Resident Doctors: Industrial Action

Monday 15th December 2025 Lords Chamber

Statement

19:30

The following Statement was made in the House of Commons on Wednesday 10 December.

“With permission, Madam Speaker Deputy, I shall make a Statement on industrial action by resident doctors. I thank you, Mr Speaker, business managers and the Official Opposition for facilitating this evening’s statement.

As we head into winter, our hospitals are running hot and the pressures on the NHS are enormous. Flu season has come earlier, with a sharp rise in cases and the peak still to come, and this year’s strain is more likely to affect older people more severely. Already, the number of patients in hospital in England with flu is the highest on record at this point in the year. It is 50% higher than this time last year and 10 times higher than in 2023. Some 95% of hospital beds are occupied, growing numbers of staff are off sick and we are already seeing the pressure in our A&E departments. It is against that backdrop that the British Medical Association is threatening to douse the NHS in petrol, light a match and march its members out on strike. This represents a different magnitude of risk to previous industrial action.

The BMA resident doctors committee is in dispute on two issues: pay and jobs. On pay, resident doctors have already received a 28.9% pay rise—the highest in the public sector. For a first-year resident doctor, that is the equivalent of a £9,400 pay rise. I have been consistent, honest and up front with resident doctors that we cannot go further on pay this year. There is a gap between what the BMA is demanding and what the country can afford. Nor would further movement on pay be fair to other NHS staff, for whom I am also responsible and many of whom will never in their careers earn as much as the lowest-paid doctor. As I have made clear to the BMA and other trade unions, I am open to discussing multi-year pay deals with any trade union if we stand a chance of bridging the gap between affordability and expectations.

On jobs, I have much more sympathy with the BMA’s demands. I have heard the very real fears that resident doctors across the country have about their futures; it is a legitimate grievance that I agree with. My Conservative predecessors created training bottlenecks that threatened to leave huge numbers of resident doctors without a job. In 2019, there were around 12,000 applicants for 9,000 specialty training places. This year, that number has soared to nearly 40,000 applications for 10,000 places.

It used to be the case that UK graduates competed among themselves for specialty roles; now, they are competing against the world’s doctors. That is a direct result of the visa and immigration changes made by the previous Conservative Government post-Brexit, and it is compounded by the Conservatives’ decision to increase the number of medical students without also increasing the number of specialty training places.

Taxpayers spend £4 billion training medics every year—we then treat them poorly, and some leave to work abroad or in the private sector. It is time that we protect our investment and give bright, hard-working UK medical graduates a path to becoming the next generation of NHS doctors. Our 10-year plan for health set out our commitment to provide that path. It pledged to introduce 1,000 extra specialty training places and prioritisation of medical graduates from the UK and Ireland.

Today, in an offer to resident doctors, I can announce that I am able to go further. I want to thank Sir Jim Mackey, the chief executive of the NHS, and his team, who have been going trust by trust to see how many extra places can be funded and are needed. Thanks to their hard work, I am in a position today to be able to offer 4,000 specialty places for resident doctors, starting with an additional 1,000 for those applying this year.

In the Department of Health and Social Care, we have been working intensively on UK graduate prioritisation. The barriers have been legal ones, so I have been working intensively with my team to see how quickly we could introduce legislation. Thanks to their efforts, the co-operation of colleagues across government, and my counterparts in Wales, Scotland and Northern Ireland, I can notify the House tonight that, subject to the agreement of resident doctors, we intend to introduce urgent primary legislation in the form of a Bill to be presented to Parliament in the new year.

The legislation will prioritise graduates from UK medical schools over applicants from overseas during the current application round and in all subsequent years. The reforms will also prioritise doctors who have worked in the NHS for a significant period for specialty training. This will not exclude international talent, who will still be able to apply to roles and continue to bring new and vital skills to our NHS, but it will return us to the fair terms on which homegrown medics competed before Brexit. The impact of these changes is that instead of four doctors competing for every training post, it will now be fewer than two doctors for every place. That is a good deal for doctors.

Following discussions with the BMA, we are also addressing the specific costs faced by resident doctors that do not apply to other NHS staff. Although I cannot go further on pay this year, I am able to offer today to put money back in resident doctors’ pockets by reimbursing royal college portfolio, membership and exam fees, with the latter backdated to April. The allowance for less-than-full-time resident doctors—many of whom are parents and carers—will be increased by 50% to £1,500, helping to close the gender pay gap.

