Resident Doctors: Industrial Action

Debate between Caroline Nokes and Wes Streeting

Thursday 10th July 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With your permission, Madam Deputy Speaker, I will make a statement on planned industrial action by resident doctors.

Today’s waiting list figures show that after 14 years of decline, the NHS is finally moving in the right direction. Since July, we have cut waiting lists by 260,000. We promised to deliver an extra 2 million appointments in our first year, and have more than doubled that figure, delivering 4.6 million more appointments. For the first time in 17 years, waiting lists fell in the month of May, and they now stand at their lowest level in more than two years. That is what can happen when NHS staff and a Labour Government work together. We have put the NHS on the road to recovery, but we all know that it is still hanging by a thread, and that the BMA is threatening to pull that thread.

On Tuesday this week, I met the co-chairs of the BMA’s resident doctors committee to discuss the results of its ballot for industrial action. In that meeting, and in a letter I sent yesterday, I offered to meet the BMA’s full resident doctors committee and work with it to improve its members’ working lives. Since the start of this year, I have offered repeatedly to meet the entire committee, but it still has not taken up my offer. Instead of agreeing to talk, the BMA responded by announcing five days of strike action. Its planned strike action will run from 7 am on Friday 25 July to 7 am on Wednesday 30 July. These strikes are unnecessary, given this Government’s willingness and eagerness to work together to improve resident doctors’ working conditions. Following a 28.9% pay rise thanks to the actions of this Government, the BMA’s threatened industrial action is entirely unreasonable. I am asking it again today to pause, call off the strikes, and instead work with the Government to rebuild its members’ working conditions and rebuild our NHS.

Before this Government came into office, a toxic combination of Conservative mismanagement and strikes was crippling the NHS. The cost to the NHS ran to £1.7 billion in just one year; patients saw 1.5 million operations and appointments cancelled, and people’s lives were ruined. Phoebe suffers from a genetic condition: neurofibromatosis, which causes non-cancerous tumours on the outside of her body. Her first operation at Great Ormond Street hospital was cancelled twice—at first due to strikes, and then because there was not the capacity to treat her. Phoebe loves going to school, and it is an absolute tragedy that her education was set back. She was prevented from doing what she loves because the NHS was not there for her when she needed it, but this year, when Phoebe’s family contacted Great Ormond Street in March, her surgery was scheduled less than two weeks later. Compared with what she went through two years ago, the difference was night and day.

That is the difference a Labour Government make, and it is why this Government were absolutely right to end the strikes when we came to office. I am so proud of what we have achieved together with NHS staff. In the words of one NHS leader I spoke to recently, there is light at the end of the tunnel and, for the first time, it is not an oncoming train. That has only been possible because of the deal this Government negotiated.

When we agreed that deal to end the strikes last year, resident doctors did not just receive a 22% pay rise; the Government also gave a genuine commitment to build a new partnership with those we now call resident doctors, based on mutual respect. I have personally ensured that that commitment was followed through. A new exception reporting process has been agreed with resident doctors in principle, so that doctors are paid for the work they are asked to do. A review of rotational training is under way and almost complete to reduce disruption to resident doctors’ lives. We promised to tackle GP unemployment, and we have delivered with an extra 1,900 GPs on the frontline who were otherwise facing unemployment. I am determined to go further to tackle doctor unemployment.

When I say to resident doctors that I want to tackle the bottlenecks they face, and the unfair competition for specialty training places, and to create more training places, they can judge me not just by my words, but by my actions. When the pay review body recommended a 5.4% average pay rise for resident doctors this year, we accepted that and funded it in full. Those are not grounds for industrial action. Indeed, in the history of British trade unions, it is completely unprecedented for a pay rise of 28.9% to be met with strikes. The BMA itself described this pay rise as “generous”.

