Resident doctors’ 29% pay claim is non-negotiable, reasonable and easily affordable for the NHS, the new leader of the medical profession has said.
Strikes to ensure resident – formerly junior – doctors in England get the full 29% could drag on for years, according to Dr Tom Dolphin, the British Medical Association’s new council chair.
The doctors’ union will not negotiate on or accept a lower figure because that is the extent of the real-terms loss of earnings resident doctors have suffered since 2008, which they want restored – in full – Dolphin told the Guardian in his first interview since taking over last month.
The 29% demand is not up for negotiation “because it’s based on a principle”, said Dolphin, a consultant anaesthetist. “If we picked a different number, that wouldn’t achieve the pay restoration. So that’s why it looks inflexible.”
Dolphin blamed the five-day strike that tens of thousands of resident doctors plan to stage later this month on Wes Streeting, the health secretary, giving them a 22% pay rise over two years last year but not following it up with an award this year to take account of the 29% claim. He said the disruption that the 120-hour walkout would cause was his fault, not theirs.
Dolphin said: “Our expectation was that the [22%] would be the start of a journey that would keep us going until we’d reached the value we had in 2008. So, clearly, the return of value has stopped and now it’s just marching on the spot. And we need to carry on that journey.
“It [29%] is reasonable because it’s based on the loss of value that we’ve had. The number is this big because [previous] governments serially ignored the BMA when we said this is building up a problem.”
Ministers fear a renewed series of strikes could encourage other NHS staff and public sector workers to submit claims for large salary rises, creating havoc in the NHS.
Dolphin said doctors felt betrayed by Streeting and the government over being offered only 5.4% this year and because promised reform of the review body on doctors’ and dentists’ remuneration, which advises ministers, had not led to recommended rises reflecting medics’ value.
Streeting and the BMA are locked in a stalemate and an increasingly angry war of words. Streeting has maintained that the government will not revisit the 5.4% salary increase it gave resident doctors for 2025-26 and called their 29% claim “completely unreasonable”, especially given the difficult state of public finances. But the union has said it will keep staging walkouts until its members receive 29%.
Dolphin offered Streeting a potential way of avoiding a six-month campaign of strikes, saying doctors were “flexible” in reaching their 29% target, ideally in an agreement spanning the next three years.
“It’s a couple of per cent [more than the 5.4% already awarded] this year, more per cent next year [and] more per cent the year after,” Dolphin said. “However that might look, they’re flexible about it.”
Resident doctors rejected the 5.4% award, despite it being the highest given to any group of public sector workers, because it contains “no element of restoration”.
Dolphin accused the minister of refusing to meet the BMA and of using “emotional language”, such as saying that neither the public nor he would ever forgive them for striking, rather than discussing the claim.
Streeting suggested in an interview with LBC on Thursday that if doctors agreed to less favourable NHS pensions in return for higher pay during their careers, that may provide a basis for a discussion of their financial demands.
But Dolphin insisted that the NHS could afford to meet their demands. While the gross cost of delivering the 29% full pay restoration is £1.73bn, that drops to £920m net once money returned to the Treasury through the tax system is taken into account, he said. That £920m is less than half a per cent of the NHS’s £190.8bn budget this year, he added.
“It’s a small proportion of the budget. It [29%] sounds like a large number but actually, put into the context of the whole NHS, it’s not a large sum compared to that,” he said.
Junior doctors staged 11 strikes, totalling 44 days of industrial action, between March 2023 and July 2024.
Dolphin said the latest strikes could go on for years. “This campaign’s been going on for several years already. We are determined to achieve the pay restoration that doctors deserve and it’s up to the secretary of state how long it takes to do that,” he said.
Conceding the 29% demand would ultimately be good for the NHS as it would make doctors more motivated and make them less likely to move abroad, Dolphin said.
The hospitals group the NHS Confederation has said the strike will undermine the government’s promise that 92% of people awaiting hospital treatment receive it within 18 weeks by 2029.
Rory Deighton, the director of its acute network, said waiting times were improving, as evidenced by the small fall in the size of the care backlog shown in NHS England’s latest monthly performance figures on Thursday.
However, he said: “To meet the government’s ambitions … will be made even harder if resident doctors down tools and go on strike, as it could see tens of thousands of appointments and operations cancelled as other staff – including consultants – are diverted to cover staffing gaps.”
Last night Prof Robert Winston, the Labour peer who pioneered fertility treatments in the UK, said he had quit the BMA after more than 60 years as a member, that the “highly dangerous” strikes would damage public trust in the profession.
Winston, 84, told the Times: “I feel very strongly that this isn’t the time to be striking. I think that the country is really struggling in all sorts of ways, people are struggling in all sorts of ways.
“Strike action completely ignores the vulnerability of people in front of you. Doctors need to be reminded that every time they have a patient in front of them they have someone who is frightened and in pain. It’s important that doctors consider their own responsibility much more seriously.”
He urged the BMA to instead work with ministers to negotiate solutions with the government, such as improvements to “appalling” working conditions and night shifts.
NHS bosses disagreed with Dolphin’s remarks. Danny Mortimer, the chief executive of NHS Employers, which represents NHS trusts in pay negotiations with unions, said: “Our members will not recognise the BMA’s characterisation of either the quality of the response the resident doctors have received from this government or the challenging realities of public sector and NHS finances.”
The Department of Health and Social Care said Dolphin’s remarks showed that the BMA was “unreasonable and irresponsible.”
A spokesperson said: “The secretary of state has been clear that his door remains open to discussing with the BMA a range of issues that would improve the working lives of resident doctors.
“It is unreasonable and irresponsible for the BMA to refuse to even sit down to talk when they are threatening strike action which will have a serious impact on patients and other NHS staff. It is not too late to step back from the brink and work with the government to avert strikes and continue the work we’ve been doing together to rebuild our NHS.”