In recent days, I formally made this offer to the BMA resident doctors committee. The BMA will now survey its members in the coming days on whether to accept this offer and end its dispute with the Government. The BMA told us that it will survey its members quickly and give us less than 48 hours’ notice of whether the strikes are going ahead. That presents serious operational challenges for NHS leaders, who need certainty now as to whether they are cancelling patient appointments and cancelling staff annual leave to cover strikes.

In my determination to prevent the havoc that strikes would cause this Christmas, I therefore made one more offer to the BMA, which I will now share with the House, the country and front-line doctors. So that the BMA could run a genuine ballot of its members and call off next week’s strikes while that ballot ran, I offered to extend its strike mandate. This would have allowed enough time for the BMA to reschedule next week’s strikes for the end of January, were the offer to resident doctors rejected in a ballot. It would have avoided the chaos that looming strike action threatens at the most dangerous time of year by removing the spectre of strikes next week. I knew that extending the BMA’s strike mandate would leave me open to attack from political opponents; that was a risk I was willing to take to stop the Christmas strikes going ahead. Madam Deputy Speaker, I must report to the House that the BMA’s leadership said no.

In the coming days, as the NHS prepares for strike action that may or may not happen, there are patients whose operations will be cancelled. There are NHS staff who will have to tell their families that they will not be home for Christmas because they have to cover for their resident doctor colleagues. This was entirely avoidable—no one should be in any doubt that the BMA has chosen to play politics with people’s lives this Christmas, and to continue holding the spectre of strikes over the NHS. I ask resident doctors to bear that in mind when they cast their votes.

The power to end these strikes now lies in the hands of doctors. Resident doctors face a choice: to continue the damaging industrial action in which everyone loses, or to choose more jobs, better career progression, more money in their pockets and an end to strikes. The deal that is on offer would mean emergency legislation to put our own homegrown talent first; to increase the number of extra specialty training places from 1,000 to 4,000, with a quarter of those places delivered now; to reduce the competition for training places from around four to one to less than two to one; to put more money in doctors’ pockets by funding royal college exam fees, portfolio fees and membership fees, with exam fees backdated to April; and to increase the less-than-full-time allowance by 50% to £1,500. It is a chance for a fresh start, to end this dispute and look ahead to the future with hope and optimism—a chance to rebuild resident doctors’ working conditions and rebuild our NHS. I urge every resident doctor to vote for this deal, and I commend this Statement to the House”.

[Lord Kamall (Con)]

My Lords, the announcement of further industrial action by resident doctors is obviously deeply concerning. These strikes, which we now know will go ahead after all, will have a serious impact on the capacity of our health service to function at precisely the time of year when demand is at its highest. Resident doctors make up almost half the medical workforce, and NHS leaders have already warned that action will cause significant disruption.

We on these Benches agree with the Secretary of State for Health and Social Care when he says that the BMA has clearly chosen to strike when it will cause maximum disruption, causing untold anxiety at the busiest point of the year. We agree with Rory Deighton, the acute and community care director of the NHS Confederation, who warned that, with the winter now upon us and rising levels of flu and staff sickness, pressure on services will be intense, with the likely consequence of

“thousands of cancelled appointments and operations”.

The impact of these strikes is compounded by the fact that NHS England has warned that it is bracing for an unprecedented flu wave this winter. In London alone, there are three times as many people hospitalised with flu compared to last year, with an average 259 hospital beds occupied each day, compared to just 89 a year ago. It is in this context that the CEO of the NHS described the BMA’s decision to strike in the run-up to Christmas as

“cruel and calculated to cause mayhem”.

There is a wider concern, shared by patients and families across the country. When the Government caved in to the BMA last year with an unconditional 29% pay settlement, noble Lords on all Benches warned that this would only incentivise the BMA to come back year after year with more demands. At the time, the Secretary of State brushed off these concerns and criticised those who raised this obvious observation, claiming that there would be no further strikes, no more cancellations and no more disruption. While we agree with the Health Secretary that this action by the BMA is cynical, strong words alone will not keep operating theatres open or ensure that patients receive their care in a timely manner. Appointments will still be postponed or cancelled, operations will be postponed and patients will suffer.

