Everyone says the doctor's strike is about pay. And yes, doctors in the UK are being grossly underpaid. But this strike is about something deeper. It's about a collapsing economy, systemic exploitation, broken housing, and a government – including the current Labour one – that just doesn't get it. This isn't just about the NHS. It's about whether our society is even working anymore.
This is the audio version:
This is the transcript:
Why are doctors on strike in the UK, and I mean, why are they really on strike?
We do know, of course, that superficially, this whole dispute is about pay, and I'm not disputing that. Very obviously, it is about pay, and it's about the fact that doctors have not had a proper pay rise, which now leaves them in a position where they are much worse off than they were in 2010. So clearly there's a pay dispute going on.
But it's my suggestion to you that there's also something much more important happening in this pay dispute, and the one that looks likely to follow, which is the nurses going on strike as well.
This is not just about pay.
What we're seeing are people who are well qualified, well experienced, more than capable of forming sound judgements, judgements that we have to rely upon if we're sick, who are saying they've had enough of austerity, they've had enough of the broken housing market, they've had enough of being exploited, they can't face this economy anymore because it's one which is hostile to their well-being, and they've had enough of Wes Streeting who doesn't understand how stressed these people are.
Let's just start with that question of austerity.
Doctors are worse off now than they were in 2010. The pay data shows that. Their pay has, in real terms, lagged inflation and its lagged housing costs, which have soared. And yet, Labour is saying it can't afford to give them any more.
I know they did an adjustment when they first came into office, but that was only a partial settlement, and the doctors made that clear at the time and said, "We'll accept it so long as you follow up with better offers in future years." And now Labour is refusing to do that. And there's one very simple reason why Labour is refusing to do that, and that's because it still embraces austerity.
We Streeting has got a private sector mindset. Worse than that, he's internalised the anti-public sector dogma of those with a private sector mindset, and the fact is the NHS is not, and never can be a market, if it is to meet the needs of the public in the UK and become a public good. That is something which is supplied free of charge for the benefit of everybody at public cost. It just cannot be a market.
But he is forcing people in the NHS to work in a system which is a pretend market, and he's treating the price that he's willing to pay them as if it is determined by a market, and as a consequence, those people who work in the NHS, who are valuable and whose skills can be bought by other countries overseas, can no longer survive in the environment that he's created.
A doctor on £70,000 now might, if they're lucky, or perhaps if they're exceptionally burdened, be able to borrow £350,000 to buy a house. That barely buys an average home in much of England, and the doctor will not reach that point in their career progression until they're well into their thirties, and I don't believe that doctors should need a partner to be able to afford a reasonable house for themselves to live in.
We are living in a situation where doctors are now trapped by landlords, by banks, and by interest rates, whilst monopolies exploit them for energy, for telecoms and transport. The state is enabling this, just of course, as it is also enabling the exploitation of nurses and all the other people who realise that ends just cannot be met anymore in our country.
And the doctors are in an unusual position. They know they're privileged compared to a lot of people, but they also know that they are living in a system that no longer works even for them, despite their privilege.
And to me, that is a tipping point. If those with privilege, and I stress it, the doctors have an advantage over many people in our society, cannot make this system work, it is most definitely broken.
The promise made to young people from professional life has collapsed. There is no chance of well-being anymore.
If you became a doctor in the 1970s, you were going to live comfortably, or better than that, and now you're going to live in debt, in stress, and without a good standard of living because you're going to be exploited every which way you turn.
But Wes Streeting still tells them they're being unreasonable, but why and how can he do that, because that is just not true, and he's delivering his message to the doctors in the worst way possible.
For example, he wrote an article telling the doctors they shouldn't be striking in the Daily Telegraph, the paper, which every single person who works for the NHS in the UK knows hates the NHS and everything it stands for with regard to meeting the needs of everyone, whoever they are in society. He could not have been more successful in going out of his way to show contempt for workers if he had tried.
But let's be clear, doctors don't want strikes. Nor do I. The fact is, they're being given no choice but to strike in a system that is failing all around them. This strike is therefore not just about pay, although pay is obviously a part of it. My suggestion is that this strike is a symptom of something which is much deeper, and that is systemic failure within our economy.
People are totally alienated by a system that is now making their lives impossible. This battle is therefore about something more than pay. It's about values.
It's about doctors are under attack, and who do not accept the position of a Labour government that is putting them in a wholly unwarranted position.
It's dangerous that we've reached this point, and this dispute is not just about doctors because it's about something much bigger than that. It's about how we meet our needs and what the economy is for.
