The Guardian view on junior doctors’ strikes: the next government’s first test

Junior doctors outside Downing Street as they begin their latest strike over pay on 27 June. Photograph: Vuk Valcic/Zuma Press/Rex/Shutterstock

Junior doctors deserve a pay rise. Entry requirements are among the most competitive of all professions, and even were the health service not on its knees, the early years of a medical career would be demanding. Looking after people who are ill or injured is difficult and high-stakes work. Under current conditions, with vast waiting lists, workforce shortages, a rising population of chronically unwell people and, in some places, buildings that are not fit for purpose, it can be a punishing job.

It is two years this month since the British Medical Association voted for pay rises of up to 30% over five years. Consultants agreed a deal with the government last year, as did nurses. But junior doctors, who make up about half of all NHS doctors in England, have held out. In March, in a further ballot, 98% opted to keep striking in pursuit of a 35% pay rise, on a 62% turnout. The five-day strike that started on Thursday is their 11th. When it ends they will have been on strike for a total of 44 days since they first walked out in March last year. At least 1.3m cancelled appointments have been among the results.

The name junior doctor is something of a misnomer. Doctors in the UK are “junior” until they become consultants, with up to eight years of specialist training on top of a two-year foundation and five years of medical school. The starting salary of £32,398 is about the average for graduates. But the pay rise of about 9% awarded last year (depending on experience) was not enough in light of the 26% real-terms pay cut they have experienced over the past 14 years. Since junior doctors are mostly young adults, and less likely to be homeowners than older people, many must contend with rent rises that keep outstripping wage growth, as well as other cost of living pressures. Some have spoken of having put off starting families.

By sticking to their guns, junior doctors have shown that striking for a 35% pay rise need not alienate the public. But they have little to show for it, having reached a stalemate with ministers. During the election campaign there is no one to negotiate with, and Labour’s Wes Streeting asked them to put off this week’s strike to avoid further cancellations. By refusing to do so, the doctors struck an uncompromising note before the next round of negotiations.

Their demand has always been for a phased increase. A letter sent last week by junior doctors’ leaders to the prime minister reiterated this. If Labour wins the election, resolving the dispute will be among its most urgent tasks. Given the level of public concern about the health service, which has not yet recovered from the pandemic, the pressure is intense. But doctors are far from the only public employees seeking improved terms of service. Teachers and others have seen their real-terms pay decline, while improved pay for social care workers is a Labour manifesto pledge. Mr Streeting has already said he wants to avoid setting a precedent for other unions to demand big pay rises, and will be hoping that the prospect of a reset of relations with ministers will persuade the doctors to moderate their claims.

A discontented workforce with too many gaps in it is not the only problem facing the NHS. But progress on waiting lists, or anything else, will be impossible unless the staffing situation is improved. For the next government, the ability to make a deal with doctors promises to be a crucial early test.