Now that the BMA membership has rejected the latest offer and is pressing ahead with further strikes, will the Minister lay out the Government’s plan? What additional resources have been made available to mitigate the serious disruption that these strikes will inflict? Given the combined pressures of flu and RSV, what steps are being taken to ensure that those who are eligible for vaccination actually receive it?

It appears that we are stuck in a downward spiral. Strikes are threatened, offers are rejected, strikes happen, misery is inflicted and then it is threatened all over again. If the Government do find a way of ending the threatened action, will they please do a couple of things? Will they make sure that it is conditional on updating work practices, to ensure that we have a more efficient health system? Many people who work in the health system know that some practices are out of date and have not moved on since the 1940s. Will they make sure that it does not incentivise the BMA to pocket any settlement and return next year threatening more strike action? The very uncertainty surrounding future militancy by the BMA is deeply damaging. It should be a matter of grave concern to the Government that the public seem not to have any confidence in the Government’s ability to keep doctors at work and keep the health service functioning.

As part of this, does the Minister recognise that the Government’s Employment Rights Bill risks making matters significantly worse next year? Will they think again about their rejection of minimum service levels to protect patients in the future? Finally, we know that the OBR has said that the cost of industrial action is a major risk to health spending. What estimate have the Government made of the cost of strike action in December, and will costs be paid using existing NHS budgets? As we know, the Chancellor often says there is no more money.

We are clear that these strikes must end and that the behaviour of the BMA is indefensible, but we must remember that it is not Ministers, unions or negotiators who will bear the cost of this action; it is patients and their families and loved ones. They deserve better. I am sorry to say that we are not yet convinced that the Government are on top of this and working to end the threat of these damaging strikes now and avoid incentivising future strikes in future years. I really hope that the Minister can reassure noble Lords that the Government have a plan.

[Lord Scriven (LD)]

My Lords, I thank the Minister for putting the Statement before us, but do so with a measure of frustration—a feeling shared by countless citizens. This frustration with the ongoing and deeply damaging resident doctors dispute is directed at both parties, the Government and the British Medical Association leadership. We are witnessing a breakdown in negotiation, a failure of common sense and, critically, a failure of duty towards the patients who rely on the National Health Service.

First, let me address the actions of the Government. The manner in which this dispute has been handled is, frankly, not best practice. We have seen periods of silence followed by 11th-hour media interventions by the Secretary of State. This pattern suggests not a serious negotiation but a high-stakes, last-minute political gamble, PR approach. The way the reported details of the last-minute offer were put before the public and resident doctors serves only to deepen this suspicion. This approach disrespects the process and the professionals involved. Given that the issues addressed in the Government’s 11th-hour offer have been known since the general election, why did the Government choose a high-stakes, last-minute intervention, rather than presenting the offer within a calm, realistic timeframe that could have facilitated constructive consideration by resident doctors?

Further, I must express my dismay at the tone sometimes employed by the Secretary of State. Using rhetoric that seeks to divide resident doctors from the public is counterproductive. This dispute will not be solved through grandstanding but through respect and meaningful compromise. The Government must reflect on their tone and timing.

However, the frustration I feel over the Government’s handling is matched in equal measure by my frustration over some of the tactics and demands employed by the BMA leadership. The pursuit of this round of strike action, especially scheduled at the most challenging time of the year, is, in my view, deeply irresponsible. The BMA has a singular responsibility that transcends typical union negotiations. Their members are the direct custodians of people’s health. We are currently grappling with two severe pressures on the NHS: the rising tide of flu and the deliberate scheduling of this strike to coincide with the Christmas period. To choose this time, when hospital rotas are already thin and the NHS is under maximum strain, is totally unacceptable. It shows a disregard for the welfare of the most vulnerable patients. We on these Benches wish to thank the consultants, those resident doctors who decide to go into work, and the other dedicated staff who will keep our NHS safe during this unnecessary strike, for doing the right and decent thing.

The core demand pushed by the BMA leadership is full pay restoration. While I acknowledge the significant financial pressures facing resident doctors, a demand for full restoration to a prior decade’s real-terms value is neither achievable nor reasonable in the present economic climate. By focusing the entire dispute on this single maximum pay demand, the BMA leadership is allowing the Government to ignore the far more crucial systematic issues that genuinely plague resident doctors and threaten the future of the NHS workforce.

