A Controversial Dual Role: Doctor and Tech Entrepreneur
Dr Jack Fletcher, the leader of a major doctors’ union in the UK, is at the center of a growing controversy as his involvement in a private tech company comes under scrutiny. The Mail on Sunday has uncovered that Dr Fletcher, who is leading strikes by resident doctors in the NHS, is also part of a start-up firm that supplies payroll software to the health service. This dual role has raised concerns about potential conflicts of interest.
The strikes led by Dr Fletcher have cost the NHS an estimated £3 billion so far. These actions have been driven by demands for better pay and working conditions. However, the revelation that Dr Fletcher is involved in a company that benefits from the very system he is challenging has sparked public debate.
The Company Behind the Payroll Software
Dr Fletcher co-founded PayPulse Ltd in September 2023, a tech start-up that provides payroll software to the NHS. The company charges the health service £20,000 to manage doctors’ overtime claims and aims to expand its contracts with other NHS trusts. According to company records, Dr Fletcher holds a 33 per cent stake in the business alongside another doctor and a software engineer.
PayPulse markets itself as a platform developed in partnership with the NHS. It helps plan accurate work schedules and allows doctors to submit overtime reports directly into the payroll system. The company’s growth has been significant, with assets rising from £431 in 2024 to £45,914 in 2025.
Ethical Concerns and Union Policies
The British Medical Association (BMA) has a policy opposing the outsourcing of NHS contracts to the independent sector, arguing that it wastes time and money. However, the BMA clarified that this policy focuses on clinical services, not software services. Despite this, the union requires its leaders to declare any commercial interests and manage potential conflicts of interest.
Dr Fletcher, who graduated from Newcastle University in 2020, was previously a technical specialist in an Apple store while studying medicine. On the PayPulse website, he is described as “the doctor with the big ideas, a drawing board and an eye for design.” His professional background includes both medical and tech expertise.
Ongoing Pay Disputes and Industrial Action
The controversy surrounding Dr Fletcher’s role comes amid ongoing pay disputes between resident doctors and the government. After a series of strikes began in March 2023, the doctors secured a 28.9 per cent pay rise. However, negotiations broke down this year, with Dr Fletcher accused of reneging on a multi-year pay settlement with Health Secretary Wes Streeting.
A disputed breakdown in talks led to a six-day walkout over the Easter holidays. The resident doctors’ committee demanded a further 26 per cent pay rise to restore pay to 2008 levels. The rejected offer included a 4.9 per cent increase for 2026-27 and additional training posts.
Transparency and Contractual Agreements
South Tees Hospitals NHS Foundation Trust, where Dr Fletcher works, confirmed that it maintains a register of interests for staff and board members to ensure transparency. The trust stated that all policies were followed before entering the contractual agreement with PayPulse Ltd. However, the contract was awarded without competitive tendering, as it was granted under a single action waiver.
Dr Fletcher’s company is now marketing itself to other NHS trusts, despite the ethical concerns raised. The BMA and PayPulse claim that Dr Fletcher has stepped back from his commercial role after becoming chairman of the resident doctors’ committee. However, neither party disputed that he remains a director and shareholder.
Responses and Future Outlook
The BMA emphasized its commitment to transparency and stated that Dr Fletcher has disclosed his involvement in PayPulse from the start. The union added that it is satisfied that any potential conflict has been managed appropriately. The BMA also blamed the cost of the strikes on the government’s failure to provide a credible pay plan.
Dr Fletcher did not comment on the allegations, but a spokesman for PayPulse stated that the company provides high-quality software solutions developed in collaboration with doctors and professionals in South Tees. He added that Dr Fletcher continues to contribute to the creative direction of the company and manages data governance, though these roles are not financially compensated.
As the dispute continues, the situation raises important questions about the ethics of leadership in the NHS and the balance between public service and private enterprise.
