Friday briefing: Inside the dispute driving resident doctors back to the picket line
Good morning. Earlier this week, my colleague Karen McVeigh asked readers to send in suggestions for topics they’d like First Edition to cover, and straight into our inbox were several people asking about the upcoming doctors’ strike in England. Reader Fay asked: “I would like to see more about the coming strike and what it will mean for the NHS. With waiting lists so long and the likely impact on patients, what are the doctors’ justifications?” Lo and behold, that is the focus of today’s newsletter. I spoke to Denis Campbell, the Guardian’s health policy editor, about all of that, the political implications of the strike for the health secretary, Wes Streeting, and the government, and what a resolution might look like. But first, here are this morning’s headlines. Five big stories Politics | Rachel Reeves is set to abandon a plan to raise income tax in her budget with the chancellor reportedly “ripping up” the main measures in the wake of a week of extraordinary briefing wars in the party. US politics | Donald Trump is facing the prospect of a politically damaging congressional vote on releasing the Jeffery Epstein files after attempts to press two female members of Congress to withdraw their backing for it appeared to have failed. Economy | Hundreds of thousands of homeowners will lose their right to subsidies for eco-friendly heat pumps as a result of government plans to bring down energy bills at the budget. Cop30 | A row over the definition of the term “gender” threatens to bog down pivotal talks at the Cop30 climate summit. Before the UN talks in Brazil, hardline conservative states have pushed to define gender as “biological sex” over their concerns trans and non-binary people could be included in a major plan to ensure climate action addresses gender inequality and empowers women. UK news | Services in Surrey failed to identify that Sara Sharif was at risk of abuse, did not question unexplained bruising, and staff members visited the wrong address the day before her murder, a review has found. In depth: ‘I cannot see any resolution coming any time soon’
First off, this is not a new dispute. It began back in March 2023, when you would have heard it referred to as the junior doctors’ strike. They have since had a rebrand, and are now known as resident doctors. “There was a feeling,” Denis Campbell says, “that the name junior doctors did not really reflect the variety and sometimes seniority of the role.” *** What do resident doctors in England do? “While technically still in training, and below the level of consultant, resident doctors range from relatively freshly qualified doctors to some actually very experienced doctors who’ve got 13-14 years’ experience at the coalface of the NHS, treating patients in quite often senior roles,” Denis tells me. You are most likely to encounter them at outpatient appointments, making your diagnosis, or agreeing your pathway of care and treatment. “To a large extent they are the backbone of the NHS,” he says. *** Why are they going on strike? There have been nearly 50 days of stoppages since March 2023, initially over pay. “Resident doctors are very concerned that their incomes have been eroded significantly since 2008 by inflation and years of minimal pay rises,” Denis says. They originally sought a 35% increase, but have so far received just under 29% over three years. The British Medical Association (BMA) is now seeking a further 26% over the next few years, calling it “full pay restoration” – taking salaries back to their 2008 real-terms value. This chart (below) shows how the BMA views the erosion of pay in real terms. As they put it, “resident doctors are still working more than a fifth of their time for free” compared with 2008.