That's the question that is being asked. The risk is that when people can't afford to work, and they can't afford to pay the rent, and they can't afford to feed their children, and all of those situations are coming to pass, then that economy might actually fail in its entirety.
That is what I mean by systemic failure.
That is the point that we are reaching.
We are on the cliff edge waiting for all those things to happen, not just amongst 20% or so of the population as they do now, but on a widespread basis.
Henry Ford, who set up the Ford car company, knew all about this. 📍 He knew in the 1920s that if he did not pay his people enough so that they could afford to buy his cars, he could never be successful.
We are now in a situation where Wes Streeting has to understand if he does not pay the people who work for the NHS enough that they can afford to work for it, we can't have a programme of care in this country, and everything else falls apart as a consequence.
That's the crisis we face. It is a lack of understanding. It is a lack of understanding that, because of the level of exploitation by the financial services industry and monopoly industry in this country, that is extracting rent and interest, and monopoly profits from people, the whole thing is on the precipice of collapse.
Labour needs to get its head about this very soon.
The doctors are just the start.
Meltdown is on its way, and what then? Who knows? The anger is rising, and it can't be contained forever. And when even the doctors are feeling this anger, are feeling alienated from the world in which they live because the government has chosen to do nothing about meeting their needs, then we are in deep trouble.
My question to you is. Do you think that's really the case?
There's a poll down below this video. You can vote there, and please leave your comments.
I want to know what you think about the future and whether this doctor's strike is really the point where we recognise that the crisis facing our society is so big that it encompasses most people within it.
Like and subscribe, of course, to this video and to this whole channel, but do something else as well.
Why not write to your MP about this?
There is a link to a transcript of this video down below, and on that, you will also find that there is a way to turn the transcript into a letter to your MP using ChatGPT.
Democracy, as I often say, is not a spectator sport.
It's a participatory sport.
You are the participant. Please take part. Please tell your MP what you think and demand change because, without that change, we are, I believe, in very deep trouble.
Poll
What is the doctor's strike really about?
- The growing economic failure of the UK? (69%, 249 Votes)
- Austerity? (20%, 73 Votes)
- Pay? (7%, 27 Votes)
- Greed? (3%, 10 Votes)
- I don't know (1%, 3 Votes)
Total Voters: 362
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“Wes Streeting has to understand if he does not pay the people who work for the NHS enough that they can afford to work for it”
That is the point.
He wants the NHS to fail,
He wants to privatise the NHS (pointing to its failure)
HIS PERSONAL FINANCIAL FUTURE depends on this.
I suggest a recall petition ref Streeting & have him ejected, indeed, there should be rolling recall petitions one or two per month aimed at key cabinet members, strip Starmer of his loyalists.
Richard,
you rightly draw attention to the most fundamental problem in our society which is housing and our attitude to it. There has been an ingrained habit of thought here, pandered to by governments of all stripes, that rising house prices are a GOOD thing, when they are actually a very bad thing. When the cost of basic items of food go up this is announced in the media as problem. When house prices rise it is seen as an indicator of prosperity. Why? I think it is because we the gave up on trusting our currency, our economy, our financial services industry and therefore our governments years ago and so choose to save in something we regard as more trustworthy- housing. The social effects of this, particularly on the younger generation are now visible with well paid professionals, not just in London unable to afford to buy a house without parental help. If their parents did not “get on the housing ladder” then there is no money to recycle towards the young. This is exacerbated by the privatisation of rental accommodation and the poor quality and insecurity of tenure that goes with it. This is not a sustainable way of providing housing and it has other negative social effects besides the ones i have described- fuelling ant- immigrant sentiment for instance. I do not think that simply increasing wages is going to do the trick. All that will do is fuel an upward house price spiral, which will leave nobody any better off. Radical measures are needed to curb house prices e.g building more good quality homes to rent, restrict second home ownership.
Much to agree with
I very much agree with your comments.
I think that the doctor’s issue is a precarious one because it will be exploited against them.
What I think it shows is the difference between those well paid people who are adding something productive to the economy and those that are not, who are living off rents, interest charges, investments, assets etc., – these are well paid working people in other words.
I think that all working people’s lives are on the line to be honest and the end game is AI which will be embraced as an opportunity to cut costs, seized upon by a weak government claiming that we have run out of money.
I think ‘AI Think’ is dominating much of employment thinking these days – maybe the exploitation going on is capitalism’s last hurrah whilst it works out how to fleece us next? Maybe the attitude is ‘We’re replacing them anyway so why pay them more?’. Will there be anyone left to fleece? Employers seem to be letting go of ’employment’ as the silver bullet of AI takes hold..
