England is bracing for a significant upheaval in its healthcare system as resident doctors prepare to embark on a five-day strike starting Friday, July 25, 2025. The British Medical Association (BMA) has confirmed that the industrial action will proceed after talks with the government failed to yield a satisfactory resolution, particularly over pay disputes that have simmered for years.
Over 50,000 resident doctors, the term now used in place of "junior doctors" to better reflect their expertise and responsibilities, voted overwhelmingly in favor of the strike. Their central demand is a 29% pay rise, which they argue is necessary to restore wages eroded by inflation since 2008. Despite recent pay increases totaling 28.9% over the past three years, the BMA insists these rises have not kept pace with the real cost of living, leaving doctors financially strained amid mounting student debt and training costs.
The dispute has been marked by intense negotiations between the BMA and Health Secretary Wes Streeting. After five days of talks focused on improving working conditions, the government maintained that further pay rises were off the table, offering instead non-pay-related concessions such as covering mandatory exam fees, providing doctors with more control over placements during their initial training years, and speeding up career progression. However, the BMA co-chairs, Dr Melissa Ryan and Dr Ross Nieuwoudt, expressed deep dissatisfaction with these proposals.
"We have always said that no doctor wants to strike and all it would take to avoid it is a credible path to pay restoration offered by the government," said Ryan and Nieuwoudt. "Unfortunately, we did not receive an offer that would meet the scale of those challenges. While we were happy to discuss non-pay issues that affect doctors' finances, we have always been upfront that this is at its core a pay dispute." They emphasized that more than a fifth of resident doctors' pay has been eroded since 2008, and the simplest way to address this is through a meaningful pay increase.
Health Secretary Wes Streeting, meanwhile, has condemned the decision to strike as "reckless and needless," accusing the BMA of demonstrating "complete disdain for patients and the wider recovery of the NHS." He pointed to the substantial pay rises resident doctors have already received, noting that they have had the highest pay increases in the public sector for two consecutive years. Streeting argued that the strike action was "completely unjustified" and "unprecedented in the history of British trade unionism."
He further criticized the union for rejecting offers that included new roles to accelerate career progression and financial support for mandatory exams and rota adjustments. A government source described the BMA leadership as exhibiting "weak leadership" and being "unable to control the committee," suggesting the union had misled officials into believing a deal was possible.
The strike, scheduled to begin at 7am on July 25 and last until 7am on July 30, is the first national industrial action by a healthcare union under a Labour government since the winter of discontent in 1979. It comes amid growing public opposition, with recent polling showing 52% of the public against the strikes, and 75% opposition among those over 65 — the demographic most reliant on NHS services.
Adding to the complexity, tensions have escalated between the BMA and NHS leadership over patient safety concerns during the strike. NHS England, under new chief executive Sir Jim Mackey, has instructed hospitals to minimize cancellations of appointments and operations, especially for urgent cases such as cancer treatments and transplant surgeries. This approach contrasts with previous strikes in 2023 and 2024, where non-urgent work was widely canceled to allow senior doctors to cover emergency services.
The BMA has voiced strong opposition to this plan, warning that attempting to maintain routine services will overstretch consultants providing cover for striking resident doctors, potentially risking patient safety. BMA deputy leader Dr Emma Runswick highlighted that senior doctors "cannot physically be in two places at once," warning that the new strategy could lead to "last minute cancellations" and potentially harm patients. She advocated for the majority of planned care to be rescheduled, as was done in past strikes.
Financial considerations around strike cover have also stirred debate. The BMA has suggested that consultants be compensated at rates exceeding £300 an hour for night shifts during the strike. Dr Runswick defended this stance, noting that the NHS sometimes needs to "incentivise" doctors to provide cover outside their normal working hours. However, NHS Providers, representing hospitals, has urged consultants to accept standard NHS pay rates to avoid unsustainable costs.
Daniel Elkeles, chief executive of NHS Providers, described the strike decision as "a crushing blow for patients and for the NHS." He urged resident doctors to notify hospitals of their strike plans to help minimize disruption, especially for critical services such as cancer, transplant, and maternity care. Rachel Power, chief executive of the Patients Association, expressed grave concern over the strike's impact, stating, "Unacceptable delays and barriers to accessing the care patients need have been the reality for years. This latest strike adds even more uncertainty for people who are waiting in pain, with anxiety, and without answers, and will leave more patients vulnerable and unsupported as their health and wellbeing deteriorates."
As the strike looms, NHS England's co-national medical director, Prof Meghana Pandit, acknowledged the challenges ahead. She urged the public to continue seeking care when needed, using services like the 111 online platform for non-life-threatening issues and calling 999 in emergencies. "Local services are working extremely hard to minimise the impact for patients, as they always do, but some disruption to services is inevitable," she said.
The upcoming strike highlights the ongoing struggle within the NHS to balance fair compensation and working conditions for its staff with the imperative to provide uninterrupted patient care. With both sides standing firm, the coming days will test the resilience of England's healthcare system and the resolve of its medical professionals.
