conditions. Following a 28.9% pay rise thanks to the actions of this Government, the BMA’s threatened industrial action is entirely unreasonable. I am asking it again today to pause, call off the strikes, and instead work with the Government to rebuild its members’ working conditions and rebuild our NHS.
Before this Government came into office, a toxic combination of Conservative mismanagement and strikes was crippling the NHS. The cost to the NHS ran to £1.7 billion in just one year; patients saw 1.5 million operations and appointments cancelled, and people’s lives were ruined. Phoebe suffers from a genetic condition: neurofibromatosis, which causes non-cancerous tumours on the outside of her body. Her first operation at Great Ormond Street hospital was cancelled twice—at first due to strikes, and then because there was not the capacity to treat her. Phoebe loves going to school, and it is an absolute tragedy that her education was set back. She was prevented from doing what she loves because the NHS was not there for her when she needed it, but this year, when Phoebe’s family contacted Great Ormond Street in March, her surgery was scheduled less than two weeks later. Compared with what she went through two years ago, the difference was night and day.
That is the difference a Labour Government make, and it is why this Government were absolutely right to end the strikes when we came to office. I am so proud of what we have achieved together with NHS staff. In the words of one NHS leader I spoke to recently, there is light at the end of the tunnel and, for the first time, it is not an oncoming train. That has only been possible because of the deal this Government negotiated.
When we agreed that deal to end the strikes last year, resident doctors did not just receive a 22% pay rise; the Government also gave a genuine commitment to build a new partnership with those we now call resident doctors, based on mutual respect. I have personally ensured that that commitment was followed through. A new exception reporting process has been agreed with resident doctors in principle, so that doctors are paid for the work they are asked to do. A review of rotational training is under way and almost complete to reduce disruption to resident doctors’ lives. We promised to tackle GP unemployment, and we have delivered with an extra 1,900 GPs on the frontline who were otherwise facing unemployment. I am determined to go further to tackle doctor unemployment.
When I say to resident doctors that I want to tackle the bottlenecks they face, and the unfair competition for specialty training places, and to create more training places, they can judge me not just by my words, but by my actions. When the pay review body recommended a 5.4% average pay rise for resident doctors this year, we accepted that and funded it in full. Those are not grounds for industrial action. Indeed, in the history of British trade unions, it is completely unprecedented for a pay rise of 28.9% to be met with strikes. The BMA itself described this pay rise as “generous”.
Thanks to this Government, the average annual earnings per first year resident doctor last year were £43,275. That is significantly more, in a resident doctor’s first year, than the average full-time worker in this country, and it is set to increase further with this year’s pay award. For resident doctors in their second year out of medical school, their average annual earnings rose to £52,300 last year. In core training years, resident doctors earned an average of £67,000. Specialty registrars earned on average almost £75,000. There is no question but that these are highly trained, highly skilled medics who work hard for their money, but to threaten strikes in these circumstances is unreasonable and unnecessary, so it is no wonder that the BMA has lost the public’s support.
At the beginning of this dispute, resident doctors faced a Conservative Government cutting their pay and refusing to talk to them. A clear majority supported action as a result. In February 2023, 56% of the public backed junior doctor strikes. Today, that support has collapsed. Just one in five people believe that the BMA is doing the right thing. Patients are begging resident doctors not to walk out on them, and I hope the BMA is listening, because many resident doctors are.
For the first time since the BMA’s campaign began, a majority of BMA resident doctors did not vote for strike action. They can see that the Government have changed and our approach has changed, yet the BMA’s tactics have not. Resident doctors have received the highest pay award in the public sector, both this year and last year, so renegotiating this year’s pay award would be deeply unfair to all other public servants. Such a deal would be paid for by their future earnings, and with the greatest respect to resident doctors, there are people working in our public services who are feeling the pinch more than they are.
Even if it would not be unfair on public sector workers, it is unaffordable. It should be apparent to anyone that the public finances this Government inherited are not awash with cash, so I will not and cannot negotiate on this year’s pay award, and I am not going to lead resident doctors up the garden path by making promises unless I know I can keep them. As I have said in person, in writing, in private and in public, I am willing and ready to get around the table and work together to improve the working conditions of resident doctors. There is so much more that we can do together. I do not just hear the complaints that resident doctors have about their placements, rotations and bottlenecks— I agree with them. I know the NHS has been a bad employer, and I am determined to change it. My offer to talk comes with no preconditions attached. I will also say this to resident doctors directly: consider very carefully the consequences of your actions.
