Streeting to resident doctors: ‘I deeply regret position we find ourselves in’

Wes Streeting has sent a personal letter to NHS resident doctors, saying “I deeply regret the position we now find ourselves in” as they prepare to strike.

The Health Secretary said while he cannot pledge a bigger pay rise, he is committed to progress to improve their working lives.

He also said he does not now believe the British Medical Association’s resident doctors committee (RDC) has “engaged with me in good faith” over bids to avert the strike.

Sir Keir Starmer also made a last-minute appeal to the doctors, saying the strikes would put patients at risk and that “everyone loses” if medics follow the RDC’s path.

Thousands of resident doctors are to walk out from 7am on Friday for five days.

In the letter sent on Thursday afternoon, seen by the PA news agency, Mr Streeting said: “I wanted to write to you personally about the situation we find ourselves in.

“This Government came into office, just over a year ago, with a great deal of sympathy for the arguments that resident doctors were making about pay, working conditions and career progression.

“I was determined to build a genuine partnership with the… RDC to make real improvements on all three fronts.

Strike action should always be a last resort - not the action you take immediately following a 28.9% pay award from a Government that is committed to working with you to further improve your lives at work

“We have made progress together. While some of my critics in Parliament and the media believe I was naive to agree such a generous pay deal to end the strikes last year, I stand by that choice.”

Mr Streeting said he had agreed that pay deal “because I believed it to be fair”, adding resident doctors have now had an average 28.9% pay award under Labour.

He added: “Strike action should always be a last resort – not the action you take immediately following a 28.9% pay award from a Government that is committed to working with you to further improve your lives at work.

“While I’ve been honest with the BMA RDC that we cannot afford to go further on pay this year, I was prepared to negotiate on areas related to your conditions at work and career progression, including measures that would put money back in the pockets of resident doctors…

“Based on discussions with the BMA RDC leaders between July 8 and 19, I set out three substantive areas where I believed we could work together to make real improvements.”

These included tackling the “arduous” training pathway, and “I made it clear that I was prepared to agree actions to reduce the costs you face as a result of training”, Mr Streeting said.

He said he had also been looking at the cost of equipment, food and drink, and “was prepared to explore how many further training posts could be created – additional to the 1,000 already announced – as early as possible”.

Mr Streeting said he had asked the BMA for strikes to be postponed for a “few weeks so we could work together on a detailed package that could form an offer to you to end this dispute”.

He wrote to the RDC on Monday evening setting out a way to avert strike action, which had been discussed with the RDC in draft form, he added.

“I had responded to their requests for where additional information was required,” he said.

“I no longer believe that they have engaged with me in good faith.”

Mr Streeting continued: “I deeply regret the position we now find ourselves in. The public, and I am sure many of you, do not understand the rush to strike action.

“I would like to thank all those that will be turning up to work and supporting their colleagues in providing care for patients despite the challenging circumstances. I urge you to join them. We can achieve more for both doctors and patients by working together.”

Later, Mr Streeting said there is “no getting around the fact that these strikes will hit the progress we are making in turning the NHS around”.

He added: “But I am determined to keep disruption to patients at a minimum and continue with the recovery we have begun delivering in the last 12 months after a decade-and-a-half of neglect. We will not be knocked off course.”

Sir Keir wrote in the Times: “The route the BMA Resident Doctors Committee have chosen will mean everyone loses. My appeal to resident doctors is this: do not follow the BMA leadership down this damaging road. Our NHS and your patients need you.”

Daniel Elkeles, chief executive of NHS Providers, told PA health staff will be working “flat out” to see as many patients as they can during the strike, after NHS England made clear it wants as much pre-planned care as possible to continue.

He said: “Striking doctors should think carefully if they are really doing the right thing for patients, for the NHS and for themselves.

“NHS trusts will do everything they can to postpone as few appointments as possible…

“The strike will throttle hard-won progress to cut waiting lists, but NHS trust leaders and staff will be working flat out to see that as many patients as possible get the care they need.”

The public have been urged to keep coming forward for NHS care during the walkout.

GP surgeries will open as usual and urgent care and A&E will continue to be available, alongside 111, NHS England said.

Elsewhere, the Health Service Journal (HSJ) reported that NHS chief Sir Jim Mackey had told trust leaders to try to crack down on resident doctors’ ability to work locum shifts during the strike and earn money that way.

Leaders have also been encouraged to seek “derogations”, where resident doctors are required to work during the strikes, in more circumstances, the HSJ reported.

Rory Deighton, acute and community care director at the NHS Confederation, said: “These strikes were not inevitable – the Government entered negotiations with the BMA in good faith to discuss improving the working and training lives of resident doctors…

“The impact of these strikes and the distress they will cause patients rests with the BMA.”

We’re asking for an extra £4 per hour to restore our pay. It’s a small price to pay for those who may hold your life in their hands

The BMA argues real-terms pay has fallen by around 20% since 2008, and is pushing for full “pay restoration”.

The union is taking out national newspaper adverts on Friday, saying it wants to “lay bare the significant pay difference between a resident doctor and their non-medically qualified assistants”.

It said the adverts “make clear that while a newly-qualified doctor’s assistant is taking home over £24 per hour, a newly-qualified doctor with years of medical school experience is on just £18.62 per hour”.

The BMA said Mr Streeting and his officials have refused to continue talks across the strike days and the minister’s letter to them “amounted to nothing more than vague promises on non-pay issues”.

RDC co-chairs Dr Melissa Ryan and Dr Ross Nieuwoudt said in a statement: “Pay erosion has now got to the point where a doctor’s assistant can be paid up to 30% more than a resident doctor. That’s going to strike most of the public that use the NHS as deeply unfair.

​“Resident doctors are not worth less than they were 17 years ago, but unfortunately they’ve seen their pay erode by more than 21% in the last two decades. We’re not working 21% less hard so why should our pay suffer?

“We’re asking for an extra £4 per hour to restore our pay. It’s a small price to pay for those who may hold your life in their hands.”

The statement said Mr Streeting had every opportunity to prevent the strike, and added: “We want these strikes to be the last we ever have to participate in.

“We are asking Mr Streeting to get back around the table with a serious proposal as soon as possible – this time with the intent to bring this to a just conclusion.”

The Department of Health and Social Care (DHSC) said the framing of the BMA advertising campaign was “disingenuous”.

“Given their repeated use of debunked ways of measuring inflation to overstate their pay claims, it follows a pattern of deliberately misleading calculations from the BMA,” a spokesperson said.

“The average annual earnings per first year resident doctor last year was £43,275. That is significantly more, in a resident doctor’s first year, than the average full-time worker in this country earns.

“Resident doctors in their second year earned an average of £52,300 last year and at the top end of the scale, resident doctors in specialty training earned an average almost £75,000 – this is set to increase further with this year’s pay award.”

The Conservatives accused Labour of having “opened the door” to fresh strikes with a “spineless surrender to union demands last year”.

Shadow health secretary Stuart Andrew said: “They handed out inflation-busting pay rises without reform, and now the BMA are back for more.

“They are disrupting care, ignoring patients and gambling with lives. This is a betrayal of the NHS and those who rely on it.

“The public deserves hospitals where the doctors are on the front line rather than the picket line. But every day Labour refuses to stand up to union overreach, Britain moves closer to a health service run on the unions’ terms rather than the patients’.”