Doctors’ leader claims new reduced pay offer killed chances of ending strikes in England | NHS

The doctors’ leader claims ministers destroyed any chance of ending junior doctors’ strikes by abruptly reducing the amount of money they offered to secure a peace deal.

Dr Jack Fletcher accused the government of “playing games” and forcing junior doctors to go on a 15th strike over pay and work; which has disrupted the NHS this week.

Fletcher, chair of the British Medical Association’s resident doctors’ committee (RDC), said the sudden removal of a last-minute discussion about money from the table was the “breaking point” that disrupted weeks of talks that had looked set to resolve the four-year dispute.

Fletcher escalated his war of words with Wes Streeting, claiming the health secretary was talking “nonsense” about the dispute and undermining public trust in doctors by portraying them as “bad people” and a “huge problem” due to their long-running strike campaign.

In an interview with the Guardian, Fletcher warned that if Streeting did not meet his demands for a 26% pay rise and a huge increase in specialist medical training places, junior doctors in England would continue to strike until their legal powers expire in August.

He insisted the doctors’ demands were “reasonable”, although no other group of public sector workers wanted the same “full pay restoration” as they did – restoring the real value of their wages to 2008 levels.

Surveys show that public opinion, which supported the demand for pay for junior doctors when they first went on strike over pay in 2023, is now firmly against junior doctors, whose salaries have increased by 28.3% in the last three years. Their 15 strikes so far have cost the NHS an estimated £3 billion and forced NHS services to rearrange hundreds of thousands of appointments and procedures.

Fletcher believes Streeting is only improving what junior doctors offer when they strike. He left open the possibility of residents striking every month until August, a scenario NHS England boss Sir Jim Mackey recently warned hospital bosses might face.

But he also made clear he wanted to continue talks with the health minister to find a way forward after junior doctors’ work permits expired at 7am on Monday morning. NHS trusts have tried to offer 95% of the tests, treatments and appointments they usually offer but have struggled to do so with so many staff off during the pre-booked Easter holidays. Many hospitals had to cancel hip and knee replacement surgeries and other surgeries.

Fletcher claimed government negotiators had destroyed the possibility of genuine peace, which emerged after two months of talks in January and February. He said the downturn came as ministers made an unexpected last-minute U-turn through the reform of the pay progression framework, which determines how quickly they gain experience as they gain experience, and reduced the amount of money they are willing to give to junior doctors, in a bid to meet 26% pay demands.

But the Department for Health and Social Care (DHSC) disputed Fletcher’s statement and said his remarks “misrepresented” what was discussed during the talks.

The debate that led to the BMA abandoning negotiations centered on how much additional income junior doctors could expect to receive as a result of “node reform” and how soon this would happen. He wanted more cash up front than the government was prepared to provide.

Fletcher said he and his fellow RDC negotiators “spent eight weeks talking about a pay progression structure that would potentially work.” [to end the dispute]But he added: “At the last minute, they not only reduced the total investment amount, they reduced it, extended it… [and said:] ‘I’m sorry it has to be that way. [over] three years.”

“Something happened. That’s what triggered the industrial action.”

A DHSC spokesman disputed Fletcher’s account of the negotiations, saying: “It is disappointing that the BMA continues to misrepresent what happened during constructive discussions that were conducted entirely in good faith.”

“As the BMA is well aware, the agreement was always intended to be a three-year agreement, which would see junior doctors on average 35.2% better off than they were four years ago.

“It is equally disappointing that the BMA has decided to continue the strikes this week rather than submit any counter-offer, but the foreign secretary has made it clear that his door is always open.”

It is understood specialist doctors are being offered £700 million in extra pay over the next three years; This amount is understood to be £150 million in 2026/27, £250 million in 2027/28 and £300 million in 2028/29. Until then, they were discussing a two-year deal with more money for each year, Fletcher said.

RDC negotiators were so enraged when they saw the government violating what they believed had been agreed upon that they broke off negotiations and went on strike. “We have been discussing figures greater than £150 million and £200 million for two years [for the first two years]. “You can’t avoid industrial action by playing games like extending agreements to three years,” Fletcher said.

However, the RDC leader praised Streeting for going a long way to meeting the BMA’s concerns about doctors being made full-time unemployed in a medical “gig economy” due to the government’s recent introduction of the law. Medical Education (Prioritization) Act emergency legislation. In the allocation of 9,600 specialist medical training places created each year, doctors trained in the United Kingdom are given priority over their colleagues trained abroad.

He said the 26% pay rise had gone a long way to helping the BMA achieve its other main aim of returning the “competitive ratio” for early career doctors applying for specialist medical training to the 1.8:1 ratio last seen in 2018, before many more foreign medics arrived in the UK.

The DHSC said the legislation, which promises to create up to 4,500 extra training places, should reduce the competitive ratio – doctors’ chances of success – to less than 2:1.

But the BMA fears Streeting’s decision to withdraw an offer for a further 1,000 training places for this year, which was part of the mooted deal, means the rate will remain higher than they were seeking. He added that this would continue to force doctors who miss out on a training place to accept three-, six- and 12-month contracts with NHS trusts.