But, Denis says, there is a new complication for the government. “The BMA has now made the dispute about a second matter: that many thousands of resident doctors are finding it impossible to get a place to start training in the medical specialty of their choosing, whatever it might be,” he says. “There is a real bottleneck in the availability of places. Early-career doctors are reaching the point when they’ve done their general training while moving around hospitals in England. They are now ready to start training to be a specialist, the way most doctors are, but are finding that pathway blocked. “This is a problem that has been building up, and is a new, very complicating factor in the strike because it’s now a pay-and-jobs dispute. And both of these issues are very, very hard to deal with. There is no magic wand for the government to wave to solve either problem.” *** What has been the impact on patients and waiting lists? Now we come to Fay’s question. Of course, doctors on strike don’t just down tools and let people die. “It’s not that during strikes, 100% of resident doctors refuse to work. Many of them do so. But there is a significant impact on hospitals,” Denis explains. Across 12 walkouts so far, more than a million NHS appointments in England have been cancelled – mostly outpatient visits and some planned surgery. Consultants are drafted in to “act down”, Denis says, covering junior colleagues’ roles. Wes Streeting claimed during the last strike that the actual impact on patients was being minimised, and has urged the NHS to keep more planned care running, saying the health service “can’t put life on hold” during industrial action. Denis says that reflects the minister’s view that the strikes have become “a new normal” the NHS must endure until the dispute ends. *** Why is Streeting being so rude about the BMA? At a conference in Manchester this week, Streeting accused the BMA of “cartel-like behaviour”, saying its pay demands were “completely unreasonable” after doctors received almost 29% in rises over the past three years. He warned that ministers wouldn’t be “held to ransom” and went as far as to describe them as a threat to the NHS. Denis says the remarks “raised the temperature of what was already a pretty fractious dispute”. The strike is politically awkward for Streeting and the government. We may be many decades on from the industrial disputes of the 1970s, but the language in the rightwing and tabloid press of “greedy union barons” and Labour kowtowing to their “paymasters” every time they settle a dispute persists in 2025. Streeting was also, in opposition, scathing of the Conservative administration’s inability to resolve the dispute. “Streeting sort of gave the impression that the reason the Tories didn’t get the dispute resolved was an unwillingness to engage and a lack of effort on their part,” Denis says. “But actually, since Labour got in, they have put resident doctors’ pay up by the sort of rise that almost anyone else in the public sector would kill for. But he’s found he is up against a very implacable, energised and determined group of vital, valuable, important public sector workers.” *** What is the most likely resolution? I asked Denis whether he saw a resolution in the offing, and his reply was pretty downbeat. “We may quite realistically end up with strikes every month from the new year onwards,” he says. “Having spoken to people on both sides regularly and at length, I cannot see any resolution coming any time soon. “Streeting seems to be banking on enthusiasm for the strike waning due to it costing doctors money each time they don’t work, and public opinion turning against the strikers – and hoping the dispute will eventually fizzle out,” Denis says. “I have to tell him that, from having spoken to a number of people in the BMA this week, I think that is highly unlikely to happen. The doctors seem determined to just keep on going and going until they get full pay restoration. That’s what they want. They’re determined to get it. I think their plan, as far as I understand it, is to keep on striking until they do.” What else we’ve been reading
Victor Raison speaks to farmers from Port-au-Prince, Haiti, about how gang warfare and the climate crisis – which together have displaced more than 1.4 million people to camps and the surrounding hillsides – are leading to environmental degradation and affecting the country’s landscape. Karen I long ago gave up caring how people pronounce my surname, not least because even my own extended family don’t agree on it. Emma Russell has a lovely piece talking to people with unusual names. Martin Bee-lamb or Bell-umm Adam Gabbatt looks at the growing use of AI-generated campaign videos, such as Andrew Cuomo’s misleading ad targeting Zohran Mamdani in the New York mayoral contest and why they might be here to stay. Karen I still very much miss seeing the Fall live. In Far Out, Ben Forrest looks at how Mark E Smith always remained firmly anchored to his Prestwich roots. Martin This special visual report categorises those who favour Reform into five groups, from working right to squeezed stewards to reluctant reformers, in a set of charts. By Guardian visual projects team, Ana Lucía González Paz and Ashley Kirk, based on the largest poll of supporters yet, from Hope Not Hate. Karen Sport
