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The government has retracted its proposal to create an additional 1,000 doctor training positions in England following the British Medical Association’s (BMA) refusal to halt a planned six-day strike next week. These new training posts were initially part of a broader set of measures introduced earlier this year in an attempt to settle the ongoing conflict involving resident doctors, formerly referred to as junior doctors.
Prime Minister Sir Keir Starmer issued a 48-hour ultimatum on Tuesday evening, demanding that the union call off the strike in order to retain the offer of extra training posts. The strike itself was announced last week after negotiations between the government and the doctors’ representatives failed to resolve disputes over pay and staffing shortages. A spokesperson for the Department of Health and Social Care described the deal offered to doctors as “generous,” but explained that the uncertainty caused by the strike made it impossible to proceed with launching these posts this year. “These posts would have gone live this month, but as systems now need to prepare for strikes and more uncertainty, it simply won’t be operationally or financially possible to launch these posts in time to recruit for this year,” they said.
The government emphasized that rescinding the offer would not reduce the total number of doctors within the NHS, as the posts planned were to replace existing short-term positions that resident doctors currently occupy while awaiting official training placements. Dr Jack Fletcher, chair of the BMA’s resident doctor committee, expressed deep disappointment with the government’s decision. “It is genuinely disheartening to be at this point after what had been constructive talks up until a few weeks ago when the government moved the goalposts,” he said. “It is simply wrong that the development of the doctors of the future is being used as a pawn like this. We have consistently maintained that we are willing to postpone industrial action should a genuinely credible offer be provided.”
In addition to the offer of extra training posts, the government had proposed covering certain out-of-pocket costs such as exam fees and promised accelerated pay progression. However, the BMA ended negotiations, claiming that the offer had been diluted at the last moment, particularly concerning the pay progression element. This came soon after the government accepted the independent pay review body’s recommendation of a 3.5% pay increase effective from this month, applying to all doctors including resident doctors. The BMA labeled this as a “crushing blow,” especially given the anticipated rise in inflation linked to the conflict in Iran. Despite pay having increased by about a third over the past four years, the union pointed out that, when adjusted for inflation, current pay is still roughly 20% lower than in 2008. Notably, the BMA uses the Retail Price Index (RPI) as their benchmark for inflation because that figure is used by the government in computing interest on student loans.
The training positions on offer would be for doctors who have completed their first two years of training and are beginning to specialize in areas like general practice or surgery. Last summer, there were approximately 30,000 applicants competing for around 10,000 such roles, including some international applicants. The upcoming strike beginning at 07:00 BST on Tuesday will mark the joint longest industrial action since this dispute began, with only one previous six-day walkout having taken place. This will be the fifteenth strike since the dispute started in March 2023. Resident doctors represent nearly half of the medical workforce in the NHS, and about two-thirds of them are members of the BMA
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