Intended for healthcare professionals


Junior doctors begin four day strike

BMJ 2023 ; 381 doi: (Published 11 April 2023) Cite this as: BMJ 2023;381:p820
  1. Abi Rimmer
  1. The BMJ

Junior doctors in England have begun four days of strike action, with union leaders continuing to call on the health secretary to put a “credible” pay offer on the table.

Trainees in England are undertaking a 96 hour walkout that started at 6 59 am on Tuesday 11 April and will end at 6 59 am on Saturday 15 April.

In a statement the health and social care secretary for England, Steve Barclay, expressed disappointment at the action. He said he had hoped to begin formal pay negotiations with the BMA last month but that its demand for a 35% pay rise was “unreasonable” and would result in some junior doctors receiving a pay rise of more than £20 000.

The BMA has calculated that pay awards for junior doctors in England from 2008-09 to 2021-22 have delivered a pay cut in real terms of 26.1%. The union has said that to achieve pay restoration by reversing this cut a 35.3% pay uplift would be needed. 1

Barclay said that confidential talks on pay could resume only if the BMA were willing to move significantly from this position and cancel strikes.

In response the BMA Junior Doctors Committee co-chair Vivek Trivedi said that the union had been “knocking on the health secretary’s door” asking to meet for negotiations. “His decision to refuse to table a credible offer—indeed he has not tabled a single offer so far—means that this action is solely due to this government’s repeated inaction,” said Trivedi. “We would still be willing to suspend strike action this week if the secretary of state makes a credible offer that can be the basis of negotiation.”

Taking to Twitter, the junior doctor Elle-Louise Morris said she would be striking this week because she is worried about the future of the NHS. “If we cannot retain staff, the NHS won’t be able to continue. I spend a lot of time thinking about changing jobs, despite loving my work, as the pay doesn’t match the responsibility.” 2

The BMA has said that more than a decade of real terms pay cuts meant that newly qualified doctors now earn £14.09 an hour. 3

Foundation trainee Eilidh Garrett, who started working as a doctor in July, said on Twitter that before medical school she had worked as a medical secretary and was paid more in that role than she is now. “Do I deserve to start on £14 [an hour]? To be paid less than I was as a medical secretary? To be paid less than a doctor 10 years ago? I think not,” she tweeted. 4

Ben Hockenhull, a consultant paediatric and adult anaesthetist, tweeted that he would be covering for junior doctors who were striking. “The fact that an FY1 [first year foundation trainee] now gets paid virtually the same as I did 14 years ago, with massively increased student debt and practice costs, is ridiculous,” he said. 5

He added that all grades of doctor, in both primary and secondary care, had seen “a degradation of pay and conditions over the course of my career.” 6


Matthew Taylor, chief executive of the NHS Confederation, said that the four day strike was expected to cause much disruption to frontline services so that urgent and emergency care could be prioritised. “Health leaders understand why junior doctors feel they have no choice but to take part in these latest walkouts, but they are disappointed to be in this worrying situation where patients will have to wait longer for care and where basic safety will be compromised,” he said.

“As we’ve seen with other forms of industrial action, a period of negotiation is likely to happen eventually—it’s just a question of when and how much damage will be caused along the way. Health leaders want both sides to do everything within their power to find some common ground as soon as possible.”

The NHS’s national medical director, Stephen Powis, said he was very concerned about the potential severity of the strike’s effects on patients and services across the country. “This time the action immediately follows a four day bank holiday weekend, which is already difficult as many staff are taking much needed holiday, and it will be more extensive than ever before—with hospitals facing nearly 100 hours without up to half of the NHS medical workforce,” he said.

“This week we will continue to prioritise emergency, critical, and neonatal care, as well as maternity and trauma services, but it inevitably means that hundreds of thousands of appointments will need to be postponed again, including in cancer care, and there is likely to be a significant impact on a range of local services.”