NHS Boss Warns of Monthly Strikes by Junior Doctors
A senior official within the National Health Service (NHS) has issued a warning that junior doctors may begin striking on a monthly basis, following a statement from Wes Streeting that it is “hard to see” an agreement being reached. Sir Jim Mackey, chief executive of the health service, recently informed hospital chief executives that the union is likely to hold strikes “every four weeks” for the next year.
This development comes as resident doctors—also known as junior doctors—are set to walk out for six days starting at 7am on Tuesday, just after the Easter bank holiday weekend. These strikes have been ongoing for 59 days since March 2023 and are expected to continue until August.
Sir Jim Mackey has warned that the NHS could face a “long slog” of walkouts lasting another 12 months if the government fails to reach a pay deal imminently. He suggested that the NHS should become “less reliant” on doctors to treat patients. As a result, the NHS will now undergo a permanent shift in how it deploys its workforce, making greater use of other clinicians such as nurses, pharmacists, and paramedics.
Newly implemented laws championed by former Labour deputy leader Angela Rayner mean any future ballot by the British Medical Association (BMA) would give the union a mandate for a full year. Next week’s walkout will be the 15th round of strikes by resident doctors in England since 2023 and is expected to cost the NHS more than £250 million in lost activity and overtime payments to senior colleagues.
Sir Jim told the Health Service Journal that NHS England is now considering ways to “build [services] less reliant on a transient training workforce and more on a more blended clinical family.” He said it is necessary to explore alternative service models “if we continue to have a system that feels unreliable, [when] one of the key things the population needs from us is reliability.”
He indicated the organisation would get “more active in this area” if it faced a “long period of strikes,” but stressed this was not meant “as a threat to residents.” The NHS England chief said some local leaders had told him services ran more smoothly during resident doctors’ strikes, when consultants and other clinicians had filled in for them. Alternative ways of working that make less use of resident doctors would also better suit hospitals that had long struggled to recruit trainees.
Sir Jim previously built a less resident doctor–reliant service at Northumbria Healthcare Foundation Trust, which he led for 20 years up to 2023. He acknowledged that “a pipeline of consultants” is needed but argued there are “different service models that are less reliant [on trainees]” successfully operating in other countries.
He was speaking on Tuesday before news broke that the BMA will also ballot senior doctors, including consultants, on their own strike action. Sir Keir Starmer has accused resident doctors of “recklessly” walking away from an offer that would have seen some earn more than £100,000 a year.
Last week, the BMA’s resident doctors’ committee rejected an offer worth up to 7.1 per cent for this year without even putting it to members for a vote. The proposed deal would have taken their total pay rise over the past three years to 35 per cent. The “hypocritical” union has said that inflation caused by the Iran war means they need a bigger rise despite offering its own staff an uplift of just 2.75 per cent.
Health secretary Wes Streeting today wrote to Dr Jack Fletcher, chairman of the BMA’s resident doctors committee, describing the latest round of strikes as “unnecessary and damaging.” He added: “Having rejected the deal that we had agreed with you and your officers, I had expected the BMA Resident Doctors Committee to at least come back with a counterproposal to end these strikes, given your stated commitment to reaching a negotiated settlement. You could not agree one.”
If members of your committee cannot reach an agreed position among themselves, it is hard to see how the Government will be able to reach an agreement with your committee.”
The Government scrapped plans to expand speciality doctor training places yesterday after the union failed to meet a 48–hour deadline set by the prime minister to call off the industrial action. The move would have allowed more resident doctors to advance their careers by undertaking additional training to become specialists.
But the Department of Health and Social Care said it would no longer be “financially or operationally” possible to offer 1,000 more places this year as the NHS prepares to deal with the fallout from the strike. Mr Streeting accused the BMA in his letter of being “delusional” for believing they could continue to take industrial action and reject the offer while also enjoying its benefits.
Resident doctors today said they would “happily” meet with Mr Streeting over the long Easter weekend in bid to avoid next week’s walkouts, but said there must be “an improvement” on the deal. Mr Streeting said the pay offer meant that “for the most experienced resident doctors, basic pay would have increased to £77,348 and average earnings would have exceeded £100,000.”
First–year doctors fresh out of medical school would earn on average £52,000 a year, £12,000 more than three years ago. This is more than many NHS staff in other roles will earn at the peak of their career. Sir Keir said the offer was made after “months of collaboration with the BMA” and their refusal to now accept will leave patients “paying the price.”
He added: “That is why walking away from this deal is the wrong decision. It is reckless.”
