Why did doctors reject Wes Streeting’s offer? It still fails to treat us with respect | Jack Fletcher

A.Resident doctors in England have voted overwhelmingly in favor of planned strike action this week, as the government’s latest offer fails to solve the medical jobs crisis and does nothing to stem the exodus of doctors from that country.

Despite government manipulation, this offer will not lead to more doctors in our NHS. It’s a start, but the proposed increase in specialist training positions over the next three years, from the additional 1,000 announced in the ten-year health plan to 4,000, only redirects “locally employed doctors”, rather than increasing capacity. This won’t mean more doctors in the workshops of our A&E departments – it will just be a matter of moving deck chairs on a sinking ship.

This year, it is estimated that almost 40,000 doctors will apply for around 10,000 specialist training places. These are doctors who have had years of training and are ready to care for their patients, but they will be denied opportunities because the positions don’t exist. Even with the proposed bill, without additional measures, we will continue to turn away these doctors. Many more will join the training bottleneck queue. Many will leave the NHS altogether.

Patients are already feeling the consequences of these shortages. In some areas, including my own in the northeast, some life-saving treatments are only available during office hours because there aren’t enough specialists to provide them. A&E departments are overwhelmed. Yet we continue to turn away thousands of aspiring A&E doctors due to a lack of emergency medicine training places. These problems are the result of political choices and are revealed in real time.

Adding to this employment crisis is the well-established fact that medical residents have faced a significant decline in the value of their salaries for over a decade. We have asked for a fair process over several years to begin to repair this loss. We have made it clear that we do not expect an instant reversal and that we are prepared to negotiate constructively. However, the government’s last minute offer brought nothing at all in terms of remuneration. Meanwhile, the government is quietly imposing real terms pay cuts on doctors in early 2026, thanks to a below-inflation increase.

What has made this situation even more difficult to accept are the speeches made by the Health Secretary in recent weeks. The same professionals whose union he accuses of “juvenile delinquency” will run together overloaded services at the height of this flu season. Thousands of us, myself included, will be caring for patients during this busy holiday season instead of spending time with our loved ones. We knew we would be working over Christmas when we signed up, but the disrespectful language used and lack of meaningful engagement with the issues we raise shows a worrying disconnect with the workforce and public we care for.

Accepting the current offer would mean accepting a further reduction. This would mean a continued shortage of jobs. This would mean more pay cuts in real terms, pushing more doctors out of the profession and the NHS.

There is still a constructive way forward. The government can choose to work with us to develop an evidence-based workforce plan, create the required training positions, and begin serious salary negotiations to retain doctors. These steps are essential for an NHS that depends on resident doctors who want to stay, progress and care for patients.

I remain ready to negotiate and end the strike. But we need the Secretary of State to recognize the reality we find ourselves in, to treat the profession with respect and to work with us to reach a credible agreement – ​​even at this late hour.

• Dr Jack Fletcher is a specialist acute medicine doctor working in the North East of England and Chairman of the British Medical Association’s UK Resident Doctors Committee.

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