In conclusion, the strikes are not only unnecessary and unreasonable, but unfair. They are unfair on patients, unfair on other NHS staff, and unfair to the future of the NHS, which is in jeopardy. The tragedy is that they will never have had a Secretary of State as sympathetic to their legitimate complaints as this one. If they want to know what the alternative is, its Members are not sat here. They have not even bothered to show up today, and that party does not even believe in the NHS. The grass is not greener on the other side. I ask them not to squander this opportunity. At this stage, we can still come out of this dispute with a win for the BMA’s members, a win for the NHS and a win for patients, but if the BMA continues down the path of strike action, it will lose its campaign, resident doctors will be worse off, and the heaviest price of all will be paid by patients. I commend this statement to the House.
The public will be understandably concerned about what this industrial action will mean for them and the provision of local NHS services. For patients with an appointment scheduled or even on a waiting list, that concern will be particularly acute. Let me be clear: this BMA strike action—as the Secretary of State has said, it is supported by less than 50% of those eligible to vote—is irresponsible, wrong and unnecessary. On that, I agree with the Secretary of State.
Will the Secretary of State enlarge on the additional steps that he is taking to seek to resolve the industrial dispute and prevent the strike action from going ahead? I heard what he said about his willingness to talk. Does he anticipate further meetings before strikes start on 25 July, and does he anticipate a risk of any other parts of the NHS workforce balloting for strike action?
If this strike action does take place, what steps are being put in place to minimise disruption, what is the plan to protect patients who will need to access NHS services over this period, and can the Secretary of State guarantee that emergency cover will remain and that there will be minimum service levels in place? More broadly, and based on the previous strikes, how many appointments do the Government anticipate are at risk of being cancelled or postponed, and has he assessed what impact the decision by the BMA will have on his aim of reducing waiting lists and meeting his 18-week target?
The previous chief financial officer of NHS England said that nearly all the money allocated to the NHS at the autumn Budget will be eaten up by NHS pay settlements, the national insurance hike and increased inflationary costs, just to maintain services at their existing level. Following the recent spending review and the Chancellor’s announcement of additional funding, how much of that does the Secretary of State anticipate will be spent on staffing costs, including the already agreed pay award and the national insurance increase, and how much of it will actually make it to the frontline in the form of additional care, or to fund the reforms that he set out recently?
What does the Secretary of State anticipate will be the long-lasting impact of strike action on relations between the Government and trade unions in the health space? The 10-year plan was published just last week. As I said at the time, it is sensible and I am supportive of what he has set out in that, but concerns have been raised about its deliverability. The Secretary of State has said previously that he will need to work with the unions to deliver on the plan. Is he still confident that that will be possible? Does he believe that they will agree to the changes that are required, or is there a risk of further strike action over the coming years because doctors have sensed a weakness?
In opposition, the Secretary of State had some very strong and well-articulated views on industrial action. He said strike action was
“playing politics with our NHS”.
On that, I agree with him. He said that
“the Government ought to be pulling out all the stops”—[Official Report, 22 December 2022; Vol. 724, c. 218.]
and that
“the power to stop these strikes is in the Government’s hands.”—[Official Report, 12 December 2022; Vol. 724, c. 732.]
He is the Secretary of State now. Does he agree that the power to stop these strikes is in his hands?
Our message to the Government is clear. The Secretary of State needs to do what he has said he will do: face down union pressure and deliver an affordable settlement that is fair to staff, patients and, crucially, taxpayers. On his watch, resident doctors are set to leave the frontline to go on to the picket line—whether that happens will be down to him. Sadly, Labour’s weakness is fuelling this crisis. If the Government do not get a grip now, a summer of discontent and strikes risks turning into a summer of chaos, and it will be patients who pay the price.
The shadow Secretary of State is right to say that I criticised my predecessors for their unwillingness to negotiate. The difference between me and them is that I have acted. Resident doctors have had a 28.9% pay increase thanks to the decisions that I have taken as Secretary of State, with the support of the entire Government. They have a Secretary of State who does not slam the door in their face, but who is open to working with them to improve their conditions.
