The BMA has rebuked a suggestion from the health secretary that strike action planned to begin this week is ‘morally reprehensible’ and could threaten the future of the NHS.

Speaking at the NHS Providers conference in Manchester, Wes Streeting said the Government was ‘not going to be held to ransom’ by the association’s resident doctors committee.

He warned that the offer he made last week in a ‘final attempt’ to prevent strike action may be withdrawn because of the anticipated £240m cost of the walkout.

That offer included a doubling of specialty training posts, support with exam and portfolio fees and medical royal college memberships, but no movement on headline pay.

Jack Fletcher, chair of RDC, said: ‘Sadly, we’ve still seen no new offer from the Government, or any progress that would persuade us to call off Friday’s action.

‘As it stands, what the secretary of state has put on the table will still see thousands of resident doctors turned away from jobs this year, while continuing to back a real-terms pay cut that the Government has suggested for doctors next year.

‘I made clear to the secretary of state this morning that without movement, we would be forced to go ahead as planned.

‘We want to reach a deal on both pay and jobs, that delivers for doctors and patients, but the Government seems intent on preventing this.’

Meanwhile, BMA council chair Tom Dolphin has written to trust chief executives to urge them to make sure they plan for safe patient care during the five-day walkout.

He said NHS England boss Jim Mackey has set ‘a very ambitious target for hospitals to effectively carry out almost as many operations as they would on non-strike days’ which he warned could be unsafe.

He said resident doctors have a ‘legal right’ to take strike action, and that they ‘must not be bullied or coerced into staying in work’.

During his speech, Mr Streeting said ‘the last thing patients need this winter is strike action by the BMA’ as he praised trust leaders for ensuring 11,000 more procedures went ahead in the latest round of strikes than in June 2024 and kept costs down by £100m against previous rounds of industrial action. 

‘Strikes do have unavoidable and serious consequences, particularly when they’re called during winter,’ he added. ‘That’s why I made a comprehensive offer to the BMA last week, in a final attempt to prevent strike action.

‘Coming off the back of a 28.9 per cent pay rise, which they have already received from this government, I would have thought that my offer to go even further with extra jobs, prioritisation and money back in their pockets would have demonstrated how serious this government is about improving resident doctors’ lives and carer prospects.’

Addressing the BMA directly, he said: ‘Postpone the strikes, trust your members, and give resident doctors a say [on the offer]. Patients, doctors and the wider NHS staff all lose if strikes go ahead, and there is still time for everyone to win.’

Mr Streeting said the NHS budget does not allow him to give ‘everything to everyone all at once’ and said that while he understood and appreciated resident doctors’ frustrations about their pay and conditions, he had to consider the NHS’s 1.5 million staff as a whole through ‘choices and trade-offs’.

He said many other NHS staff have had lower pay uplifts, and in many cases would not earn ‘anywhere near’ what doctors do at the height of their career earnings than the lowest paid doctor.

Responding to questions, Mr Streeting said that, if strikes go ahead, they would ‘set the system back’. ‘There isn’t a more pro-doctor, pro-NHS government waiting in the wings; there is Nigel Farage and the Reform party,’ he said.

And he said the BMA consultants committee and pensions committee are among the ‘most effective lobbyists against paying higher tax’, which makes it difficult for the Government to raise funds to redistribute to other groups.

‘As a cancer survivor, as much as I think my surgeon is worth his weight in gold, we have to be honest and realistic about the challenges in the system, the challenges in the public finances and challenges facing every family in the land. It’s time for the BMA to get real.

‘We are not going to be held to ransom, we are going to plough on regardless and I think it’s becoming increasingly clear that the BMA is no longer a professional voice of doctors – they are increasingly behaving in cartel-like behaviour and they threaten not just the recovery of the NHS under this government but they threaten the future of the NHS full stop, and I think that is a morally reprehensible position to be in.

‘I cannot think of a precedent in British trade union history where after that level of pay rise people have then chosen to walk out on strike.’

While he dismissed a question from a Telegraph journalist asking if continued strike action by resident doctors may make him consider making it illegal for doctors to take industrial action, he said ‘with that power comes a responsibility and a duty of care to patients’.

He suggested the turnout in the latest ballot of the BMA’s resident doctor committee showed that fewer than half of all resident doctors voted for industrial action. He said the BMA was ‘not interested in the choices and trade-offs you have to contend with as a government’.

His speech was otherwise very upbeat, saying that the NHS was ‘on the road to recovery’ and ‘top of the tree’ in terms of government spending priorities.

With the certainty and security of multi-year investment in the NHS, he said trust leaders have a ‘moral duty’ to ensure budgets are spent efficiently so that ‘every penny’ counts – by ‘reducing waste and increasing productivity’.

Mr Streeting thanked trust leaders in the room for their efforts since Labour came to power last year and that they, alongside frontline staff, are behind the ‘green shots of recovery’ because a ‘can do culture’ was ‘back in the NHS’ after years of decline under the Conservatives.

He said he was confident that the target for 92 per cent of patients to be seen within 18 weeks by the end of the Parliament would be met.

‘This isn’t the moment to take ease off the gas,’ he told the room. ‘It’s the moment to push on the accelerator.’

The speech confirmed widely trailed reports that NHS leaders were being given the go-ahead for a 50 per cent cut to headcounts in ICBs (integrated care boards), a move touted to save £1bn which would be pumped back into frontline services.

ICBs will be tasked with transforming the NHS into a Neighbourhood Health Service, with a greater focus on preventing illness – the main themes of the NHS Providers conference.

‘Our investment is not simply pouring more water into a leaky bucket. We’re plugging the holes, cutting out the waste and rebuilding our NHS.’

He also brushed off speculation that he was vying to become the Prime Minister in a plot to oust Sir Keir Starmer and while not commenting directly on briefings from Downing Street, he said there was a ‘toxic culture’ within No 10.