Health Secretary Wes Streeting (Image: Getty)
Wes Streeting has accused resident doctors of labouring under a “delusion” after the British Medical Association rejected a Government pay and jobs offer, triggering the longest strike in their three-year dispute. Thousands of resident doctors – formerly known as junior doctors – will walk out for six days from 7am on Tuesday, April 7, until 6.59am on Monday, April 13, immediately after the Easter bank holiday. It marks the 16th round of industrial action since the first strike in March 2023, with NHS leaders warning of a potential year-long slog ahead.
Last-ditch talks on Tuesday and Wednesday collapsed, and a Thursday deadline for agreement passed without a deal. Mr Streeting responded with a blistering letter to BMA Resident Doctors Committee chair Dr Jack Fletcher, withdrawing a pledge to create 1,000 extra specialist training places this year.
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Striking doctors earlier this year (Image: Getty)
Health Secretary Mr Streeting wrote: “The BMA seems to be labouring under the delusion that you can reject the deal but claim the benefits of the offer.” He said he had expected a counter-proposal after the BMA rebuffed the package, but none came. Mr Streeting added: “If members of your committee cannot reach an agreed position among themselves, it is hard to see how the government will be able to reach an agreement with your committee.”
The government’s final offer included an average 4.9% pay rise this year – taking cumulative increases to 35.2% over four years, the highest in the public sector – with higher rises for the lowest-paid FY1 and FY2 doctors. It also promised reform of the pay structure for more frequent uplifts tied to competencies, reimbursement of Royal College exam fees, and up to 4,500 additional specialty training posts over three years, including the now-scrapped 1,000 this year.
Mr Streeting stressed the extra posts were conditional on ending strikes, citing the estimated £250m cost of each walkout and tight deadlines for August training recruitment. Mr Streeting said: “It is simply not operationally or financially possible” to deliver them amid ongoing action.
NHS England chief executive Jim Mackey warned of “a long slog” of continuing strikes, predicting services would increasingly redesign care to reduce reliance on resident doctors. National director for emergency planning Mike Prentice told trusts the Easter timing would create a “significant strain on staffing resources” as many staff are on holiday.
Senior figures now question whether the dispute is soluble. The BMA has demanded a 26% pay rise, which ministers say is unaffordable given public finances. Mr Streeting cast doubt on future negotiations, noting the committee’s internal divisions and the BMA’s decision to press ahead with disruptive action over the holiday period despite months of detailed talks.
In his letter, Mr Streeting highlighted elements of the rejected deal, including substantial contract reforms for locally employed doctors and new industrial relations structures. He reminded Fletcher that the government had already delivered a 28.9% pay rise since he took office and passed legislation prioritising UK medical graduates for training places – without using it as leverage.
Even at the 11th hour, Mr Streeting said it was “not too late” to accept the offer or call off strikes, but his focus has now shifted to managing the disruption and prioritising other NHS workforce talks.
NHS bosses face cancelled appointments, longer waits and pressure on remaining staff. The strike is expected to cost around £250-300m, compounding existing strains.
The row, which has rumbled since 2023, shows no immediate sign of resolution as both sides remain far apart on pay and the future of the training bottleneck.