The responsibility for these strikes lies squarely with those running the BMA’s resident doctors committee. Despite failing to get a majority of their members to vote for strike action for the first time in their campaign, they are still proposing to lead their members out on a five-day strike. They even made the announcement on the day that I had already written to them to suggest that we meet to avert unnecessary strike action.
The shadow Secretary of State is right to talk about the jeopardy facing the future. Because we produced our 10-year plan in partnership with patients, the public and NHS staff, there is not only much in it that resident doctors should welcome, but much that they suggested. Our 10-year workforce plan will set out training, education and retention of the workforce, and we will work closely with resident doctors on standards. They should start to experience an improvement in their working conditions on everything from the availability of nutritious food and drink to reducing violence against staff and tackling discrimination. We have already committed to prioritise UK graduates for training, and we have started a conversation on contractual reform with trade unions across the board. We are determined to recruit more people locally and to tackle social disadvantage, access to medicine and all the issues that are at the forefront of the minds of resident doctors, such as placements, rotations and future career progression, including specialty bottlenecks. I absolutely want to work with them.
These are not conditions for strikes. These are conditions to work in partnership with the Government, just as other NHS unions and so many other trade unions across the public sector do. I say to resident doctors once more that sitting in front of me is the ghost of Christmas past. Reform—its Members are not in their place today—is the ghost of Christmas future. Perhaps BMA members might consider that they are lucky to have the ghost of Christmas present in front of them.
This Government are facing enormous challenges across our economy, and we cannot sort out every issue that we inherited overnight, or even in one year—it is going to take time. BMA members should be proud of the progress that we have made together, and reassured that we want to make further progress with them, but there has to be some give and take here, and there has to be some reasonableness. Given the potential consequences of their action for patients, for their fellow staff and for the future of the NHS, the strike action is unreasonable, unnecessary and deeply unfair.
Over the past three years, doctors have received a 28.9% pay rise following earlier strikes. The BMA is now calling for a further 29% increase, but we have to be honest: after years of economic mismanagement by the Conservatives, the public finances are in a dire state. That kind of increase does not feel affordable or realistic right now. That said, we cannot ignore the reality of working conditions in our NHS. Doctors are expected to save lives in collapsing wards and to deliver care in corridors, rather than in safe clinical settings. It is degrading and dangerous for both staff and patients. We need constructive dialogue, not escalation, to resolve this dispute swiftly and fairly, and most importantly, we need urgent action to rebuild our NHS and restore working conditions that our doctors and patients can be proud of.
First, will the Secretary of State improve staff morale by committing to end the dangerous and dehumanising practice of corridor care? Secondly, does he not see that by dragging out social care reform, delayed discharges and corridor care are only going to worsen doctors’ experiences of working in the NHS, weakening morale and lowering care standards?
I also reassure the hon. Member that, while the Casey commission is under way, work on social care goes on, whether that is the £4 billion increase in investment in social care through the decisions taken by my right hon. Friend the Chancellor, or other improvements such as to carer’s allowance, the disabled facilities grant and uplifts in funding for local authorities. However, I am also committed to ensuring that, as we improve the flow of patients through our hospitals and deal with the scourge of delayed discharges, we are a lot better at thinking about how we use the taxpayer pound to best effect to deliver the right care, in the right place and at the right time. That will often mean using NHS resources to commission social care to help tackle delayed discharges, and we will be keeping a close eye on that.
Finally, I thank the hon. Member for joining the voices of reason in this Chamber. I hope it is not lost on the BMA and resident doctors watching that this is not a case of an intransigent Government unwilling to work with and support them who are trying to face down, for political and ideological purposes, a trade union speaking up for its members. This Labour Government have delivered a 28.9% pay increase and we are willing to work further to improve conditions for resident doctors. That work can start now, and I am ready to meet the BMA immediately.
There are other voices of reason in this Chamber, including among the Liberal Democrats, who recognise the pressure on the public finances. They recognise that we are trying to do many things across the NHS that will also directly benefit resident doctors, such as making sure they have the right kit and are working in decent buildings. We are improving the conditions that they are working in and that patients are treated in so that, together, we are building in, working in and being treated in an improving NHS. That is the prize, and that prize is being thrown into jeopardy by the resident doctors’ actions. If they go down this path, with all of the consequences that will follow, I am afraid—for them, let alone for the NHS and for the country—things will get worse rather than better, and I urge them not to take that course of action.