This failure is a stain on both parties. The Government must return to the table with a genuine commitment to a multi-year funded plan that addresses the systematic non-pay issues, and the BMA leadership must immediately reassess the morality of its current strike schedule and shift its focus from an unrealistic pay demand to achievable reforms in training and conditions.

I have two further questions for the Minister. The recent offer included a promise to create up to 4,000 extra speciality training posts. However, the BMA leadership has claimed that these posts are simply being cannibalised or repurposed from existing locally employed roles. Will the Minister confirm categorically that these 4,000 places represent genuinely new, funded training opportunities that increase the total number of doctors retained in the NHS career structure and are not merely a reclassification of existing roles?

Given that the pay restoration demand is deemed unachievable, how will the Government—outside of pay—guarantee fundamental reforms to the working time directive enforcement, the quality of training rotations and the rota planning to ensure that resident doctors are used efficiently for patient care and for the development of their skills, thereby making a medical career in the NHS sustainable and attractive?

Our healthcare system cannot afford this deadlock. I urge both sides to put down their political weapons, swallow their pride and focus on the real-world issues before the consequences become truly tragic.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, the Government have made a comprehensive offer to resident doctors to resolve their disputes. I listened closely to the assessment of the Government’s performance made by the noble Lords, Lord Kamall and Lord Scriven, and it is not a reflection I agree with. This has dominated the agenda, and the Secretary of State has taken a proactive and collaborative approach with the BMA resident doctors committee. For example, he has had 18 meetings and seven phone calls with the BMA; he has sent 10 letters; and there have been dozens of meetings with officials.

I cannot recognise the suggestion of a hands-off, confrontational approach: the Secretary of State has consistently chosen to do everything he can, particularly to cancel the Christmas strikes, which are timed for the most damaging period of the year. The Secretary of State even went as far as to extend the BMA’s strike mandate, giving it time to call off strikes while it consulted its members and an option to rearrange if the offer was rejected. I am astounded that the BMA rejected the offer that was put before it. It was a comprehensive offer to resident doctors to resolve their disputes, providing those currently applying with more training job opportunities, prioritising UK-trained graduates, and it would have put money back in the pockets of resident doctors. Among a whole range of things that noble Lords have rightly acknowledged, the rejection of the offer means that NHS colleagues will be cancelling Christmas plans to cover shifts and patients will have their operations cancelled as the NHS prepares for the worst.

The noble Lord, Lord Kamall, asked: what happens next? In these circumstances, it is a very powerful question. The Government will consider our next steps, with our first priority being to deal with strikes. I reassure noble Lords that the focus of the department and the NHS will be on getting the health service through the double whammy—as has been well referenced by noble Lords—of flu and strikes. We have already vaccinated 17 million people, which is 170,000 more than last year; we will continue to work intensively with front-line leaders to prepare for the coming disruption.

On the offer, the BMA asked us to create more training places, which is what we would have done. The offer would have created 4,000 new speciality training posts for resident doctors over the next three years, with an additional 1,000 for this year. Under this deal, more doctors in non-training roles would have had the opportunity to progress their careers and become the consultants and GPs of the future we all want to see. Sadly, this offer is no longer on the table, thanks to the rejection by the BMA membership. That is why our focus has to be on dealing with strikes and getting through.

Our operational response is to mitigate the impact of any industrial action. We should acknowledge, as we have heard from the Front Benches, that flu rates are the highest they have been in the last five years for this time of year. I am sure that all noble Lords, while recognising legitimate concerns about access to training places, will remain concerned that an offer that would have made a real difference has been wholly rejected and strikes are going ahead. In response to the noble Lord, Lord Scriven, I do believe there was a way out and the BMA membership has chosen not to take it.

On the estimated cost of strike action, the July strikes cost the NHS around £250 million. If those costs repeat themselves for November and December, strike action will have cost around £750 million in this year alone. The cost of the five-day resident doctors’ strike in July could have paid for training for over 1,600 GPs over three years or 28,000 hip and knee replacements. But, again, the Government’s offer has been rejected so we will have to make our first priority dealing with the strikes.