I know some local authority heads of department on £70K a year, and officers on much more than that at £120K? My union tells me that I’d be on £56K a year but for austerity brought about by a private sector banking stupidity. I’m not even on £45000.
Doctors – privileged? I don’t like that concept at all. I had a discussion with my daughter about this. My view is that no one who works is privileged at all. Start looking at ‘privilege’ and you start looking at identity politics and it’s all over. Real privilege is living off money flows not generated by labour – not work. I don’t care if mummy and daddy got you through med school – if you’re a doctor you are a working person – working class or middle class – you’re a working person. Period.
What the doctor’s plight also shows is something about this country. It is a country obsessed with NOT spending money on tangible things and no longer understands investment but is quite happy to give private banks a line of credit to boost making money out of money and also ready to bail out that operation should it be too ‘exuberant’. All whilst pleading poverty to voters and working people who are crying out for interventions. I’m talking about ‘spend to save’ investment.
Spend to save thinking is an anathema to exploitative capital who are always looking to create charges that earn them income as systems fail.
Wages are not really keeping up with anything. This means that the burgeoning private health sector gets its chance and its pick of doctors – the benefits of state retrenchment.
As you know, I don’t vote, so when I say I didn’t vote for this I really didn’t. Because this is what you will get whether you vote or not. It has been decided that government will get out of the way to feed us to a bunch piranhas.
Thanks
“What I think it shows is the difference between those well paid people who are adding something productive to the economy and those that are not”
Back in the 1960s Labour under Wilson had a “selective employment tax” (SET) designed to drive people into useful employment. It caused problems.
Those employed by Goldmans et al are, broadly speaking, in useless employment. They are also vastly over paid & deform the employment market. Ref this G’ article:
https://www.theguardian.com/technology/2025/jul/27/it-wants-users-hooked-and-jonesing-for-their-next-fix-are-young-people-becoming-too-reliant-on-ai
supposedly on A.I. – but – extract:
“This is not surprising considering that Goldman Sachs, the sort of blue-chip investment bank Rohan is keen to work for, last year received more than 315,000 applications for its 2,700 internships.”…………..this is sick & needs to stop, the financial parasites are draining useful people from society.
We need an SET aimed directly at the finance sector. 30% additional tax on the earnings of employees (& if the finance sector tries to put up pay – to compensate – keep raising the tax). The finance sector is at the very core of the problems experienced by UK society – it needs vastly cutting down to size & one can start with making it very very unremunerative to work in that sector – the Uk needs faily paid doctors and nurses and and … it does not need people working in the financial parasite sector.
Matt Stoller writes on monopoly and anti-trust in the US. That perspective, I believe, gives him an insight into the transformation of our world; notably under Trump and MAGA. He sees a pervasive loss of the idea of freedom that insidiously persuades people not to challenge the gathering, rampant inequality, by persuading them that, if you are not an oligarch; that is your fault. You lost.
This made me think again about the extraordinary headline in that supposed defender of freedom and liberal values, ‘The Guardian’, about a winning Women’s football team: “Proper England: Selfless”. And why it has stuck in my mind; because it is a perfect illustration of the subconscious submission to the values of the oligarch. Why do I say that?
Ask yourself this question Would that headline have seen the light of day, if England had lost the game?
The subliminal message from the oligarchy to the masses? Straight out of Orwell. Only winners are selfless. You have it all, or nothing at all.
Much to agree with
Systemic problems can be hard to grasp and even harder to articulate. Most people are wired to find simplistic explanations, which leads to identifying ineffective solutions.
The UK economy for working people has changed especially since the GFC. However there are very many who have no real understanding of what’s happening – not just financially but psychologically. And those who are able to benefit personally from the way thing are and resist change.
Without major change inequality is inevitably going to get worse. The media is dominated by an elite for whole the economy is largely working and there are relative large numbers of the older generation (with low or no mortgage) for whom the economy has largely served them well during their lives. The society they were gonna into has been cynically eroded over 40 years with a largely unseen and unrecognised cost; the breaking of the intergenerational commitment of society.
You and a handful of independently minded people, have simplifying a systemic problem down to a ‘growing in wealth inequality’ and worked to get that message widely understood – largely using channels they can control.
Wealth is held not just that at the individual level but at a societal level. The quality of our land, water and air and the assets we collectively own/ed, like utilities and various care services, which have become an attractive home for growing amounts of idle wealth that are doing nothing better than driving up asset prices (house costs, shares etc.). All interconnected. People feel it.
