The strike by 50,000 resident doctors in England to reverse the erosion of their pay, terms and conditions is a confrontation with Keir Starmer’s Labour government.

Labour faces the first national strike since coming to office last July. It views the resistance shown by resident doctors as a threat to pay restraint throughout the National Health Service (NHS) and its plans for further cuts and privatisation.

Resident doctors, formerly known as junior doctors, are not “students” or “trainees” in any conventional sense. They are fully qualified physicians providing essential services in every part of the NHS while undertaking postgraduate training.

A 90 percent strike vote by members of the British Medical Association (BMA) was a demand for justice—a 29.2 percent pay increase to restore wages in real terms to the level of 2008. Labour’s Health Secretary Wes Streeting has imposed a 5.4 percent award for this year.

Last-ditch talks with BMA leaders to avert strike action failed. Streeting made clear negotiations would not be reopened on pay. This was co-ordinated with a filthy smear campaign in the right-wing and liberal media, including the Guardian, citing NHS Trusts bosses branding resident doctors as “greedy.”

Streeting’s council of war

Streeting has tried to drive a wedge between resident doctors and other NHS staff by claiming they are “unreasonable” for refusing the highest pay award in the public sector this year. He has convened a council of war to make an example of them, aimed at every section of health workers.

In a chilling call with NHS leaders, revealed by the Daily Telegraph, Streeting declared: “It is really important that these strikes are not pain free for resident doctors or the BMA, because otherwise we will see broader contagion across the BMA and potentially broader contagion across the public sector.”

Describing resistance to pay restraint and austerity by hundreds of thousands of workers across the NHS and public sector as “contagion” shows the fear of the Starmer government. It confirms the appeal issued by NHS FightBack urging doctors “to link their pay fight to a mass working-class movement against the dismantling and privatisation of the NHS… a broader offensive to reverse decades of underfunding, outsourcing, and profiteering.”

Sir Jim Mackey, NHS England’s CEO, insisted on a “much more resistant” approach, denouncing previous strikes for being “net positive” for doctors—because some were able to earn back lost wages doing overtime to clear backlogs. He is pressing hospitals to keep as many routine operations running as possible during strikes, exposing patients to danger with skeleton staff in Accident and Emergency units.

The strategy is to break the will of resident doctors through financial pain, career threats, and scapegoating. Resident doctors have been warned their training progression may be delayed, that they are endangering patients, and even that they are putting the NHS in jeopardy, to cast them as the public enemy.

Labour’s NHS cuts, privatisation and arms spending

The real threat to the NHS comes from the Starmer government’s cost-cutting and acceleration of NHS privatisation. Streeting, who has made the Telegraph his platform of choice for announcing anti-NHS policies, wrote an op-ed in its pages on the first day of the strike: “I have been up front with the BMA from the start that I could not go further on pay than we already have this year… The country cannot afford it.”

The BMA estimates that restoring pay for resident doctors would cost £1.73 billion. In comparison, the Starmer government’s commitment to increase military spending to 2.5 percent of GDP equates to £13.4 billion more a year from 2027, with a pledge to raise this to 5 percent. Handouts to big business continue, with £20 billion in tax relief for capital expenditure, and corporation tax remains at just 25 percent.

The Starmer government’s prioritising the war machine and corporate enrichment is incompatible with the future of the NHS.

Streeting’s “reform” agenda is a euphemism for rationing care, outsourcing, and shifting more services into private hands. The NHS must not remain a “shrine” to its founding principles, he has threatened, hiring former private health bosses to advise on “modernisation” with the backing of private healthcare providers.

Starmer’s NHS “recovery” plan includes launching a £2.5 billion privatisation offensive, outsourcing a million treatments per year. In March, Labour abolished NHS England, axing 12,000 jobs, with more to follow as Integrated Care Boards and hospitals face being dismantled. Over 100,000 NHS jobs are at risk.

Oppose the isolation of resident doctors by the BMA

BMA resident doctors committee co-chairs Dr. Melissa Ryan and Dr. Ross Nieuwoudt said of Streeting, “What we have seen so far is a series of ‘no’s’—no to movement on pay, no to student loan forgiveness, no to any credible move forwards...”

This refutes the lie sold to resident doctors by the BMA leadership that the settlement they rushed to agree with Streeting when Labour came to office was “a journey to pay restoration.”

The two-year deal providing a 22.3 percent uplift fell well short of the 35 percent demanded. Rebranding “junior” to “resident” was hailed as long-overdue recognition of their value, even as Streeting campaigned in the right-wing press to overhaul the NHS in terms no Tory would have dared.

The BMA leadership is closing every avenue for doctors to mobilise broader support. Only selective regional pickets have been sanctioned—in strict compliance with anti-strike laws limiting numbers to six. Doctors have been told not to travel if no picket exists at their hospital. The BMA has even instructed removal of other trade union banners, limiting visible support.

NHS workers must overcome the attempts by all the health trade union officials to sabotage a unified fight. The Royal College of Nursing (RCN), GMB, and Unite have all reported strong opposition among their members to the 3.6 percent pay offer for 2025/26 in England in consultative ballots.

The GMB and Unite unions have reported 67 and 89 percent rejection votes among their NHS members, but have immediately appealed for a meeting with Streeting to avert industrial action. The RCN is also expected to announce an overwhelming rejection in the result of its indicative ballot of 345,000 nurses. However, no decision on formal strike action will be made until later this year while it discusses broader pay reform.

The way forward

The resident doctors strike is a decisive battle—not just over wages, but for the future of the NHS. They are confronting the Starmer government, the political establishment, and the media on behalf of the millions they serve in their frontline NHS role.

But this fight cannot be won through isolated, symbolic actions and appeals to Labour ministers. It must become the launching pad for a united industrial and political offensive across the NHS and beyond:

• Form rank-and-file strike committees, independent of the trade union apparatus, to take control of the dispute and link up with nurses, ambulance workers, porters and cleaners.

• Build toward a generalised NHS strike to defeat Starmer’s pay restraint and privatisation drive.

• Fight for full pay restoration and a publicly funded, publicly owned NHS, free from profiteering and corporate control.

The way forward is through the adoption of a socialist perspective, breaking the grip of the financial oligarchy over society and expropriating the wealth of the major corporations and banks to pour billions into public health, housing and education

NHS FightBack, established by the Socialist Equality Party and affiliated with the International Workers Alliance of Rank-and-File Committees (IWA-RFC), is fighting to build this leadership across the health sector. Get involved today!