Through the Employment Rights Bill, we want to create a positive and modern framework for trade union legislation; we want productive and constructive engagement; we want to respect the democratic mandate of unions; and we want to reset our industrial relations. For me, this sets us back considerably, sadly, and that has been clearly acknowledged. What do strikes do? They suck up time, resources and energy, and the costs for the NHS, as I have already stated, are around £250 million. While we have made a number of offers and acknowledged legitimate concerns, I do not believe that that has been treated in the way it should have been.

The noble Lord, Lord Scriven, asked about the 4,000 roles. That was in response to the BMA, which asked us to create more training roles, which was a fair request and exactly what we would have done. It would have created 4,000 new speciality training posts for resident doctors over the next three years, with an additional 1,000 this year. It would have meant more doctors in non-training roles having an opportunity to progress. But, as a Government, it is our duty to consider our next steps, and our first priority will be to deal with the strikes.

19:49

[Baroness McIntosh of Pickering (Con)]

My Lords, will the Minister respond to the question asked by the noble Lord, Lord Scriven: are these genuinely new training places? I put this question last week and did not really get an answer. I understand that resident doctors are concerned about the inability to plan ahead for training places, and want to have a place that will last for up to a year or longer. They are at the age where they want to put down roots and probably marry and have a family, but because of the way training is organised, that is not possible.

Furthermore, I am not quite sure if it was a 29% or 30% pay increase in any one year, but whatever it was, I understand that this still leaves resident doctors with an under-pay performance of less than 17% compared to 2009. They are being paid less than a train driver, a tube driver or even an Uber driver. I believe we owe them the respect they deserve. My father and brother had to work every Christmas or new year. In my father’s time it was every other night and weekend on call. We have come a long way since then, but we need to give the British-born doctors who want to train a priority in the system which is not being shown to them at the moment.

[Baroness Merron (Lab)]

The noble Baroness has just made a very good case as to why the offer which has been rejected would have been so helpful. On the issue of pay, our door has remained open to the BMA and to reasonable, realistic solutions to resolving the dispute, on which we have been repeatedly clear. I know the noble Baroness did not say this, but I say more broadly that there can be no suggestion that the BMA was not aware that we can go no further on pay this year. Resident doctors have already had a good deal on pay—an average 28.9% rise over the last three years—but pay expectations have to take account of the fiscal position and the impact across the whole of the NHS and beyond. I am glad to hear that noble Lords are in agreement with that approach.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the BMA pay claim has been ridiculous right from the start, and I share my noble friend the Minister’s outrage at the decision to carry out these strikes at a moment when the health service is on its knees, certainly in Birmingham. We are in a critical situation: the service is working under huge pressure, and ambulances are finding it very difficult to discharge patients at A&E because we cannot get the flow of patients through the system.

Listening to the noble Lord, Lord Kamall, I wondered if my noble friend the Minister shares my view. I remember the 2014 junior hospital doctors’ dispute. Although that was ostensibly about pay, what came through was frustration at the way training and working lives were organised, with inflexible placements and utterly insensitive rota allocations. It made junior doctors’ working lives increasingly difficult. This was 2014. Does my noble friend the Minister think that part of the reason we are here now is that nothing was done to respond to the substantive issues juniors raised at the time, and that at some point, there will be a constructive way forward? I am convinced that tackling the way junior and resident doctors are treated in the health service will have to be at the heart of what we do.

[Baroness Merron (Lab)]

I am grateful to my noble friend, and I share his view. I am sure he will be very familiar with this, but it is worth reminding ourselves that in the Statement we are debating, the Secretary of State said last week:

“On jobs, I have much more sympathy with the BMA’s demands. I have heard the very real fears that resident doctors across the country have about their futures; it is a legitimate grievance that I agree with”.


As the Secretary of State outlined and my noble friend referred to, we have inherited

“training bottlenecks that … leave huge numbers of resident doctors without a job … UK graduates”

used to compete

“among themselves for specialty roles; now, they are competing against”

the rest of the world.

“That is a direct result of the visa and immigration changes made by the previous … Government post-Brexit, and … compounded by the”


then Government’s

“decision to increase the number of medical students without also increasing the number of specialty training places”.—[Official Report, Commons, 10/12/25; col. 429.]

This has not just come about, and I am grateful to my noble friend for reminding us of the history of this.