It also reinforces the grossly unfair caricature, which is often thrown at trade unions by the Conservatives, that they are all unreasonable, do not want to work with the Government of the day and are only interested in combat and agitation. In my experience, the vast majority of trade unions and trade unionists are interested in constructive engagement, striking good deals and moving forward the interests not just of their members, but of our whole country. I urge the BMA resident doctors committee to stand in that proud tradition of British trade unionism and in the proud traditions of the wider Labour movement, but I am afraid I do not see those traditions or behaviours reflected in the current approach of the BMA RDC.
I think the career of resident doctors and the prospects they can look forward to, which the right hon. Member described, have worsened. That is one of the things that is at the heart of the dispute they have taken up with the previous Government and now with this one. Many of the things doctors used to be able to look forward to—guaranteed jobs and progression into consultant roles or general practice—have steadily eroded. We have far too much doctor unemployment and far too many specialty bottlenecks. We have what I think is a really unreasonable set of behaviours towards resident doctors in terms of placements, rotations and the ability to take time off work to attend weddings and other important life moments. The tragedy of the position we find ourselves in is that I recognise that and I want to address it. We can do that together without the need for strike action, and those are not reasons for strikes. Worse still, especially at a time when I am prioritising dealing with doctor unemployment, they are inflicting further costs on the NHS, patients and the taxpayer. That makes my freedom and flexibility and my resources to deal with those issues more limited—that is the tragedy of their tactics.
I ask the Secretary of State this: will he ensure that this unhappy, unwholesome and unhealthy action does not jeopardise the health of my constituents, and will he write to the local authorities—the integrated care boards—in my area and others to set out how they can minimise the impact of this action? The last thing that you want, Madam Deputy Speaker, or that I or any Member across this House wants, is for those at risk to be put at greater risk as a result of this irresponsible action by these militant people.
I assure the House that we will do everything we can to mitigate the impact of the strikes on patients and the disruption that will follow. What I cannot say to the House, however, is that we can offset or cancel the impact or detriment felt by patients. We will look carefully at the data on the experience and impact of the strikes that occurred during the previous round of negotiations. I will ensure that that information is published so that the House can see the impact of the previous strikes, so that we can brace ourselves for what may lie ahead.
I will be honest with my hon. Friend: I feel a considerable degree of discomfort when I look back at a whole number of deals and pay awards, under this Government and our predecessors, where the “Agenda for Change” workforce have been left further behind. I will be honest with the House: at this moment, I have to resolve the immediate action that is being proposed by the BMA, but I am not going to allow the reform we have committed to with the “Agenda for Change” unions to be deprioritised —we owe that to them. We owe it to the nurses and to all the “Agenda for Change” staff to ensure that they are paid fairly, are given a fair day’s pay for a fair day’s work, and receive the terms and conditions that they deserve. My priority at this stage is the “Agenda for Change” reform. Of course, I will do everything I can to resolve the resident doctors strikes, but what I cannot do is reopen this year’s pay award.
I am almost tempted to call back the right hon. Member for North East Cambridgeshire (Steve Barclay), who is still a Member of this House, to remind the BMA what it went up against twice before; indeed, I could call back any of my Conservative predecessors to remind the BMA that the grass is not greener on the other side of this House. It currently has a Secretary of State who has shown through actions, not just words, a willingness to work together, and I hope that it rediscovers the spirit of partnership that we had last year.
Many people will have been flabbergasted by the sheer scale of the pay rise that was awarded in the first place, without anything in return to deliver the NHS reforms that the Government seek. Those people will now be absolutely outraged that the BMA is going on strike after having a near 30% pay increase. I plead with the Secretary of State to hold the line in these negotiations, and to take away the cross-party support he has in holding the line against the BMA on this issue.
I do not think that the staff themselves are the drain on productivity; instead, the obstacles we face are the systems and pathways in which staff work and the conditions in the NHS—we are in real agreement on those things. I urge the BMA to keep all that under consideration before its next public intervention, which I hope will be to accept the offer to get around the table to avert the strike action that I think the whole House agrees is unnecessary, unreasonable and unfair.
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