Resident doctors fought hard—but they were left to fight alone

How could resident doctors have won more from Labour? (Photo: Guy Smallman)

Why did resident doctors in England this week end their long-running pay and jobs dispute for a poor government offer?

The BMA union members voted by a small margin to accept a deal that ministers admit will increase pay by just 4.9 percent this year. The union had originally demanded a path to full pay restoration—that would have meant a rise of 29 percent.

On the vital question of resident doctors’ training posts, the health secretary added no more than 4,500 new jobs, despite the huge backlog in applications.

While some 53 percent of BMA members accepted the deal, an impressive 47 percent voted against on a 57 percent turnout.

No one can accuse the residents of lacking the spirit for a protracted battle with the government.

They were set to walk out for four-days last month in what would have been their sixteenth round of action since 2023. But the strike was called off after the offer was made.

The BMA resident doctors committee’s decision to put the government’s offer out to ballot—despite it coming nowhere close to its demands—sowed confusion.

And it added to the number of striking doctors that no longer believed that they could win against an intransigent government.

But there are ways resident doctors could have won a much better deal.

If other major health unions—all of which had derided pay offers for their members as “not enough”—had pushed for strikes themselves, and sought unity with the residents, the pressure on Labour would have been immense.

Some 1.4 million people work for the NHS in England. Instead, the leaders of the RCN and Unison—the two biggest health unions—focused on structural changes to the pay system and winning battles over banding.

That meant there was no generalised campaign for all health workers to reject the imposed pay offer, leaving the residents to fight alone.

Even so, BMA leaders could have pursued a far more active strike strategy that sought to build confidence and militancy. It could have tried to involve other health workers at a local level and create a united opposition to poor pay.

Instead of showpiece picket lines restricted to high profile hospitals, designed to catch media attention, the union could have argued for picket lines at every hospital.

Combining those with demonstrations in major cities could have brought thousands more doctors into activity and united them with the huge support they have among patients and public.

By making more of the doctors’ fight being one about the future of the NHS and patient care, the union could have won more active supporters.

But the BMA leadership was so worried that any such radicalism would cost them support that it even gagged most strikers from talking to the media in case they get the line wrong.

So instead of galvanising new forces, the BMA’s strike strategy handed the initiative to the top of the union, rather than the rank and file.

Once it became clear that the leadership had effectively run out of ideas, demoralisation set in among some.

Pay and jobs continue to be huge issues for both resident doctors—and the rest of the NHS workforce—and the latest deal does little to take the heat out of the issue.

But to win in the future, residents must look beyond the strategy of their existing leadership and find one that rests more on their own power—and that of other health workers.