25-07-2025
Why are British doctors so radical?
PICTURE THE British Medical Association (BMA), the main doctors' union, and you may imagine a professional body of tweed-wearers. It is more like a giant version of Extinction Rebellion, albeit ready to block health care, not roads. Its latest strike, a five-day walkout by resident (formerly known as junior) doctors, is to start on July 25th. How did they get so radical?
The union has long been a nuisance for governments. Aneurin Bevan, the architect of the National Health Service (NHS), called it a 'small body of politically poisoned people'. Yet strikes by doctors were rare. Until 2023 there had been only three national ones in the NHS's 75-year history.
But from 2023 to 2024, that number shot up. A wave of doctors' strikes in England led to the rescheduling of half a million operations and appointments. The strikes were paused only when the government offered a 22% pay rise over two years.
Now, the BMA's central demand is to restore doctors' real-terms pay to 2008 levels. By its own preferred measure, retail-price inflation, salaries are down by 21% even after last year's bump. Student debt is another grievance. But advocates insist it's not just about money. Dr Julia Patterson, who leads EveryDoctor, a campaign group, says conditions in the NHS are so grim that 'you wonder why anybody would cling on.' One of those who has, Dr Lois Nunn, describes the toll of long hours and a five-hour round-trip commute between her hospital and young family. With a shortage of specialty training posts, placements are highly competitive. Many of her doctor friends have moved to Australia; those who remain, she says, are 'quite miserable'.
The malaise is not uniquely British. In Germany health workers recently went on strike over pay. Fearing increased competition, last year thousands of South Korean doctors downed stethoscopes over the government's push to recruit more medical students. Even in America, doctors are starting to unionise. 'We've lost our voice within the system,' says Dr Matt Hoffman, a doctor organising in Minnesota.
Yet only in England has this frustration hardened into radicalism. In recent years self-styled 'unashamed socialists' took over most of the main committees. The logo of Broad Left, a key faction, is a stethoscope shaped like a hammer and sickle.
The BMA has become a platform for activists' causes. At its recent annual conference it passed several motions on the war in Gaza, including one to suspend ties with the Israeli Medical Association. The BMA softened its critical stance on the Cass Review, an NHS-commissioned report that questioned the evidence base for youth-gender services, only after more than 1,000 members signed a letter in protest.
Not all doctors support the BMA. It's a 'deeply dysfunctional mess', says one who left. Public support has fallen: 34% of Brits support strikes compared with 52% last year. If strikes go ahead, Labour's pledge to cut waiting lists will almost certainly be broken. Coroners have linked previous strikes to at least five patient deaths.
Wes Streeting, the health secretary, has called the strike action 'completely unjustified'. Yet even before now, the BMA's transformation has already been profound. It is no longer simply a doctors' guild, but a political force.
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