Football | Goals from Bukayo Saka and Eberechi Eze secured a 2-0 victory for England against Serbia at Wembley. Cricket | England captain Ben Stokes announced his readiness for the Ashes with six wickets on the first day of their in-house warm-up game. Cricket | The 18 first-class counties have been criticised by the England and Wales Cricket Board for failing to make any progress in increasing the ethnic and gender diversity of their senior leadership. Something for the weekend Our critics’ roundup of the best things to watch, read, play and listen to right now
TV The Beast in Me (Netflix) | ★★★★★ Even without two astonishing performances from the lead actors – Claire Danes and Matthew Rhys – the script, the sheer style and confidence of it all would be things of beauty. But add what that pair are doing, and this clever, taut eight-part psychological thriller moves seamlessly into top-tier television. They spark off each other through beautifully written scenes designed to immerse you in the world of two people discovering what it means to find someone who truly sees you and accepts you in your entirety, and how much of them you will accept in return. It is, they are, absolutely wonderful to watch. Awards will surely be given, and in the meantime you cannot look away. Lucy Mangan Film The Running Man | ★★★☆☆ Edgar Wright, that unstoppable force for good in cinema, has revived the sci-fi thriller satire last seen in 1987 with Arnold Schwarzenegger; it now stars Glen Powell and is adapted directly from the original 1982 novel written by Stephen King under his “Richard Bachman” pen-name. Powell plays Ben, an honest, hardworking guy who desperately needs cash to buy medicine for his sick daughter. In despair, Ben signs up for a top-rated reality TV show called The Running Man; he has to go on the run across the US, hunted by professional killers, and if he can survive for 30 days, he gets a billion dollars. The resulting film is never anything but likable and fun – though never actually disturbing in the way that it’s surely supposed to be. Peter Bradshaw Music Celeste: Woman of Faces | ★★★★☆ It’s far from a fanbase-confounding left turn – a Metal Machine Music for the jazz-inflected pop-soul set – but nor is Woman of Faces hugely commercial. Its sound manages to be both sumptuous and stark. Its opulence results from its orchestrations and modern classical flourishes. But there’s something austere about it, too. Its emotional tone is sombre; songs deal with the societal pressures placed on women and the deleterious effect of technology on our lives, and the overwhelming theme is the fallout from a broken relationship. Every song is individually stunning – excerpted on a playlist, they would stop you dead in your tracks. In that sense, at least, Woman of Faces feels like a thoroughly modern pop album. Alexis Petridis Podcast IMO: The Look This new spin-off of Michelle Obama’s IMO podcast coincides with the launch of a coffee-table tome about her fashion evolution. It’s a highly polished affair (aren’t all things Obama?), with guests including former Teen Vogue editor Elaine Welteroth and Jane Fonda. Like the woman herself, though, it also offers substance alongside its style, revealing much about the pressures she faced as the first Black woman to reside in the White House. Hannah J Davies The front pages
“BBC apologises to Trump over Panorama but rejects £1bn claim” says the Guardian. The Telegraph smells more blood: “Second Trump clip doctored by BBC”. “84 in … 113 out” – the Metro keeps tabs on “Starmer’s asylum swaps with France so far” while the i paper has “UK to unveil stricter new ‘Denmark-style’ laws for migrants”. The Daily Mail splashes on “Fear of being seen as racist contributed to failures that doomed tragic Sara” while the Express has “Sara failed by officials ‘afraid to cause offence’” – both headlines refer to the murder of Sara Sharif. “Andrew ‘knew Epstein abused girls’” says the Daily Mirror. The Times runs with “Five days of NHS strikes opposed by most doctors”. Today in Focus
The surprising truth about Reform voters The biggest survey of Reform voters to date reveals unexpected views. Aditya Chakrabortty reports Cartoon of the day | Ben Jennings
The Upside A bit of good news to remind you that the world’s not all bad
It gave us Mike Leigh’s acerbic and acclaimed comedy drama Abigail’s Party and the gritty Liverpudlian series The Black Stuff. Now the revered BBC strand Play for Today, which ran on the BBC’s main channel and was watched by millions in the 1970s and 1980s, is back, writes Mark Lawson. He celebrates its award-winning hits and the new writers it introduced, including David Hare and Stephen Poliakoff. The new Channel 5 version will be a very different beast: less overtly political and not limited to one-off dramas. Four new plays, starting on 13 November, count women among their writers. The opener, Never Too Late (pictured above), stars Anita Dobson and Nigel Havers, and includes a plot twist that Lawson believes has the potential for a full series. Sign up here for a weekly roundup of The Upside, sent to you every Sunday Bored at work? And finally, the Guardian’s puzzles are here to keep you entertained throughout the day. Until tomorrow. Quick crossword Cryptic crossword Wordiply