Thanks to this Government, the average annual earnings per first year resident doctor last year were £43,275. That is significantly more, in a resident doctor’s first year, than the average full-time worker in this country, and it is set to increase further with this year’s pay award. For resident doctors in their second year out of medical school, their average annual earnings rose to £52,300 last year. In core training years, resident doctors earned an average of £67,000. Specialty registrars earned on average almost £75,000. There is no question but that these are highly trained, highly skilled medics who work hard for their money, but to threaten strikes in these circumstances is unreasonable and unnecessary, so it is no wonder that the BMA has lost the public’s support.

At the beginning of this dispute, resident doctors faced a Conservative Government cutting their pay and refusing to talk to them. A clear majority supported action as a result. In February 2023, 56% of the public backed junior doctor strikes. Today, that support has collapsed. Just one in five people believe that the BMA is doing the right thing. Patients are begging resident doctors not to walk out on them, and I hope the BMA is listening, because many resident doctors are.

For the first time since the BMA’s campaign began, a majority of BMA resident doctors did not vote for strike action. They can see that the Government have changed and our approach has changed, yet the BMA’s tactics have not. Resident doctors have received the highest pay award in the public sector, both this year and last year, so renegotiating this year’s pay award would be deeply unfair to all other public servants. Such a deal would be paid for by their future earnings, and with the greatest respect to resident doctors, there are people working in our public services who are feeling the pinch more than they are.

Even if it would not be unfair on public sector workers, it is unaffordable. It should be apparent to anyone that the public finances this Government inherited are not awash with cash, so I will not and cannot negotiate on this year’s pay award, and I am not going to lead resident doctors up the garden path by making promises unless I know I can keep them. As I have said in person, in writing, in private and in public, I am willing and ready to get around the table and work together to improve the working conditions of resident doctors. There is so much more that we can do together. I do not just hear the complaints that resident doctors have about their placements, rotations and bottlenecks— I agree with them. I know the NHS has been a bad employer, and I am determined to change it. My offer to talk comes with no preconditions attached. I will also say this to resident doctors directly: consider very carefully the consequences of your actions.

[Madam Deputy Speaker (Caroline Nokes)]

Order. May I suggest to the Secretary of State that his statement has already taken 10 minutes and he has not asked for additional time? Does he wish to consider whether his statement is to the House, or to those outside the House? He might like to make a few closing remarks.

[Wes Streeting]

Thank you, Madam Deputy Speaker. I will move to closing. I did share the statement in advance, including with Opposition parties and the Speaker’s Office. I just say to resident doctors, and it is important that the House knows what we are saying to them, that they should carefully consider the consequences of their actions. Five days of strike action mean patients and their families receiving the phone call they are currently dreading, being told that the operation or appointment they have been waiting for—often for far too long—is being cancelled and delayed. I know how I would feel if that happened to a member of my family, and I ask them to consider how they would feel if that happened to a member of theirs. While they are out on the picket line, protesting the 28.9% pay increase they have had, their friends and colleagues and other NHS staff—many of whom are paid less and receive less than them—will be inside, picking up the pieces and working in harder conditions to cover for the consequences of resident doctors’ actions.

In conclusion, the strikes are not only unnecessary and unreasonable, but unfair. They are unfair on patients, unfair on other NHS staff, and unfair to the future of the NHS, which is in jeopardy. The tragedy is that they will never have had a Secretary of State as sympathetic to their legitimate complaints as this one. If they want to know what the alternative is, its Members are not sat here. They have not even bothered to show up today, and that party does not even believe in the NHS. The grass is not greener on the other side. I ask them not to squander this opportunity. At this stage, we can still come out of this dispute with a win for the BMA’s members, a win for the NHS and a win for patients, but if the BMA continues down the path of strike action, it will lose its campaign, resident doctors will be worse off, and the heaviest price of all will be paid by patients. I commend this statement to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

--- Later in debate ---

[Wes Streeting]

I completely agree with my hon. Friend. I urge BMA members to consider not just the significant progress that they have already made by working with a Labour Government, but the wider context in which we are operating. It is not just resident doctors who have seen their pay eroded over more than a decade of Conservative Government; it is the entire public sector. It is not just resident doctors who are working in crumbling buildings with out-of-date equipment and technology; it is the same in our schools, our hospitals, our prisons and the entire public sector estate.