[Baroness Browning (Con)]

My Lords, the Minister was asked what happens next. May I ask her to consider this? Notwithstanding what has already been discussed tonight in this Chamber, the general public out there are going to face a long period with a lot of bank holidays. If we think back to the Covid period, people, for different reasons, were reluctant to dial 999 or 111 to get medical advice or to seek assistance. I know from a personal point of view that I would really not want to be admitted into an emergency department unless I was literally dead. People have a fear of this: we see the trollies and hear now of the shortage of staff. I say that having worked in an operating theatre over a Christmas period.

Can the Minister say what plans the Government have already made to give accurate information to the general public about how they should proceed during this Christmas period if they have relatives who are showing cardiac symptoms or severe respiratory problems? There is a need for some practical guidance on what to do and to encourage people—if they are sitting at home and are genuinely that ill, they must seek help.

[Baroness Merron (Lab)]

I absolutely agree with a number of the points made by the noble Baroness, particularly her last one: people must seek the help they need. I assure your Lordships’ House that the entire focus of the department and the NHS will be on getting the health service through this double whammy of flu and strikes. Despite the huge extra numbers, there will still be people who are not vaccinated. Therefore, in addition to seeking help when needed, I also make a plea to those who have not yet been vaccinated please to do so; that will help immensely.

It is probably worth saying that the next round of strikes will bring the total number of days of strike action to 59, over 14 rounds of industrial action, since March 2023. So I remind your Lordships’ House that this did not start with this government but has preceded it for some time.

To the noble Baroness’s point about performance, I pay huge tribute—as I am sure we all do—to the dedication of NHS staff at this time. During the November round of strike action, the NHS set an ambitious goal to maintain 95% of planned care. It succeeded in doing that, which is totally down to the NHS workforce pulling round. We also proved last time that we could maintain a near full programme of elective care. Our immediate plan, which the noble Baroness asked about, is to replicate this over the upcoming five days of industrial action in December. There is no reason for these strikes, and I know the effect they have and the concern they create for the general public. The noble Baroness allows me to remind us that these strikes are not supported by the general public.

[Lord Sentamu (CB)]

My Lords, one of the four priorities named in the Budget delivered by the Chancellor of the Exchequer was reducing waiting lists. If this strike goes ahead, what increase would there be in the waiting lists? Secondly, the Secretary of State in his Statement said that he is putting

“money back in … doctors’ pockets by”

funding

“royal college portfolio, membership and exam fees … backdated to April”,—[Official Report, Commons, 10/12/25; col. 430.]

and increasing the allowance for less-than-full-time doctors to £1,500. Where is the money coming from? Is this funded, or will this money be borrowed?

Finally, taxpayers spend £4 billion training medics every year. Are the Government persuading resident doctors to keep their social contract with taxpayers? It seems to me that calling this strike at this point in time is a bargain betrayed.

[Baroness Merron (Lab)]

I certainly understand the noble and right reverend Lord’s point. The offer we made—which covered a number of the areas that the noble and right reverend Lord referred to, plus more—is not applicable because it was not accepted. We put it forward, developed it further and did all we could that was realistic. The noble and right reverend Lord asked whether it is funded, but I will change the tense of his question: it would have been funded, but the offer was rejected and therefore is no longer on the table. That is why it is not going ahead.

On waiting lists, as I mentioned to the noble Baroness, Lady Browning, we have proved that we can maintain a near full programme of elective work, with 95% of planned care being maintained—and, again, let us pay tribute to the NHS staff who have done that. But let us not suggest that there are no effects. It affects the staff who step in to cover for their colleagues. We have an NHS in desperate need of reform. We are turning it around, but these strikes get in our way. As I mentioned, we cannot underestimate the amount of effort, finance, direction and morale—the list could go on—that these strikes take up. I am grateful to the noble and right reverend Lord for raising those points.

[Baroness Royall of Blaisdon (Lab)]

My Lords, I share the outrage, fury and frustration about this industrial action. My noble friend the Minister and others around the Chamber are absolutely right to pay tribute to the workforce, and I give a particular shout-out to nurses. We are always focused on doctors—I hope noble Lords present who are doctors will forgive me—but nurses do a splendid job, and too often we forget that they work for relatively little pay as well.

I was glad that when the Secretary of State was negotiating, he was talking about the training places, because the training bottleneck is absurd. I know many brilliant young resident doctors who are so frustrated and have a terrible deal, so I urge my noble friend to pass on to the Secretary of State my view that, when he is next around the negotiating table, training places should be there in the negotiations.

