As the new year approaches, the National Health Service (NHS) across the United Kingdom is bracing for a fresh wave of industrial unrest, with resident doctors in both Scotland and England at the heart of heated disputes over pay, working conditions, and the future of the medical profession. The situation, which has already led to significant disruption in England and now threatens Scotland with its first-ever national doctors’ strike, highlights the growing tensions between healthcare workers and government officials determined to balance fiscal responsibility with the urgent needs of a strained health system.
On December 22, 2025, Scotland’s Health Secretary Neil Gray publicly stated his strong desire to avoid a resident doctors’ strike, but he made it clear he believes the government has already put forward the best pay deal possible. According to BBC, Gray emphasized, “I would always rather we had avoided strike action, that has been my aim throughout discussions.” Nevertheless, the reality on the ground tells a different story. Medics in Scotland have overwhelmingly voted for a four-day walkout, scheduled from 7:00 AM on Tuesday, January 13, 2026, to 7:00 AM on Saturday, January 17, 2026—an unprecedented move for NHS Scotland, which had previously managed to avoid such industrial action even as strikes rippled across the rest of the UK.
The ballot saw a 58 percent turnout among the 5,185 eligible resident doctors, with a staggering 92 percent voting in favor of the strike. The core of their frustration lies in pay: the Scottish government’s current two-year offer includes a 4.25 percent increase for 2025/26 and a 3.75 percent increase for 2026/27—the same deal accepted by nurses, paramedics, and other NHS workers earlier in the year. But BMA Scotland, the doctors’ union, has condemned the offer as the lowest in the UK and notably less than what the independent pay review body recommended.
For newly qualified doctors, the proposed deal would see basic pay rise from £34,500 to £37,345 by 2026/27, while doctors with a decade of experience would see their salaries increase from £71,549 to £77,387. Even so, BMA Scotland argues that these increases lag behind inflation, which has eroded doctors’ real earnings for the past 15 years. The union is pushing for a boost in hourly pay from £17.40 to £20.90, reflecting the demanding nature of their work—often involving night shifts, weekends, and extended hours, with additional payments for these unsocial shifts.
Dr Lucas O’Donnell, deputy chairman of BMA Scotland’s resident doctors committee, minced no words in his criticism, telling BBC, “For doctors who are looking after, at times, 150 patients, at a time when you are the first responder to heart attacks, strokes, cardiac arrests, I don’t think £20.90 is some kind of largess or luxury.” He went on to lament the exodus of colleagues to countries like Australia and Canada, adding, “We had a deal which prevented strikes, we just want to keep to what the Scottish government had already agreed.”
On the other side of the negotiating table, Neil Gray disagreed with the union’s assertion that the latest offer reneges on previous commitments. “By any stretch of the imagination, by any measure, we have made progress to close that gap in resident doctor pay,” Gray said, while also stressing the need for fairness and affordability. He remains wary of the impact a strike could have on NHS waiting times, a priority for the government as winter pressures mount.
Across the border in England, the story is both parallel and distinct. Resident doctors there have just ended a five-day strike, returning to work at 7:00 AM on Monday, December 22, 2025. The industrial action, which coincided with a surge in flu cases, created what Health Secretary Wes Streeting described as “the most serious threat to the NHS since I became Health and Social Care Secretary.” According to Press Association, Streeting expressed deep gratitude for NHS staff who kept services running during this challenging period, stating, “To everyone who played a role in keeping NHS services running through this exceptionally challenging month, thank you for the real difference you have made.”
But the threat of further disruption is far from over. The BMA’s latest ballot saw 83 percent of resident doctors vote to continue strike action, with a 65 percent turnout. The union is now balloting for a mandate to extend industrial action for another six months—potentially until August 2026. Dr Jack Fletcher, chair of the BMA’s resident doctors committee, emphasized the need for a “proper fix to this jobs crisis and a credible path towards restoring the lost value of the profession.” He suggested that solutions could include the creation of new jobs and a responsible multi-year approach to restoring doctors’ pay, arguing, “Those are solutions that mean we can build out our future workforce to end the current crisis, solutions which are very much within Government’s power.”
The BMA’s demands have not gone unnoticed by the government, but there is little sign of consensus. Streeting dismissed the union’s call for an additional 26 percent pay rise as unaffordable, particularly after what he described as a “large pay rise after Labour came into office in 2024.” He insisted, “I do not want to see a single day of industrial action in the NHS in 2026 and will be doing everything I can to make this a reality. My door remains open, as it always has done, and I’m determined to resume discussions with the BMA in the new year to put an end to these damaging cycles of disruption.”
Despite the back-and-forth, both sides appear to recognize the urgency of the situation and the damage caused by continued strikes. Dr Fletcher remarked, “There have been plenty of opportunities for strike action to have been avoided but all too often the Government has moved too little and too late. Nevertheless, the tone of the conversations we had at the eleventh hour before these strikes were cause for optimism that the Government is finally understanding the frustrations of resident doctors in England.” He added, “We are going into the new year with a renewed can-do spirit, and we hope Mr Streeting will do the same.”
As negotiations resume in both Scotland and England, the stakes could hardly be higher. Resident doctors represent nearly half of Scotland’s medical workforce and play a similarly critical role throughout the UK, often serving as the first responders in emergencies and managing heavy patient loads. Their demands for fair compensation and better working conditions are set against a backdrop of soaring NHS waiting lists, winter illnesses, and ongoing staff shortages—a perfect storm that has tested the resilience of the health service and the patience of its workforce.
With ballots, negotiations, and potential strikes looming, the coming months will be pivotal for the NHS, its staff, and the millions who rely on its care. The hope, shared by union leaders and government ministers alike, is that 2026 will bring less confrontation and more constructive dialogue—before the next crisis arrives.
