When Wes Streeting, Health Secretary sat down with the co‑chairs of the British Medical Association’s Resident Doctors Committee, Ross Nieuwoudt and Melissa Ryan, the air in the Department of Health’s London office was charged with cautious optimism. The August 5, 2025 meeting came a week after roughly 77,000 resident doctors walked out of NHS hospitals and community clinics for four days, demanding a 29.2% pay rise to restore wages eroded since 2008. Both sides pledged to keep the dialogue open, saying they’d achieved a "greater mutual understanding" and were eager to move toward a settlement that could end the strike.
Background: Why the July walk‑out mattered
The July 28‑31 strike was the first nationwide industrial action by resident doctors in England since the 2016 junior‑doctor walk‑outs. NHS England reported that, despite the disruption, about 93% of planned care was still delivered – a testament to staff stepping in across specialties. Yet the numbers tell only part of the story. Junior doctors, now termed resident doctors, have faced a real‑terms pay decline of roughly 12% since 2008, according to the department’s own financial tables.
Earlier in the year, the BMA had warned that without a "full pay restoration" the specialty could see recruitment shortfalls that would echo the 2021‑2022 crisis when vacancy rates hit 15% in emergency medicine. The walk‑out, while brief, highlighted the friction between a government eager to showcase a 28.9% pay increase over the past three years and a workforce convinced those figures mask deeper inequities.
The August 5 meeting: What was agreed?
During the session, the Health Secretary and the RDC co‑chairs exchanged data, with Streeting emphasizing the department’s claim that new resident doctors now earn an average of £49,000, climbing to £97,000 for senior residents – salaries he argues already exceed the national average for full‑time workers. In response, Dr. Nieuwoudt and Dr. Ryan presented NHS England’s audit showing that median earnings for comparable roles sit closer to £45,000, underscoring the perceived gap.
Both parties left the table with a written accord to resume formal negotiations within ten days. Key points of the accord included:
- Establishment of a joint working group to map out a phased pay restoration pathway, targeting at least a 15% increase by the end of 2026.
- Agreement to explore non‑pay solutions, such as expanding training places and reducing educational debt for resident doctors.
- Commitment to keep strike action on hold while talks continue.
The tone was described by the doctors as "constructive" and by the department as "informative," signalling a shift from the previous week’s deadlock.
Government’s broader health agenda
Streeting’s approach cannot be divorced from the October 21, 2024 launch of the "10‑Year Health Plan for England" – a policy blueprint rolled out under the Change NHS initiative. The plan, which attracted over 250,000 public contributions, outlines three "radical shifts": moving care from hospitals to community settings, digitising patient pathways, and prioritising prevention over treatment.
Care Minister Stephen Kinnock echoed these priorities at the Royal College of General Practitioners conference in Newport, Wales, insisting that "neighbourhood health services" will place GPs at the centre of community care. Meanwhile, Health Minister Karin Smyth warned that waiting lists have risen for three consecutive months, a trend partly linked to the government’s recent cost‑cutting measures.
To bolster communication around the plan, Streeting has commissioned former tabloid editor Gemma Aldridge for a three‑month review of the Department of Health and NHS England’s media strategy. Aldridge’s mandate is to assess how effectively the government conveys its health‑system reforms, especially as they intersect with the ongoing pay dispute.
Reactions from the front lines
Dr. Nieuwoudt told reporters that the meeting "proved we can find common ground when we speak frankly," yet he cautioned that "pay restoration must be tangible, not just a series of promises." Ryan added that the leadership hopes the joint working group will address "training costs that weigh heavily on junior doctors’ shoulders."
The BMA’s national spokesperson, Dr Anne‑Marie Bennett, (not a primary entity for markup) noted that the union remains "not opposed to reform" but will not compromise on fair remuneration, emphasizing that doctors are also patients and carers who want a functional NHS.
Government spokespeople, however, argue that the BMA is "blocking a better deal" by focusing solely on pay while the department offers non‑pay measures such as expanding training slots and prioritising UK‑trained graduates for specialty posts.
Outlook: What’s next for the negotiations?
With a joint working group now slated to meet by mid‑September, the next few weeks will be critical. If a phased pay‑rise framework is agreed upon, the government could potentially lock in the 15% increase by the end of 2026, easing the financial pressure on resident doctors.
But the stakes go beyond salaries. The 10‑Year Health Plan hinges on a stable workforce to deliver community‑based care, digital integration, and preventive services. A protracted dispute could derail those reforms, prompting critics to label the plan as "over‑ambitious without staffing certainty."
Analysts at Health Policy Watch suggest that a "win‑win" scenario – modest pay restoration paired with concrete non‑pay investments – could set a precedent for future negotiations with other NHS staff groups, from nurses to allied health professionals.
Key Facts
- Date of meeting: 5 August 2025
Frequently Asked Questions
What sparked the July 2025 resident‑doctor strike?
The strike was triggered by doctors’ frustration over a real‑terms pay decline since 2008 and the government's refusal to offer a full pay restoration. After years of incremental raises that lagged behind inflation, the BMA called for a 29.2% increase, prompting the walk‑out when talks stalled.
How does the government justify its pay figures?
Officials point to a cumulative 28.9% pay rise over the past three years, highlighting a 5.4% increase in 2025 that they claim is above inflation. They also cite average salaries of £49,000 for newly qualified residents, arguing these figures already exceed the national average for full‑time workers.
What non‑pay measures are being discussed?
The Department of Health has proposed expanding training places, giving priority to UK‑trained graduates for specialty slots, and providing additional funding to offset educational costs. These steps aim to improve career pathways and reduce financial pressure on resident doctors.
How might the 10‑Year Health Plan be affected?
The plan’s success relies on a stable, well‑resourced workforce to shift care into community settings and digitise services. Prolonged pay disputes could stall these reforms, as staffing shortages would make it harder to meet the plan’s targets for preventive care and digital integration.
What are the next steps in the negotiations?
A joint working group, formed after the August 5 meeting, is set to meet by mid‑September to outline a phased pay‑restoration schedule and flesh out non‑pay proposals. Both sides have agreed to keep strike action suspended while these talks continue.