![With Keir: Replying to your comments about the cost of living [YouTube]](https://thedailybritain.co.uk/wp-content/uploads/2026/04/pmkeirstarmer.jpg)
Resident doctors are set to stage a six-day strike beginning on 7 April after the British Medical Association accused Keir Starmer of pushing the dispute further from resolution by using NHS training places as a political bargaining chip – a tactic the union says has made a deal less likely, not more.
The BMA’s resident doctors committee formally rejected the government’s offer last week and, having been given a 48-hour ultimatum by the Prime Minister to reconsider, did not back down. Talks continued on Thursday but with little optimism on either side that the strike – which will fall during the Easter school holidays when NHS staffing is already stretched – can be averted.
The government has confirmed that 1,000 NHS specialty training places, which had been earmarked to go live this month, will now not be delivered. NHS England boss Sir Jim Mackey confirmed the offer has now “come off the table.” The BMA says that decision will harm patients. The government says the BMA brought it on themselves.
How the dispute reached this point
The row over resident doctors’ pay has been running for years, predating Labour’s election victory. When the Conservatives left office, resident doctors were still engaged in industrial action over what the BMA described as a decade of real-terms pay cuts. The Starmer government inherited the dispute and initially reached a deal – offering significant pay rises – which drew criticism for settling too quickly and without sufficient conditions.
This latest breakdown centres on a new dispute over what comes next. The government put forward a package it described as “historic,” which included:
An average pay rise of 4.9% in 2026-27, building on last year’s 29% uplift – bringing the total increase over four years to around 35.2% compared to the low point of doctor pay in the recent period. A pay rise of up to 7.1% for the most junior Foundation Year 2 doctors. An increase of up to 4,500 specialist training places over the next three years, intended to ease the logjam that prevents early-career doctors from progressing into their chosen specialism. Reimbursement for the cost of Royal College examinations. Pay progression reforms and other improvements to working conditions.
Dr Jack Fletcher, chair of the BMA’s resident doctors committee, said the government made “very late changes to the pay offer, reducing the pay investment and stretching it over a longer period in a way that had not been previously talked about – ministers effectively moved the goalposts on the deal at the last minute.”
That accusation – that the government altered the terms after lengthy negotiations – is central to the BMA’s justification for rejecting the deal without putting it to a member vote, which Starmer has characterised as an act of institutional bad faith.
The training places row
The most inflammatory element of the standoff has been the government’s decision to link the 1,000 specialist training places scheduled to go live in August to whether or not the strike is called off.
Wes Streeting, the health secretary, told the BMA that those places would be scrapped unless the union accepted the deal. Starmer reinforced that position in a piece in The Times on Tuesday, describing the BMA’s rejection as “reckless” and stating there were now 48 hours to reconsider before the offer expired.
Fletcher’s response, in a letter to Streeting on Wednesday, was pointed: “The political rhetoric – threatening to remove training places – coupled with the way the government has communicated the offer, has needlessly and avoidably inflamed the dispute, ultimately pushing the chance of a deal further away. A final offer followed by threats that parts of the offer may be withdrawn is not the way to end this dispute.”
Fletcher also argued that NHS England had already confirmed the 1,000 posts were going ahead before the government reversed course: “Removing potential doctors’ posts at a time when corridor care and GP queues are already putting the NHS under pressure is clearly bad for patients. Creating posts and improving patient care should not be dependent on calling off a strike.”
The BMA’s position is that NHS training places serve patients as much as they serve doctors – and that threatening them as a lever in an industrial dispute crosses a line.
The government’s position is straightforward: “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 April in time to recruit for this year.”
What both sides still want
In his letter, Fletcher set out what the BMA needs to see from the government before the strike can be called off. The unresolved issues include whether the £700 million in additional “progression pay” promised to doctors will be delivered over one, two or three years – a significant difference in practical terms. The BMA has also demanded pay deals running until 2029 to protect doctors from the effects of inflation, particularly given that the Iran war is already pushing the cost of living higher.
Fletcher made clear that no deadline will work as a negotiating tool: “Any ‘deadline’ disappears the moment there is a credible and sustainable offer on the table.”
Talks would continue, he said, and “if a credible offer is made, resident doctors are prepared to postpone next week’s strikes.”
The BMA also opened a new front this week, announcing it would ballot consultants and other hospital doctors – including SAS (specialty and associate specialist) doctors – about striking over “inadequate” pay and poor career development. The union is explicitly threatening coordinated strike action across different doctor groups.
The broader context
The strike could not come at a worse time for the NHS or for the government. The Easter school holidays mean hospital staffing is typically lower, with consultants and senior staff taking leave. A six-day walkout by tens of thousands of resident doctors during that period will create significant disruption, and NHS bosses have been warning about the impact on services for days.
Starmer, writing in The Times, noted that each strike costs the NHS around £250 million and said: “Progress slows. Waiting times fall more slowly. Pressure on staff increases. That is what makes this so frustrating – and so completely avoidable.”
The BMA’s resident doctors committee defended its decision by pointing to the inflation outlook – arguing that with the Iran war driving up the cost of living, a deal that looks adequate today may not be in six months’ time. That is precisely why the committee wants multi-year pay commitments rather than a one-year deal that leaves doctors exposed to future inflation spikes.
For Starmer, the dispute carries significant political risk. His government came to power promising to fix the NHS and end the cycle of industrial action that defined the latter years of Conservative rule. A major doctors’ strike over Easter, at a moment when the government is already under pressure over the Iran war and the May local elections, is the last thing Downing Street needs.
You may also like: Reform housing chief sparks fury with ‘everyone dies in the end’ Grenfell comments
Leave a Reply