This Government are facing enormous challenges across our economy, and we cannot sort out every issue that we inherited overnight, or even in one year—it is going to take time. BMA members should be proud of the progress that we have made together, and reassured that we want to make further progress with them, but there has to be some give and take here, and there has to be some reasonableness. Given the potential consequences of their action for patients, for their fellow staff and for the future of the NHS, the strike action is unreasonable, unnecessary and deeply unfair.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Wes Streeting]

I entirely agree with my hon. Friend. Looking back at all the contributions this morning, I have been struck by the fact that, quite extraordinarily, the entire House, on both sides of the Chamber, has spoken with one voice. There has been total unanimity across this House during these exchanges that the proposed strikes are unreasonable, unnecessary and unfair. For the avoidance of doubt, let me tell the BMA and the resident doctors committee that this House has spoken with one voice to say: abandon this rush to strike, get around the table and work with us to rebuild resident doctors’ working conditions and to continue rebuilding our national health service. I thank the House for its support.

[Madam Deputy Speaker (Caroline Nokes)]

I thank the Secretary of State for his statement today.

NHS England Update

Debate between Caroline Nokes and Wes Streeting

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

My hon. Friend is absolutely right about the need to improve procurement. One thing that Attlee and Bevan could not have predicted in 1948 is that the single-payer model of the national health service makes it ideally placed for this world of artificial intelligence, genomics, machine learning and big data. We must unlock that potential so that we have new treatments, new technology, productivity gains and efficiencies, but we also have to get the basics right on procurement. We have to change the culture of profligacy, routine deficits and routine over- spending. That is why, today, the leadership of NHS England has summoned to London chairs and chief executives from across the country to get an immediate grip on the £5 billion to £6 billion deficit that was already being baked in for the 2025-26 financial year. Those chairs and chief executives have just become so accustomed to the idea that Governments will just come in and bail them out.

I said before the election that there would be no release of money in winter, because winter is predictable. The NHS was given additional resources and it must learn to live within its means. Despite howls of outrage before and since the election, I have kept to my word. I said that there would be accountability for people who think that the Government are there to bail them out. Having come from local government, where that culture would never be tolerated, I and this Government are bringing that same financial discipline to the NHS. We will not tolerate deficits. It is important that we get better value for money, while also making sure that, nationally, we are providing support through the procurement platform. That is how we will help the system deliver better value, and we will liberate frontline leaders to focus on the things that really matter, which are services for patients.

[Madam Deputy Speaker (Caroline Nokes)]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Wes Streeting]

I do think that is the case. I also think that this is not just about form and function but about the opportunities for productivity gains through modern technology and practices. One of my frustrations is that whenever we talk about the exciting frontiers of life sciences and medical technology—this country’s competitive advantage, and how we need to build on that position— I am greeted with a weary sigh from poor frontline NHS staff, and managers for that matter, who say, “That’s lovely, and we agree with you, but we’d just like a machine that turns on reliably, and it would be nice to use systems that do not require seven passwords to deal with a single patient.” I feel their pain. We will prioritise that investment in technology.

Finally, we do want to liberate the frontline, and I am grateful for the leadership that GPs have shown in agreeing a contract with the Government for the first time since the pandemic, which contains substantial reform to benefit them and, even more importantly, their patients. We also have to liberate management in the NHS. As Lord Darzi said, it is not the case that there are too many managers, but there are layers and layers of bureaucracy between me as the Secretary of State and frontline staff. We have to liberate frontline staff and managers to help them be more effective, to manage their resources more efficiently and, most importantly, to deliver better and safer care.

[Madam Deputy Speaker]

I call the Chair of the Health and Social Care Committee.

Tobacco and Vapes Bill

Debate between Caroline Nokes and Wes Streeting

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

That is a very helpful intervention because it gives me the opportunity to say thank you to my counterparts in Wales, Scotland and Northern Ireland. This is a genuinely four-nations Bill, and through it, we have an opportunity to create a smokefree generation in every corner of our country.

