BMA Chair: 29% Pay Demand by Resident Doctors is Final

The new medical profession leader has stated that the 29% salary claim of resident doctors is non-negotiable, acceptable, and easily achievable for the NHS.

Strikes to ensure resident (previously junior) doctors in England receive the full 29% might go on for years, according to Dr. Tom Dolphin, the British Medical Association's new council head.

The physicians' union will not discuss or accept a lesser sum since it represents the extent of the real-term loss of pay suffered by resident doctors since 2008, which they want fully recovered, Dolphin told the Guardian in his first interview since taking over last month. 

Dolphin, a consultant anaesthetist, stated that the 29% demand cannot be negotiated because it is founded on a concept.  "If we choose a different number, we would not achieve the salary restoration.  So that's why it appears stiff."

Dolphin blamed the five-day strike planned by tens of thousands of resident doctors later this month on Wes Streeting, the health secretary, who gave them a 22% wage increase over two years last year but did not follow up with an award this year to account for the 29% claim.  He claimed that the interruption caused by the 120-hour strike was his fault rather than theirs. 

Dolphin stated, "We assumed that the [22%] would be the beginning of a journey that would take us till we achieved the value we had in 2008.  So, the repatriation of value has ended, and it is now simply marching on the spot.  And we must continue on that journey.

"It [29%] is appropriate since it is based on the loss of value that we have experienced.  The number is this large because [past] governments repeatedly ignored the BMA when we warned that this was becoming an issue."

Ministers are concerned that a new round of strikes could drive other NHS employees and public sector workers to seek significant salary increases, wreaking havoc on the NHS. 

Dolphin claimed that doctors felt misled by Streeting and the government after being offered only 5.4% this year, and that promised reform of the review board on doctors' and dentists' remuneration, which advises ministers, had not resulted in suggested increases reflecting medics' value.

Streeting and the BMA are at odds and engaged in an increasingly heated verbal exchange.  Streeting has stated that the government will not renegotiate the 5.4% wage increase it granted resident doctors for 2025-26, adding that their 29% claim is "completely unreasonable," especially considering the situation of public finances.  However, the union has stated that it will continue organizing walkouts until its members earn 29%. 

Dolphin gave Streeting a potential opportunity to avoid a six-month strike campaign, stating that doctors were "flexible" in meeting their 29% aim, ideally through a three-year agreement.

"It's a couple of per cent [more than the 5.4% already awarded] this year, more per cent next year [and] more per cent the year after," Dolphin informed the crowd.  "However that might look, they're flexible about it."

Resident doctors rejected the 5.4% award, despite it being the most paid to any category of public sector workers, because it contains "no element of restoration". 

Dolphin accused the minister of refusing to meet with the BMA and of using "emotional language," such as suggesting that neither the public nor he would ever forgive them for striking, rather than confronting the allegations.

Streeting stated in an interview with LBC on Thursday that if doctors agreed to less attractive NHS pensions in exchange for greater pay during their careers, this may serve as a starting point for a discussion of their financial expectations.

However, Dolphin claimed that the NHS could afford to accommodate their demands.  While the gross cost of delivering the 29% full pay restoration is £1.73 billion, this falls to £920 million net if money returned to the Treasury through the tax system is factored in, he explained. 

"It represents a modest fraction of the budget.  It [29%] appears to be a high amount, but when compared to the overall NHS, it is not a large sum," he explained.

Between March 2023 and July 2024, junior doctors went on strike 11 times, for a total of 44 days.

Dolphin warned that the recent strikes could last for years.  "This effort has been going on for several years now.  We are determined to accomplish the salary restoration that doctors deserve, and the secretary of state will decide how long that takes," he said. 

Accepting the 29% demand would benefit the NHS in the long run since it would encourage doctors and make them less inclined to leave the country, according to Dolphin.

The NHS Confederation, which represents hospitals, has stated that the walkout will undercut the government's promise that 92% of those waiting for hospital treatment will receive it within 18 weeks by 2029.

Rory Deighton, the acute network's director, claimed waiting times were improving, as indicated by a minor reduction in the size of the care backlog in NHS England's latest monthly performance numbers released on Thursday. 

Winston, 84, told the Times, "I feel very strongly that now is not the time to strike.  I believe the country is struggling in a variety of ways, as are its citizens.

"Strike action completely disregards the vulnerability of those in front of you."  Doctors should be reminded that every time they see a patient, they are dealing with someone scared and in pain.  Doctors must take their responsibility far more seriously.

He asked the BMA to collaborate with ministers to reach agreements with the government, such as improving "appalling" working conditions and night hours. 

Dolphin's comments drew criticism from NHS officials.  Danny Mortimer, the CEO of NHS Employers, which represents NHS trusts in pay negotiations with unions, stated, "Our members will not recognise the BMA's characterisation of either the quality of the response the resident doctors have received from this government or the challenging realities of public sector and NHS finances."

The Department of Health and Social Care stated that Dolphin's words demonstrated that the BMA was "unreasonable and irresponsible." 

A spokeswoman stated, "The secretary of state has made it clear that his door is still open to discussing with the BMA a variety of issues that would improve the working lives of resident doctors."

"It is absurd and irresponsible for the BMA to refuse to even sit down to talk when they are threatening strike action that will have major consequences for patients and other NHS employees.  It is not too late to pull back from the brink and collaborate with the government to avoid strikes while continuing the work we've been doing together to repair our NHS."