On October 23, the British Medical Association’s (BMA) resident doctors committee confirmed a resumption of national strike action from November 14–19 by its members in England. The walkout is part of their two-year campaign for pay restoration and now also addresses the growing employment crisis facing doctors in the National Health Service (NHS).

The strike covers around 50,000 resident doctors (formerly known as junior doctors) and has been met with a torrent of vitriol from Labour’s Health Secretary Wes Streeting. He has doubled down on the hostility shown during the previous five-day strike in July, which he equated to a “war” against the government that resident doctors could not win.

BMA capitulation emboldens Streeting

Despite this smear campaign, the BMA suspended further stoppages over the summer to enter talks with Streeting that were a dead end. Streeting had already said that negotiations would be limited to non-pay issues, insisting the 5.4 percent pay award for this year was “non-negotiable,” leaving doctors 21 percent worse off in real terms compared to 2008.

To cover their retreat, the BMA leadership claimed progress could be made on training and employment issues while reporting that a “multi-year pay deal” starting in 2026/27 was a breakthrough for pay restoration. Despite already having a 90 percent majority for strike action on pay, a second ballot on strike action among first-year doctors (FY1s) was held over the shortage of speciality training leaving many unemployed was organised. This returned a 97 percent majority on a 65 percent turnout on October 6. A BMA survey showed a third of FY1s and more than half of FY2s lacked substantive employment or regular work from August.

Dr. Jack Fletcher, chair of the BMA’s resident doctors committee then claimed:

“By putting these two disputes—pay and jobs—together, we are giving the government a chance to create a plan that supports the next generation. Patients need doctors to have jobs. Doctors need to know they will have jobs—and be paid what they’re worth.”

Asserting that Streeting would be more sympathetic over the unemployment crisis facing resident doctors was a ruse. Following talks on October 13 all “negotiations” have broken down with Streeting offering just 1,000 training places over three years, when 20,000 doctors had been locked out of training for this year alone, and no movement on pay.

Doctors’ determination to fight further pay erosion and the chronic levels of understaffing contrasts sharply with the BMA leadership’s capitulation. Fletcher lamented in confirming the strike dates for November, “This is not where we wanted to be,” pleading with Streeting to return to negotiations “to gradually reverse the cuts to pay over several years, giving newly trained doctors a pay increase of just a pound an hour for the next four years.” 

Streeting seized on the BMA’s weakness to renew his toxic smears, telling Sky News:

“You can go out on strike if you want and cost us another quarter of a billion pounds—you’ll be hurting patients, hurting the NHS’s recovery, and hurting doctors crying out for training places. I want to provide them, but I won’t be able to afford them if they go on strike.”

Streeting the grim reaper

Streeting’s attempt to pose as the NHS’s defender is grotesque. He is a bought-and-paid-for representative of the private health lobby, receiving £372,000 in donations since 2015. The Starmer government’s supposed plan to cut waiting lists is a Trojan horse for accelerated privatisation. By 2023, private providers were treating one in 10 NHS patients in England. In January, Labour announced a £2.5 billion scheme to outsource one million treatments per year. NHS-funded procedures carried out privately have already risen by 500,000 this year, worth £6.15 billion—money bled from public healthcare while pay and staffing are gutted.

In a BBC interview, Streeting denounced striking doctors for holding the country “to ransom,” echoing Margaret Thatcher’s denunciations of “the enemy within” against the 1984-85 miners’ strike.

The resident doctors strike is the first national dispute the Starmer government has faced since its election last July, prompting the demonising of medics serving on the frontline of patient care in the UK’s largest workforce of around 1.4 million. The demand for pay restoration and proper staffing is labelled as “unreasonable” to establish a broader precedent.

This hysteria is intended to legitimise a clampdown by the Starmer government against the mass opposition it anticipates to its deepening austerity agenda. The Labour government is being pressed by the ruling elite to deliver a business-friendly budget in November, with sweeping cuts to social and welfare spending.

Streeting’s assertion that most resident doctors do not back the strike dismisses overwhelming ballot mandates that exceeded anti-strike legal thresholds—proof that Labour now deems even these draconian laws insufficient.

His smearing of resident doctors as saboteurs unlike “other NHS staff who are working constructively with us” relies on the services rendered by other health trade unions to suppress strike action by hundreds of thousands of nurses, midwives and paramedics, porters, cleaners and admin workers. They have all voted by sweeping majorities to reject the 3.6 percent pay award for 2025/6 for those under “Agenda for Change” contracts. But the Royal College of Nursing, Unite, GMB, and Unison among others only held consultative, non-binding ballots to enable another below inflation deal to be imposed.

Streeting’s token offer of 1,000 training places is part of Labour’s 10-year plan in England, which claims to make the NHS “Fit for the Future”. As the World Socialist Web Site has explained this will not lead to “a recovery of the NHS,” but writes its death warrant. It is based on shrinking the workforce and saddling health workers with greater work targets, a tighter squeeze on budgets enabling Trust’s to go bust and a new “care model” to shift patient treatment from hospitals to neighbourhood health centres developed through Private Finance Initiatives: notorious for leeching billions in profit out of the NHS.

Resident doctors are paying the price for their left talking leaders’ refusal to challenge Labour’s pro-market restructuring. Between 2023 and 2024 they held 44 strike days for pay restoration, but when Labour took office the BMA rushed to accept a 22.3 percent two-year deal—far short of the 35 percent needed for pay restoration. Streeting’s offer, just one percent above that of the Tories, was lauded as a “journey to pay restoration.”

Streeting has weaponised that sellout. The 5.4 percent award this year is hailed as generous only because the health unions forced through even worse deals elsewhere, after the sabotaging the 2022–23 strike wave against the Tories by signing one rock bottom pay deal after another—while lining up workers behind electing a Starmer government which is now on a warpath against the NHS.

Build the rank-and-file and fight for socialism

What the Starmer government denounces as “unaffordable” is anything which does not provide further handouts to the private sector, deliver corporate control of the NHS or increased military spending and rearmament. The demand for pay restoration of 29 percent in gross terms equates to £1.73 billion, while the Starmer government is increasing military spending to 2.5 percent of GDP from 2027 on the way to 5 percent.

NHS workers must defend the resident doctors’ action in order to end the suppression of their resistance to de facto pay cuts, job losses and defence of patient care. The answer to the divisions sown by the BMA and other health unions is the building a network of rank-file-committees across grades and departments, democratically led and accountable to those who want to resist the cuts and austerity. This means demanding that the billions squandered on private profiteers and the war machine are used instead to fund the public health service and prevent its dismantling at the hands of the Starmer government.

NHS FightBack, established by the Socialist Equality Party and affiliated with the International Workers Alliance of Rank-and-File Committees, is fighting to build this leadership across the health sector. We encourage all NHS workers to help build this movement as part of a global struggle against capitalism to prioritise the needs of society over the profits of the financial and corporate oligarchy.