The British Medical Association (BMA) is, once again, at logger-heads with the Government over pay.

Resident Doctors (formerly Junior Doctors) in NHS England are poised to take strike action for the 15th time since 2023 in the week just after Easter. This is the response to the Government’s offer of a 3.5 pay rise, which included payments for some expenses including exam fees and an increase in the number of training posts. The BMA say this is not enough; that inflation is certain to rise and that their pay has not kept pace with inflation since 2008. On a 52.54 per cent turnout, 93.4 per cent voted for action in January.

An angry Prime Minister responded to this by giving the BMA 48 hours to call off the action or he would withdraw the offer of 1,000 extra training posts that are part of a proposed 4,000 extra speciality posts created over the next three years. Health Secretary Wes Streeting says doctors are doing all right as they have had about 30 per cent over the last three years, with basic pay increased to £77,348 and average earnings over £100,000.

The response of Jack Fletcher of the BMA’s resident doctor committee was to accuse the Government of shifting the goalposts and worse, making “threats about withholding jobs from doctors” when the NHS was already under strain. The doctors’ union points out that despite recent rises doctors’ pay is still in real-terms 20 per cent below that of 2008.

In another BMA dispute, GPs n England rejected by 98.9 per cent on a 55.1 per cent turnout contract changes that would make patient access easier using digital means. The BMA’s GP committee (GPC) warns that it would overburden GP services as it would mandate unlimited same-day urgent appointments and unlimited online consultation requests and also introduce rules affecting hospitals’ acceptance of GP referrals to specialists. It fears the deal will increase workload in already under-staffed practices resulting in “a fast track to collapse GP services”, with GPs leaving for the private sector.

The Department of Health and Social Care brushed off the strike vote saying it was “not representative” of GPs who “want to make general practice fit for the future”, claiming that the new contract would see the end of the notorious “8am scramble” for appointments.

Another union, Unison, was also unhappy about the 3.5 per cent award. Head of Health Helga Pile observed that: “Many health staff will question why colleagues working alongside them have, once again, got a higher pay rise for no apparent reason. The NHS acts as one team and how employees are treated should reflect this. All health workers have seen their pay eroded by rising bills and face daily struggles to cope with chronic staffing shortages.” This was because the majority of NHS staff were given a 3.3 per cent pay award for 2026/27. This 0.2 per cent difference is much less than that from a few years ago when doctors received a big boost to their pay, which was not matched by that for nurses and other staff, but it still rankles.

Fourteen unions have told the Westminster government that NHS staff feel “angry and let down”. The Royal College of Nursing (RCN) has complained about the 3.3 rise. They have written to Minister for Health Karin Smyth saying that staff feel “angry and let down” after years of eroded wages, chronic understaffing and rising living costs.

RCN Executive Director of Legal Jo Galbraith-Marten said “3.3 per cent isn’t enough and there is no excuse for government once again outsourcing responsibility for NHS pay to a failed Pay Review Body (PRB) process”. She not unreasonably added that: “Ministers should have negotiated with unions directly, as we requested multiple times. You simply can’t agree fair staff pay without talking to staff.”

They want to see the end of the NHS Pay Review Body process and its replacement with direct talks between unions and ministers.

Finally, the RCN complains that the 3.3 per cent rise might not be applied to all nursing staff. In particular, RCN England director Patricia Marquis notes that: “As salaried general practitioners see their pay increase, many nursing staff working in general practice are still waiting to see any uplift in their salary from last year. The government is clear in its message that general practice staff should be included in this pay uplift, and we expect this to be honoured” – but this has not been done in every case, despite funding being provided for it.