A five-day strike by 50,000 resident doctors in the National Health Service (NHS) in England begins Wednesday as planned. Resident doctors rejected new proposals from Labour government Health Secretary Wes Streeting, put to them by British Medical Association (BMA) leaders in a snap online poll last week.

The BMA announced the ballot result on Monday: a 65.34 percent turnout with an overwhelming 83.2 percent voting to strike between December 17 and 22. Streeting offered nothing regarding the central demands of resident doctors, who make up half of all hospital doctors in the NHS, including on pay restoration.

This week’s stoppage will be the 14th round of industrial action since March 2023, which started under the then Conservative government and has continued under Prime Minister Keir Starmer. The BMA agreed a deal with the incoming Labour government last September which failed to remedy pay erosion. The two-year deal of 22.3 percent over 2023-5 and the 5.4 percent for this year imposed by Streeting leaves resident doctors 21 percent worse off in real terms than in 2008, with those in their first year on hourly pay of just £18.62.

Streeting’s response to the deepening jobs crisis facing resident doctors is to expand specialty training places by just 4,000 over three years. These are not additional posts, but repurposed positions taken from locally employed doctors (LEDs). More than 20,000 applicants were excluded from training this year. The proposal included a divisive pledge to prioritise UK graduates over international medical graduates through emergency legislation, pitting doctor against doctor.

The sole purpose of tabling the offer was to allow Streeting to posture as a reasonable figure seeking to avert industrial action amid a surge of winter flu patients swamping hospitals. This was done to scapegoat resident doctors for the collapse in patient care, when decades of underfunding, understaffing and marketisation are the real cause of unsafe conditions.

Streeting demanded that all strike action be suspended and his terms accepted. Rejection would result in withdrawal of the few crumbs he offered.

Prime Minister Keir Starmer intervened last Friday to denounce resident doctors as “reckless”, demanding the strike was cancelled in an opinion piece in the Guardian. Streeting used an article in the Times to declare, “Christmas strikes could be the Jenga piece that collapses the tower”. Under conditions where an average 2,660 hospital beds were taken up by flu patients last week, up 42 percent on last year, not treating patients was “inexcusable” wrote Streeting.

However, Medical Director for the NHS in London, Chris Streather, said the flu situation was “well within the boundaries” of what the NHS could cope with.

The BMA were obliged to criticise the Labour government’s “scaremongering” over the scheduled action, with cover provided by senior doctors. But this avoided what needed stating bluntly: that it is the Starmer government that poses the real and immediate threat to the NHS. To do so would raise the need for a broader strategy to oppose Labour’s budget cuts, dismantling and privatisation.

The overwhelming rejection of Streeting’s deal is an indictment of the BMA Resident Doctors Committee (RDC), which had no basis for putting it before their members. RDC chair Dr. Jack Fletcher had even admitted that there was nothing in the offer on pay or new jobs. Seeking a climbdown and knowing that to call off the strike themselves would have been political suicide, the leadership hoped a snap poll would achieve the same result.

Fletcher claimed previous strikes had been critical in “moving the needle” and that the government was responding to resident doctors’ concerns. This was an attempt by BMA leaders to shift the responsibility for their own capitulation onto members, claiming that it was up to them to decide if a rotten deal was “sufficient”.

As soon as it was rejected, Fletcher immediately offered Streeting the RDC’s continued services. “This week’s strike is still entirely avoidable,” he declared, pledging to work with the health secretary to find a “credible offer.”

Yet again the RDC is restricting the number of picket lines at hospitals this week to a bare minimum, just as they did in November and previously, with only 16 advertised by the BMA out of 700 hospitals in England. This isolates resident doctors from the wider support they could mobilise among NHS colleagues and the working class.

The rejection of Streeting’s deal vindicates the call made by NHS FightBack for a No vote. It underscores the need to take the dispute out of the hands of the BMA apparatus by the rank and file. The attack on resident doctors is inseparable from Labour’s wider agenda to gut health and social spending to ramp up military spending, and restrict industrial action and protests in the name of the national interest.

The Starmer government is accelerating NHS privatisation, using waiting lists to justify expanded outsourcing, including £2.5 billion to private providers from January for an extra million treatments a year. Rachel Reeves’ November budget confirmed that Labour’s “10 Year Health Plan” will revive the Private Finance Initiative in all but name, to construct 250 “Neighbourhood Health Centres” through a partnership with the private sector.

At the same time, Labour has accepted a US-driven drug pricing agreement draining £1–3 billion from NHS budgets over three years, which will result in an estimated more than 15,000 avoidable deaths annually. Yet full pay restoration for resident doctors—costing just £1.7 billion—is dismissed as “unaffordable,” exposing the lie that there is a shortage of money. The real issue is breaking from the priorities dictated by finance capital, private healthcare corporations and militarism.

Resident doctors are in the frontline of the struggle against a Labour government enforcing austerity and privatisation, requiring the unification of all NHS workers in defence of a publicly funded health service. The next step in that struggle should be the formation of rank-and-file committees in every hospital and department to coordinate action across regions and professions and link the fight for pay restoration with opposition to privatisation, job cuts and unsafe workloads.

NHS FightBack calls on doctors and all health workers to contact us for a discussion on organising that counter-offensive.