A Pound an Hour and a Crisis Deferred: Why Resident Doctors Are Striking Again

The announcement of new strike dates by England’s resident doctors has reignited one of the NHS’s most enduring conflicts: a workforce at breaking point, and a government unwilling or unable to meet it halfway.

From 7am on 14 November to 7am on 19 November, thousands of resident doctors will walk out, citing the government’s failure to deliver a credible plan on pay and employment. The dispute, led by the British Medical Association’s Resident Doctors Committee, is not just about wages but about wasted potential: a system training doctors it cannot seem to employ.

Dr Jack Fletcher, who chairs the committee, described the move as a reluctant but unavoidable step. “This is not where we wanted to be,” he said, outlining how weeks of talks with the Health Secretary failed to produce meaningful progress. His words captured the frustration of a profession that feels ignored and undervalued, even as hospitals across the country struggle to fill rotas and patients wait months for treatment.

At the heart of the standoff lies a paradox: half of second-year doctors in England report being unable to find suitable jobs, even as NHS trusts rely heavily on agency staff and overtime to keep services running. Fletcher called the situation “a scandal”, with newly qualified clinicians forced out of the system while millions languish on waiting lists.

The BMA had proposed a multi-year deal aimed at gradually reversing real-terms pay cuts and improving job security. Under their plan, newly trained doctors would see a modest but steady increase in hourly pay, “just a pound an hour for the next four years,” Fletcher said, paired with commitments to expand training places and create permanent posts. The government, however, offered only vague promises of change “two years hence”, leaving the current generation of doctors facing uncertainty and financial strain.

The government’s most recent communication, arriving in what the BMA described as an “11th-hour letter,” failed to reassure the profession that meaningful reform was on the table. Fletcher’s response was pointed: “We need the Health Secretary to step up, come forward with a proper offer on jobs and on pay. We need him to embrace change and make an NHS fit for doctors and fit for patients.”

This latest dispute sits at the intersection of two crises: workforce and waiting lists. The NHS is struggling to retain young doctors, many of whom are now seeking opportunities abroad, citing better pay and clearer career pathways. Each departure deepens the pressure on those who remain, widening the gap between ambition and delivery in the health service’s recovery plan.

While Health Secretary Wes Streeting has inherited a system already weakened by years of underinvestment, the BMA argues that the opportunity for renewal remains. Incremental pay restoration, tied to a credible workforce strategy, could form the foundation of a sustainable compromise.

Instead, both sides now face another round of confrontation, with patients once again caught in the middle.

The resident doctors’ strike is not simply an industrial dispute; it is a referendum on whether the NHS can still offer a viable future to those who dedicate their lives to it. Without urgent action, the question may soon answer itself.