Resident doctors in England have voted overwhelmingly to go ahead with this week’s planned strike, because the government’s latest offer fails to address the medical jobs crisis and does nothing to stem the exodus of medics from this country.
Despite the government spin, this offer will not lead to more doctors in our NHS. It makes a start, but the proposed increase of specialty training posts over the next three years, from the 1,000 extra announced in the 10-year health plan to 4,000, simply repurposes “locally employed doctors”, rather than increasing capacity. It will not mean more doctors on the shop floor of our A&E departments – it’s just shuffling the deck chairs on a sinking ship.
This year it is estimated that nearly 40,000 doctors will apply for about 10,000 specialty training places. These are doctors who have completed years of training and who stand ready and waiting to care for patients, yet they will be denied opportunities because the posts do not exist. Even with the proposed legislation, without further measures we will still be turning those doctors away. Many more will join the training bottleneck queue. A lot will leave the NHS entirely.
Patients already feel the consequences of these shortages. In some regions, including my own in the north-east, some lifesaving treatments are available only during office hours because there are not enough specialists to deliver them. A&E departments are overwhelmed. Yet, we continue to turn thousands of aspiring A&E doctors away because of the lack of training places in emergency medicine. These problems are the result of political choices, and they are unravelling in real time.
Alongside this jobs crisis is the well-established fact that resident doctors have faced a significant fall in the value of their wages over more than a decade. We asked for a fair multiyear process to begin repairing that loss. We made clear that we did not expect an instant reversal and that we were prepared to negotiate constructively. Yet the government’s last-minute offer did nothing on pay at all. Meanwhile, the government is quietly pushing real-terms pay cuts on to doctors in early 2026 through a below-inflation uplift.
What has made this situation even harder to accept is the health secretary’s rhetoric in recent weeks. The very professionals whose union he accused of “juvenile delinquency” will be holding overstretched services together at the peak of this flu season. Thousands of us, myself included, will be caring for patients over the busy festive period instead of spending time with loved ones. We knew we’d be working Christmases when we signed up, but the disrespectful language being used, and lack of meaningful engagement with the problems we raise, shows a worrying disconnect with both the workforce and the public we care for.
Accepting the current offer would mean accepting further decline. It would mean continued shortages of jobs. It would mean more real-terms pay cuts that push more doctors out of the profession and the NHS.
There is still a constructive way forward. The government can choose to work with us to develop a workforce plan based on evidence, create the training posts required and enter serious negotiations on pay to retain doctors. These steps are essential for an NHS that depends on resident doctors who want to stay, to progress and to care for patients.
I remain ready to negotiate and to call strike action off. But we need the secretary of state to recognise the reality we’re in, to treat the profession with respect, and work with us towards a credible deal – even at this late hour.
Dr Jack Fletcher is an acute medicine doctor working in the north-east of England and chair of the British Medical Association’s UK resident doctors committee
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