I say to people who have an ideological objection to the Bill that if they believe in lower taxes, as they say they do, and in maintaining a national health service, as they say they do, they cannot duck this simple equation: an ageing population plus a sicker society equals more spending on the NHS, paid through higher taxes. The Bill is just one measure, but it will make a significant difference to the health of our society, and to the balance of that equation.

The question that opponents of the Bill must answer is this: if they want our health and care services to continue having to spend £3 billion every year on the symptoms of smoking, are they willing to accept that that means higher taxes or higher healthcare charges for their constituents? Are they happy for their constituents to shoulder the welfare bill for smokers falling out of the workforce? Those are the consequences of what we are voting on today. Higher taxes and higher welfare are not the Labour way.

There are arguments about liberty from those who oppose based on libertarian belief. They say that the state should not deny individuals the choice to smoke if they want to, but three quarters of smokers want to stop and wish they had never started. It takes a smoker an average of 30 attempts to quit before they manage it. By definition, an addict is not free; there is no choice, no liberty and no freedom in addiction. Nor is choice afforded to anyone inhaling second-hand smoke. Tobacco is not only highly addictive but uniquely harmful. Yes, some smokers can quit, but most who want to cannot. Those who have help to quit are three times more likely to succeed. That is why the Government are, as I said, investing £70 million in smoking cessation services—an investment that will pay for itself several times over—but prevention is better than cure, and that is why we are taking action, through the Bill, to stop the start.

In conclusion, this Bill marks the start of a decade in which we will shift the focus of healthcare from treatment to prevention; take serious action on not just smoking, but obesity; reform the NHS, so that it catches problems earlier and gives patients the tools that they need to stay out of hospital; harness the revolution taking place in life sciences; and fundamentally transform the NHS, so that it predicts illness and prevents it from ever taking hold. That is the future available to us, and it is the future we must realise if we are going to put our welfare system, health service and public finances on a sustainable footing. It starts with this Bill. Smokers are more likely to need NHS services, be admitted to hospital, drop out of the workforce and on to welfare, and need social care years earlier than if they did not smoke. By taking the measures set out in the Bill, we are putting the UK on the road to becoming smokefree, building a healthier, wealthier nation with a health service fit for the future and leading the world as we do so. I commend this Bill to the House.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Secretary of State.

TOEIC: Overseas Students

Debate between Caroline Nokes and Wes Streeting

Wednesday 24th July 2019 Commons Chamber

[Caroline Nokes]

The hon. Lady will know that when it comes to court hearings, judges will decide whether people have a valid claim to remain in the UK. We continue to look at all the options, including whether there is a need for those who feel they have been wronged to be able to ask for their case to be reviewed. As I have said, my right hon. Friend the Home Secretary intends to make further announcements in due course. However, it is right to reflect on the fact that this is a complicated issue, and it is right that we take time to make sure we get it right—[Interruption.] The hon. Lady may chunter at me from a sedentary position, but it is important that we make the right decisions and do not just give blanket promises that we will allow people to stay and will pay their costs, when it may be the case that they have cheated.

[Wes Streeting (Ilford North) (Lab)]

The problem is that we are no further on. Although I acknowledge the time the Home Secretary and the Immigration Minister have given to meeting Members, no remedy is being offered to people—people into the whites of whose eyes we have to look in our surgeries—who had no reason whatever to cheat, given their written communication and English language speaking skills. I cannot go back to constituents such as Maruf Ahmed and tell them that we face the prospect possibly of a new Home Secretary and a new Immigration Minister looking at this afresh, and certainly of no action at all until the summer has passed. These people’s lives are being left in limbo.

Acknowledging what the Minister has said about there clearly having been some cheating, and acknowledging what other Members have said about some people clearly having been inadvertently and wrongly caught up in this, surely the best thing to do now, given the passage of time and the numbers of people involved, is just to let those people sit a secure English language test afresh to give them the opportunity to clear their names, and, if they cannot, to politely ask them to return to where they came from.