Thanks
“Labour needs to get its head about this very soon”. Unfortunately, I doubt very much that will ever happen.
Back in 1986 just before my 24th birthday I bought my first house, a 3 bed terrace in Totterdown, Bristol.
Being Human was filmed in the other bit of Totterdown & WASNT inspired by the fact I lived there!
Salary by the time I actually bought it for £22K was £6900 from memory so about 3x earnings
Looking at Rightmove 3 beds in the same road have gone for between £326 to 422K while the salary in basically the same job is about £30K
Now the area may well have changed and the houses perceived as more desirable, (No, NOT because I moved out!) they also seem to have had work done on them BUT in terms of price to earnings they have gone from 3x average earnings to about 10X for not particularly thermally efficient Edwardian workers terraces.
Somebody is making a lot of money from land and property and it isnt Jo & Joanne Public
My experience is mjch the same – although I bought in Tooting SW17 in 1983 and now could not afford to move back to my first flat…
The only way that I have a house and owned outright is due to the fact my parents were able to buy there house at very substantial discount as they had been council tenants since they married. I worked as a tenured academic for the last 20 years which gave me a reasonable lump sum and annual income when I was forced to take early retirement.
I wrote a thesis on the Marxist concept of alienated labour. Now we are alienated in our everyday lived experience and the associate resultant mental and physical decline in health a la the spirit level
Good points.
While we’re on the NHS and Streeting’s private enterprise mindset…
I saw a lovely illustration the other day of Stephnie Kelton’s mantra, “governments can’t run out of money but they can run out of things to buy”.
Pharmacists cant keep up with the demand for prescribed weight loss injections.
https://www.thepharmacist.co.uk/clinical/nutrition-and-gastroenterology/pharmacies-warn-of-unsustainable-weight-loss-jabs-demand/
Oh dear.
What will Wes do about that one? Because online scammers are waiting in the wings to “meet” the drmand.
Maybe do something about the (poverty-related, food industry-related) CAUSES of obesity?
2 things:
Streeting’s stupidity. If Streeting succeeds and the NHS fails there will be something in its place. That something will need professionals to provide the care that it will be charging people for. But by the time the NHS fails many of the professionals who currently provide care will have gone, left the country, retired, not bothered to train or even to start their career. Why can’t Streeting see that?
Houe prices. The horrendous increase in house prices is a major disaster for a huge number of people in this country, particularly the young. There have been suggestions that action should be taken to ensure that house prices fall, but each suggestion is met with horror at the thought of those ‘poor’ people whose investments will lose value. (What happened to the warning that investments may go down as well as up?) I am old enough to remember a major house price reset many years ago, although I can’t now remember the cause. Some people ended up in ‘negative equity’ and were ‘trapped’ because they could not sell their houses as they were worth less than the outstanding mortgage. That was terrible for those individuals, but they would be a far lower number of people than those currently denied a home because of the housing crisis. But, apparently, they are the more important group of people. Why is that?
There is an element of ironic justice to this for the xenophobes who support Farage* and his cronies because if UK-trained doctors decide to seek better paid work abroad we will have to rely on importing doctors from countries who pay their healthcare workers even less than we do. I don’t think the small-mined far-right morons will enjoy that.
* I am pronouncing his name with a short second “a” because I know it would irritate him.
It was I (it seems, so far, alone) who voted Don’t know. I would have preferred to vote “all of the above” but, as I am lucky enough to live in Scotland, and it is more than half a century since I have had any dealings with a doctor in England, I really can’t claim to know.
NHS Scotland is, and has been since its inception, separate from NHS England and significantly differently organised.
Despite the constraints of the devolution settlement and the Barnet Formula, the Scottish Government, though not entirely free from the Neo-liberal virus, has reached an agreed pay settlement with Scottish doctors.
I suspect that most people currently working for NHS England would be happier working for NHS Scotland.
And you’d be welcome here.
Roger wrote “I suspect that most people currently working for NHS England would be happier working for NHS Scotland”. Many of them are already here. I’ve had a series of hospitalisations in the last year and a significant number of doctors who dealt with my afflictions were of English and foreign origin. They’re here because the pay is better, the NHS is better organised here, house prices are generally lower here and the Scottish Government is trying to protect the people from the ravages of inflation. And it’s not just doctors: a substantial number of English and foreign nurses are here too as trainee nurses get financial support. There are two main pathways: a bursary scheme and a traineeship programme. The bursary, administered by SAAS, provides a non-income assessed grant of £10,000 per year for eligible students. The traineeship, offered by NHS Scotland, provides a full-time employment contract with a salary (minimum £25,468) and benefits.
