Sir Keir Starmer told the country, repeatedly, that only Labour could be trusted with the NHS. Two years in, his Health Secretary cannot keep doctors in hospitals, cannot agree a pay deal, and has just withdrawn 1,000 promised specialist training posts on grounds of "financial and operational constraints". The BMA has rejected the government's 3.5% pay offer outright, calling it a real-terms cut that "at best barely treads water". And so resident doctors are walking out again — for six days, the longest single strike of this entire dispute.
What The BMA Actually Said
The BMA's position, when you strip out the rhetoric, is that resident doctor pay is now 21% lower in real terms than it was in 2008/09. Whether you accept that exact figure or not, the direction of travel is undisputed. Doctors who train for a decade or more are being asked to accept pay packets that have gone backwards while the cost of housing, childcare and food has gone forwards. Many are voting with their feet — to Australia, to Canada, to private practice or out of medicine altogether.
A 3.5% offer in an environment where CPI ran at around 3% and where the BMA argues the historical real-terms shortfall remains unfilled is not, in any honest reading, an offer that resolves the dispute. It is a placeholder while ministers work out what to do next.
The 1,000 Training Posts Climb-Down
What makes this worse is the simultaneous decision to scrap 1,000 promised additional specialist training posts. Those places were a key sweetener — a way of saying to junior doctors, "stay in the NHS, we will create the career path". Pulling them in the middle of negotiations because the Treasury has run out of patience tells the workforce something important: this government will not protect them when push comes to shove.
And the impact lands on patients. NHS England has admitted hospitals will run at around 95% of normal activity during the latest strike, with priority given to urgent elective surgery and to cancer patients waiting more than 62 days. That sounds reasonable until you remember the cancer waiting target is already being missed for hundreds of thousands of patients, and the diagnostic backlog stands at over 1.68 million cases. Every cancelled clinic stretches that further.
This Is What Politicised Healthcare Looks Like
Labour built the entire 2024 election around the line that the Conservatives had broken the NHS and only Labour could fix it. The verdict from the workforce is that they cannot. The waiting list still sits north of 7.3 million. There are 22 active disputes inside the NHS at the time of writing. Resident doctors are now openly discussing rolling monthly strikes through the rest of 2026. The fix that Labour was supposed to deliver hasn't materialised — instead the conflict has spread.
The reality, which Reform UK has been pointing out for two years, is that throwing more money at a system without reforming how the system spends it is a guaranteed failure. The NHS is brilliant in places, and indefensible in others. Pretending otherwise is what got us here.
What Reform UK Would Do
Reform UK would scrap NHS England as a quango layer, devolve operational decision-making back to acute trusts, and target money where it actually changes outcomes — diagnostics, cancer pathways and primary care. We would end the absurdity of paying agency staff three times the rate of permanent staff to fill rotas the system itself failed to plan for. And we would back our doctors with a serious, multi-year pay framework agreed up front, not a series of below-inflation last-minute offers that nobody believes in.
Patients deserve a working NHS. Doctors deserve a fair pay deal. Labour has now failed to deliver either. The strike that begins now is the clearest evidence yet that "fix the NHS" was a slogan, not a plan.