[Baroness Merron (Lab)]

My noble friend rightly refers, as I did earlier, to the training bottleneck. The Secretary of State was glad to acknowledge the need to tackle training. While he felt that there was no point on pay to be accepted, he certainly felt that the BMA resident doctors committee had a good point on jobs. To be honest, that is why it is so disappointing to be where we are today.

I will pass on my noble friend’s generous comments to the Secretary of State. He offered to introduce emergency legislation in the new year to prioritise UK medical graduates and other doctors with significant experience of working in the NHS in speciality training posts. That would have made a huge difference, but it has been rejected. He also offered to increase the number of training posts over the next three years, from the 1,000 that was originally announced to 4,000, bringing forward 1,000 of those training posts to start next year—that would have made a huge difference. I could go on, but I have made my point.

I agree with my noble friend’s point about acknowledging the role of nurses. In fact, if my noble friend will allow me, I will go further: we are talking about the whole healthcare team. That is another point to the issue on pay: while the BMA doctors committee continues to press for a pay deal far in excess of anything that anyone else is getting, the impact across the NHS, both on staff and on services, continues to be under threat—and we cannot allow that.

[Lord Patel (CB)]

My Lords, as a doctor, I feel that a doctor withdrawing or withholding services from a patient is dishonourable and unethical—full stop. I find no reason that I can support for a doctor to withdraw their services, because their patients are trusting them with their lives. As far as I am concerned, junior and senior doctors should never go on strike, whether or not the issue with pay is justified—that is a separate issue; there are other ways to discuss and handle that. In response to the question from the noble Lord, Lord Kamall, about what should happen now, junior doctors or resident doctors, or whatever they call themselves, should go back to work and not go on strike—not now and not ever.

There is a separate and long-standing issue with training, which has been referred to. Some years ago I reviewed medical training and was chairman of the Specialist Training Authority. There is a need now to review doctors’ training completely, particularly postgraduate training. It is not sufficient to allow for more training posts—that does not solve the issue. What is required is a complete review of the training of speciality doctors. I hope that the Secretary of State, in his discussions, can make that offer and set up a review. I have no reason whatever to support the junior doctors’ strike.

[Baroness Merron (Lab)]

The noble Lord is an honourable man, as we all know in your Lordships’ House. I heard his comments on how he sees withdrawing labour in this regard, and I hope they are heard more widely. He makes a good point about reviewing training. Unfortunately, we are currently in the position of having made an offer that was rejected. The offer we made is not going ahead, so I cannot give the commitments that the noble Lord might like. We will deal with the strikes in the first instance, as I know noble Lords would expect. I am sure that if we ever get back to a constructive discussion, the issue of a review could be put forward, as the noble Lord suggested.

[Baroness Neville-Rolfe (Con)]

I agree with the noble Lord, Lord Patel, on strikes. Why are we still allowing in overseas doctors, when domestically trained doctors cannot secure the speciality jobs that they are applying for? When will the legislation that the Government have talked about come in? It really would make a difference.

[Baroness Merron (Lab)]

I can only agree wholeheartedly with the noble Baroness about what a difference it would make. It was actually included in the comprehensive offer that we made to the BMA on 8 December. Our first point was about introducing emergency legislation, which would—exactly as the noble Baroness asks for—prioritise UK medical graduates and other doctors who have significant experience of working in the NHS for speciality training posts. At the risk of repeating myself, I can do no more than to say that the BMA has rejected that, as part of the offer, and so it will not go ahead. Had the BMA accepted it, we would have been absolutely willing and able to introduce that emergency legislation. Our job will be to consider the next steps, now that we have had confirmation of the rejection of the very point that the noble Baroness rightly emphasised.

[Baroness Wheatcroft (CB)]

My Lords, has not the time come for the BMA to reject the way the resident doctors committee is behaving? I do not believe that the NHS I know would be supportive of its actions.

[Baroness Merron (Lab)]

I am sure that the BMA will hear what your Lordships’ House has said today and, in particular, the point made by the noble Baroness. Perhaps I could conclude this important debate by referring to a YouGov poll which was conducted on 12 December. It found that only 33% of the public support strikes in this area and that 58% of the public oppose strikes. The public have made their voice clear, as has your Lordships’ House, for which I am grateful.