When devolution came into effect and public health was devolved, the NHS in Scotland very quickly abandoned the competitive market concept which the Tories had introduced and reverted to regional management. One of the many benefits of this was that a national A&E system was introduced, which meant that, in a case of a large-scale emergency (like a plane-crash) nurses and doctors could be transferred quickly to cope with the emergency right away without having to learn a different computer system.
Doctors are on strike in England, UK. They’re not on strike in Scotland, Wales or Northern Ireland.
Newly qualified Doctors in Scotland don’t leave Medical Schools with massive debts hanging round their shoulders like dead albatrosses; that they do in England is scandalous and ought to be stopped.
You touched on the paid more than me argument thrown at the Doctors. What I have not seen is a chart of pay rises from 2005 to 2025 for MP’s, Doctors and Nurses ( bold type for 2015 to 2025 ). I suspect it will wipe the smug smile off Wezzy boys face and finally close down this line of attack.
An advert is playing on Nottingham City Buses for mechanics. If my memory is correct the figure quoted is over £20 per hour. Do they deserve it, Yes. I also expect the quoted figure includes unsociable hours.
Mike often talks about recall petitions. The only time I hear these mentioned is when the MSM are talking about an MP who is excluded from the house for a certain number of days.
Is there some rule about these petitions which we are not told about ?
Your polls may be line limited but I suggest the missing option is, all of the above.
OK. Noted.
This is a topic I have a personal interest in since our daughter started today as the most junior of junior doctors. She has her first clinical shift next week – straight into nights.
In that stratum of resident doctor, pay isn’t a complaint. She hasn’t had any yet, but looks forward to the first pay cheque and a chance of paying off the overdraft she has taken to rent somewhere to live (having been allocated her workplace hospital via a lottery). However she is worried about difficulties experienced by doctors a couple of years ahead of her in finding places on a specialist training scheme.
Essentially it is about work conditions. All the penny pinching has made conditions unnecessarily difficult, and there are people voting with their feet. A significant number of UK-trained doctors now choose to move to Australia. And in nursing a huge number of qualified nurses have left nursing entirely, while pay is probably a factor I suspect many are not prepared to compromise the standard of care they know they should be delivering just because hospitals are under-staffed. They are in other jobs where they can clock off without wondering whether a patient’s condition will worsen because they didn’t have time to deal with them properly.
I don’t know how the problems of specialist doctor training happened but I suspect austerity. Successive Ministers for Health, from Lansley on, have parrotted an unevidenced complaint that the NHS has too many managers and is wasteful. With funding to the NHS being given on a basis of a 5% “efficiency saving”, once things like building maintenance had been cut they had to lose posts. And those will have been the admin jobs that had an important function, you can imagine a politician noticing there is a “workforce planning unit” and flagging that as a waste of money. Losing admin jobs has made the NHS less efficient (or more importantly, less effective) over the years; last year’s Darzi Report pointed out the absurdity of senior consultants having to spend their time chasing things like bed availability and test results which could just as easily be done by someone not clinically qualified allowing the consultant to use his/her skills with patients.
Your suggestion we have reached a tipping point is interesting but difficult to tell. Certainly this dispute represents a much wider frustration of those in the public sector who feel they are constantly being villified by politicians and attempts made to make their pay and conditions relatively worse than they had been. There ought to be a presumption that public sector pay, while generally less than the private sector, increases to account for inflation without this leading to conflict (though probably calculated on a three year rolling average, I do suspect the BMA has deliberately chosen their starting point in the current dispute as the high point when a previous catch-up rise was given).
Thanks
I voted for the growing economic failure in the UK as it affects everyone in the UK and I’m personally very aware of the damage it has caused. I retired from my day-job business in December 2006 with what seemed a comfortable financial cushion to see me well into my 80s, however the CPI inflation for the period December 2006 to June 2025 is 173.2% (so far I haven’t found data for CPIH inflation, which will be more representative of personal inflation). In other words my nest egg is worth is roughly 26.8% in CPI terms of what it was at my retirement. Obviously state pensions have had a boost over the years, although not enough to keep up with CPIH, but annuities are fixed and investments have fluctuated wildly.
One more point: You ask “why are doctors on strike in the UK?” They’re not on strike across the UK; they may be on strike in England and I’m not sure of the position in Wales and N Ireland, but they’re still at work in Scotland as the Scottish Government saw public health as being more important than adhering to neoliberal economic strictures and so-called “fiscal rules”.
Point accepted Ken
My mistake
I really should not make it