[Caroline Nokes]

The hon. Gentleman will be aware that this evidence of cheating came to light in 2014, and evidence of people’s ability to speak English now may have no relation to their ability to speak English back then, given that we are five years on. However, I absolutely refute his accusation that we are no further forward. The written ministerial statement yesterday made it absolutely clear that the Home Secretary has asked officials to review Home Office guidance. The reviewing of that guidance relates to article 8 human rights claims to ensure that we make sensible decisions that are properly balanced in terms of any belief that deception was practised and of the individual’s wider circumstances. Where there are particularly compelling circumstances, we will also look at whether there is more we can do to help people put forward their claim. Given that this cheating was exposed in 2014, it is absolutely evident that people’s circumstances will have changed; they may well have established families in this country, and those children will have a right to an education here. We must put the priority of the families first. It is right that we should seek a mechanism to support people through an article 8 claim so that they can stay, when there are grounds for them to do so.

Overseas Students: English Language Tests

Debate between Caroline Nokes and Wes Streeting

Tuesday 30th April 2019 Commons Chamber

[Caroline Nokes]

As I mentioned earlier, the licence was revoked in July 2014, and the Home Office moved swiftly to revoke that licence. Action was taken against ETS but, because of the commercial sensitivities, I am afraid I cannot divulge details. However, I will ascertain from Home Office lawyers whether I can write to the hon. Lady and let her have that information.

[Wes Streeting (Ilford North) (Lab)]

No one doubts that there was criminal behaviour and cheating, but it has been weeks since we were promised a decision by Ministers, months since we met the Home Secretary to outline concerns about people who had been wrongly implicated, and years during which these students have had their lives left in complete limbo, with them suffering mental ill health, financial hardship, family breakdown and a whole range of other detrimental consequences as a result of being accused of cheating—wrongly—by the British state. When will the Government finally get their act together? The longer this rolls on, and the longer people are caught up in expensive judicial action or lengthy, bureaucratic immigration appeals, the longer that is wasting their time, wasting their lives and wasting taxpayers’ money. Enough is enough.

[Caroline Nokes]

I gently remind the hon. Gentleman that those who were found to have a questionable result following the ETS investigations were given the opportunity to take a second test to establish their ability to speak English, so they could have taken that option. He was quite aggressive in his questioning, but I must reiterate that I think it is right, and the Home Secretary thinks it is right, to wait for the outcome of the NAO report, which we expect next month.

Windrush

Debate between Caroline Nokes and Wes Streeting

Tuesday 4th September 2018 Commons Chamber

[Caroline Nokes]

I point out to the hon. Gentleman that we have been generous in granting citizenship rights and have been determined, as I said a few moments ago, to find reasons to grant, not reasons to refuse. As I have said, the public consultation on the compensation scheme closes on 11 October, but I urge him to encourage all his constituents who may have been affected to take part in that consultation so that their voices can be heard.

[Wes Streeting (Ilford North) (Lab)]

The Minister and the Government claim that the hostile environment is over, but in Westminster Hall shortly we will be describing the situation of international students who are currently victims of the hostile environment. Is it not the case that the Home Office is in this mess because it continues to come forward with cases on the basis of flimsy evidence; it is losing appeals left, right and centre, trying to deny people access to justice; and, perhaps worst of all, at the same time as victimising people in a David versus Goliath contest in the courts, it is wasting taxpayers’ money hand over fist that should be spent on our schools, our police and our hospitals? Why will she not reinstate the appeals, as the cross-party Home Affairs Committee suggests, and why will she not genuinely end the hostile environment?

[Caroline Nokes]

The hon. Gentleman is indeed leading a debate later this afternoon about English language testing. We are very conscious that there was significant fraud. Many thousands of cases were found to have been fraudulent and many colleges not only closed as a result but were bogus colleges that we had already identified problems with. Where there is systemic fraud and abuse in the immigration system, as we saw with some language testing, it is important that the Government take action, and he will be aware that successive court cases have upheld our position.