The row over resident doctors’ pay has moved from hospital corridors to the centre of national politics. These doctors, once called junior doctors, are demanding a 29.2 per cent pay rise. They argue it would restore the value of wages lost in real terms since 2008. The British Medical Association (BMA) insists this is not a luxury but a correction. Yet the cost to the public purse would be significant.
According to the Telegraph’s analysis, meeting the demand would cost at least £1.1 billion before adding the employer’s National Insurance and pension contributions. The equivalent, in raw NHS budgeting terms, would be 31,000 additional nurses based on the current average salary of £36,559. The NHS’s long-term workforce plan, published in 2023, set out an ambition to hire 190,000 more nurses by 2036. Whether this latest pay dispute helps or hinders such targets is far from clear.
The Government has made its position plain. Health Secretary Wes Streeting refuses to reopen negotiations for this year. He points out that doctors already received an average 5.4 per cent rise, the largest in the public sector for the second year running, following a 22.3 per cent settlement last September. To press ahead with a five-day strike from 25 July, he says, is unreasonable. He also notes that no other union in British history has secured such a rise and then immediately launched industrial action.
The BMA’s counter-argument rests on its own inflation calculations. Using the retail price index (RPI), which the Office for National Statistics (ONS) no longer prefers, it claims doctors’ pay has fallen by 20.9 per cent in real terms since 2008. Using the ONS’s favoured consumer price index (CPI), the decline looks less dramatic, with base pay broadly tracking inflation since 2010. The choice of measure is not a dry statistical footnote; it is the heart of the disagreement.
The numbers are stark. A 29.2 per cent pay rise would take a first-year doctor from £33,968 to £43,819, an increase of £9,851. That would place their earnings more than 10 per cent above the average full-time wage across the country. For speciality registrars, the most senior in this category, base pay would jump by £16,336 to £72,668. These figures exclude overtime, location-based supplements and on-call payments, which can add a quarter to final earnings.
The public sector pension scheme for doctors also remains one of the most generous available, offering up to 75 per cent of final salary in retirement. Critics of the BMA’s stance say that when such benefits are factored in, the package remains competitive compared to most professions.
Yet the dispute is not only about spreadsheets. Resident doctors say the profession is at a crossroads. Morale is low and the pressures are mounting. Like nurses, doctors are part of a workforce plan that foresees a need for tens of thousands more staff over the next decade. They argue that without fair pay, recruitment and retention will suffer, placing further strain on a system already at its limits.
The Treasury faces its own constraints. Chancellor Rachel Reeves is looking at a £20 billion gap in public finances. Recent reversals on welfare cuts have made the task harder. A diluted cut to the winter fuel payment has reduced expected savings to £450 million, while last week’s scaling back of disability welfare reforms has knocked £3 billion off projected reductions.
The arithmetic is brutal. A £1.1 billion pay rise for doctors would be more than twice the savings from the winter fuel change and would erase half of the £2 billion in savings from last week’s welfare cuts. This would force choices elsewhere in the budget, almost certainly involving higher taxation or further cuts.
The political risk is equally sharp. This row risks creating a perception that the Government is pitting one group of NHS staff against another. Suggesting that a pay rise for doctors could instead pay for thousands of nurses is a tempting soundbite, but it is a divisive one. It frames the issue as a zero-sum game between two professions the health service cannot do without.
The NHS cannot function without doctors and it cannot function without nurses. Treating their pay claims as competing priorities ignores the deeper problem: a health system trying to meet modern demands with financial rules designed for leaner times. Until the funding model itself is re-examined, these disputes will return with wearying regularity, and the public will be told again and again that to pay one is to deny the other.
