The wave of resident (junior) doctors’ industrial action in the UK began already in 2016. The current regrettable situation started in 2026:
- 1 Feb 2026: BMA announces resident doctors vote 93% yes (53% turnout) for 6 more months of industrial action over pay restoration and training posts.
- 4 Feb 2026: Wes Streeting plans to offer bigger pay rise (at least double the 2.5% NHS-wide for 2026/27) specifically for resident doctors, plus working conditions guarantees.
- 24 Mar 2026: the BMA announces six-day strike (7-13 Apr) after “weeks of talks” break down; accuses government of shifting goalposts by spreading pay over three years.
- 25 Mar 2026: Government issues statement on proposed action; Streeting calls offer “historic” with 3.5% DDRB pay for 2026/27, exam fee reimbursement, and 4,000-4,500 new training posts over three years (1,000 by Apr 2026).
- 26 Mar 2026: Government publishes full “offer to BMA RDC” letter, developed over three months; gives BMA until 2 Apr to reconsider.
- 31 Mar 2026: Keir Starmer issues 48-hour deadline amid row; BMA rejects without member ballot.
- 2 April 2026: Keir Starmer withdraws the offer of additional training posts, and most of us fear that the strike will go ahead.
- As of today, 3 April 2026, the resident doctors’ strike in England is set to go ahead from 7am on Tuesday 7 April to 6.59am on Monday 13 April 2026.
So, is it ethical for doctors to strike?
No firm ethical rules exist on doctors striking. The answer to the question depends on context, patient safety measures, and goals like fair pay versus harm to vulnerable patients. Ethics must consider the balance of doctors’ rights as employees against their duty of care for patients.
Pro
Strikes can be justified as a last resort for systemic fixes, such as pay restoration to retain staff and protect long-term public health. UK analyses argue 2023-2024 strikes were permissible or even supererogatory when addressing government failures in NHS staffing and funding, with minimal disruption to emergencies. Doctors’ human right to strike applies equally, especially if action targets broader patient welfare.
Contra
Critics see strikes as breaching non-maleficence by jeopardising care, risking lives, and eroding trust, especially for time-sensitive cases without full cover. Some ethicists view strikes as permissible only if patient continuity is pre-arranged, viewing them otherwise as a social contract violation where patient interests trump worker demands. In under-resourced systems, strikes burden non-strikers unfairly.
My conclusions
A balanced test for determining whether or not a strike by doctors is ethical includes last-resort status, emergency cover, proportionality of harm versus gains, and public health impact. Guidance by the BMA supports strikes legally/ ethically if these conditions are fulfilled. The UK resident doctor actions currently planned seem to meet these conditions by sustaining emergency care while fighting pay erosion confirmed to amount in real terms to a decrease of 4-26% since 2010s.
Kier Starmer’s withdrawing of training posts seems a somewhat childish reaction and is bound to delay care and raise NHS waiting lists long-term. The BMA calls it sabotage that hurts patients by choking specialty training pipelines when emigration is already unsustainably high (33% of doctors plan to leave UK post-training). The government counters that the strikes cause immediate harm (e.g., cancelled clinics), while posts were a concession BMA demanded yet rejected.
Personally, I feel that both sides have valid arguments. At the same time, both are in the wrong, as they show too little ability to compromise. Both sides have a duty of care to patients which, in my view, includes a duty to reach a rational compromise that benefits patients.
One Response to Is it ethical for doctors to strike?
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A few points:
1. The NHS is a monopoly employer of resident doctors – RDs can’t simply ply their trade with another employer.
Hence “It’s come to this.”
2. When I was a junior (now ‘resident’) doctor (RD) we put up with being exploited because we expected to eventually reach the sunlit uplands.
Which I did – but that is no more.
Consultants are now being as exploited as residents are, and no longer act as a brake on residents’ ambitions.
Sigh.
3. The strike is not against patients.
Any strike is against NHS management/HM government.
4. When the RDs are absent, for whatever reason, the responsibility for NHS patient care is that of the NHS management.
5. Mr Starmer’s bizarre policy to remove 1000 doctors from training places directly harms patients as there will obviously be less patient care which would have been undertaken by those 1000 doctors.
Although still ‘in training’ for more senior positions, RDs are actually providing a significant amount of direct patient care.
Daft or what?
6. I have advocated that RDs might reasonably ‘work to contract’ in furtherance of their claims and not withdraw their labour, but I no longer have any influence.
[“I’ve finished the work for which you contracted me Mr/Mrs/Miss/Ms Manager – I’m leaving now, so over to you to arrange care for the patients, if you can’t care for them yourselves…”]
7. Hiring non-doctors to provide medical opinions and care for NHS patients simply forces patients who whant a ‘top’ medical opinion/care to turn to the private sector.
The NHS is no more.
Perhaps that is what the government intends…
Sigh squared.