Secretary of State's address to the House on resident doctors
The Secretary of State for Health and Social Care, Wes Streeting has made a statement to the House on industrial action by resident doctors.
Thank you, Madame Deputy Speaker.
With your permission, I will make a statement on industrial action by resident doctors.
As we head into winter, our hospitals are running hot and the pressures on the NHS are enormous.
Flu season has come earlier, with a sharp rise in cases, the peak still to come, and this year’s strain more likely to affect older people more severely.
Already, the number of patients in hospital in England with flu is the highest on record at this point in the year.
It is more than 50% higher than this time last year – and 10 times higher than in 2023.
95% of hospital beds are occupied, growing numbers of staff are off sick, and we are already seeing the pressure in our A&E departments.
It is against this backdrop that the BMA is threatening to douse the NHS in petrol, light a match, and march its members out on strike.
This represents a different magnitude of risk to previous industrial action.
The BMA Resident Doctors Committee is in dispute on two issues: pay and jobs.
On pay, resident doctors have already received a 28.9% pay rise – the highest in the public sector.
For a first-year resident doctor, that is the equivalent to a £9,400 pay rise.
I have been consistent, honest, and up front with resident doctors that we cannot go further on pay this year.
There is a gap between what the BMA is demanding and what the country can afford.
Nor would further movement on pay be fair to other NHS staff, to whom I am also responsible, and many of whom will never in their careers earn as much as the lowest-paid doctor.
As I have made clear to the BMA and other trade unions, I am open to discussing multi-year pay deals with any trade union if we stand a chance of bridging the gap between affordability and expectations.
On jobs, I have much more sympathy with the BMA’s demands.
I have heard the very real fears resident doctors across the country have about their futures.
It is a legitimate grievance that I agree with.
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In 2019, there were around 12,000 applicants for 9,000 specialty training places.
This year, that has soared to nearly 40,000 applicants for 10,000 places.
It used to be that UK graduates competed amongst themselves for specialty roles.
Now they are competing against the world’s doctors.
That is a direct result of [POLITICAL CONTENT REDACTED]
And it is compounded by [POLITICAL CONTENT REDACTED]
Taxpayers spend £4 billion training medics every year.
We then treat them poorly and some leave to work abroad or in the private sector.
It is time we protect our investment and give bright, hard-working UK medical graduates a path to become the next generation of NHS doctors.
Our 10 Year Plan for Health set out our commitment to provide that path.
It pledged to introduce 1,000 extra specialty training places and prioritisation medical graduates from the UK and Ireland.
Today, in an offer to Resident Doctors, I can announce that I am able to go further.
I want to thank Sir Jim Mackey, the Chief Executive of the NHS, and his team, who have been going trust by trust to see how many extra places can be funded and are needed.
Thanks to their hard work, I am in a position today to be able to offer 4,000 specialty places for resident doctors, starting with an additional 1,000 for those applying this year.
In the Department of Health and Social Care, we have been working intensively on UK graduate prioritisation.
The barriers have been legal ones. So I have been working intensively with my team to see how quickly we could introduce legislation.
Thanks to their efforts, the cooperation of colleagues across government, and my counterparts in Wales, Scotland, and Northern Ireland, I can notify the House tonight that, subject to Resident Doctors’ agreement, we intend to introduce urgent primary legislation, in the form of a Bill to be presented to Parliament, in the new year.
This will prioritise graduates from UK medical schools over overseas applicants during the current application round, and in all subsequent years.
The reforms will also prioritise doctors who have worked in the NHS for a significant period for specialty training.
This will not exclude international talent, who will still be able to apply to roles and continue to bring new and vital skills to the NHS.
But it will return us to the fair terms on which home-grown medics competed before Brexit.
The impact of these changes is that instead of four doctors competing for every training post, it will now be fewer than two doctors for every place.
That is a good deal for doctors.
Following discussions with the BMA, we are also addressing the specific costs faced by resident doctors, which do not apply to other NHS staff.
So while I cannot go further on pay this year, I am able to offer today to put money back in resident doctor’s pockets, by reimbursing Royal College portfolio, membership and exam fees – with the latter backdated to April.
The allowance for less than full-time resident doctors, many of whom are parents and carers, will be increased by 50% to £1,500, helping to close the gender pay gap.
In recent days, I formally made this offer to the BMA Resident Doctors’ Committee.
The BMA will now survey its members in the coming days on whether to accept this offer and end its dispute with the government.
The BMA told us that they will survey their members quickly and give us less than 48 hours’ notice on whether the strikes are going ahead.
Madame Deputy Speaker, that presents serious operational challenges for NHS leaders, who need certainty now as to whether they are cancelling patient appointments and cancelling staff annual leave to cover strikes.
In my determination to prevent the havoc that strikes would cause this Christmas, I therefore made one more offer to the BMA, which I will share with the House, the country, and frontline doctors now.
So that the BMA could run a genuine ballot of its members and call off next week’s strikes while that ballot ran, I offered to extend their strike mandate.
This would have allowed enough time for the BMA to reschedule next week’s strikes for the end of January, were the offer to resident doctors rejected in a ballot.
It would have avoided the chaos that looming strike action threatens, at the most dangerous time of year, by removing the spectre of strikes next week.
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I must report to the House that the BMA’s leadership said no.
In the coming days, as the NHS prepares for strike action which may or may not happen, there are patients whose operations will be cancelled.
There are NHS staff, who will have to tell their families that they won’t be home for Christmas, because they have to cover for their resident doctor colleagues.
This was entirely avoidable.
No one should be in any doubt, that the BMA has chosen to play politics with people’s lives this Christmas, and to continue holding the spectre of strikes over the NHS.
I ask resident doctors to bare that in mind when they cast their votes.
The power to end these strikes now lies in the hands of doctors.
Resident doctors face a choice:
To continue the damaging industrial action in which everyone loses.
Or to choose more jobs, better career progression, more money in their pockets, and an end to strikes.
It would mean emergency legislation to put our own home-grown talent first.
To increase the number of extra specialty training places from 1,000 to 4,000, with a quarter of those delivered now.
To reduce the competition for training places from around 4 to 1, to less than 2 to 1.
To put more money in doctors’ pockets by funding Royal College exam fees, portfolio fees and membership fees, with exam fees backdated to April.
To increase the less than full time allowance by 50% to £1,500.
The chance for a fresh start, to end this dispute, and to look ahead to the future with hope and optimism.
A chance to rebuild resident doctors’ working conditions, and to rebuild our NHS.
I urge every resident doctor to vote for this deal.
And I commend this statement to the House.