Wes Streeting's divide and rule tactics may have won against the doctors – but more strikes are coming

The Guardian

6 days ago

When thousands of ambulance workers went on strike on 21 December 2022 to demand better pay and conditions, the then shadow health secretary, Wes Streeting, wasn't shy in pointing out who was responsible. In their refusal to negotiate, he tweeted, Rishi Sunak and Steve Barclay had driven NHS staff to strike, leaving patients 'in no doubt who is to blame for this chaos'.
Three years and one general election later, the surgical slipper is firmly on the other foot. Resident doctors – formerly known as junior doctors – have just finished a five-day strike, demanding a 29% pay rise over the next few years. Among placards on picket lines calling for 'pay restoration' and an end to 'cuts so deep that even a surgeon couldn't fix it' were printed copies of Streeting's tweet.
Gone is the relaxed attitude displayed by the health secretary towards the British Medical Association (BMA) in 2024, when he agreed a deal with doctors that set them on a 'journey to pay restoration'. He has called this latest strike a 'gift to Nigel Farage' and urged resident doctors to cross picket lines and join their colleagues still 'turning up to work'. He has described the strike not only as 'reckless', but as an action that 'enormously undermines the entire trade union movement'.
Union general secretaries have been quick to shoot back, with Dave Ward of the Communication Workers Union calling Streeting's comments 'shameful', and the Public and Commercial Services Union's Fran Heathcote accusing the health secretary of 'carping in the Murdoch press' instead of negotiating a settlement. For a government whose relationship with organised labour has so far been largely harmonious – apart from Unite's suspension of Angela Rayner over the Birmingham bin strikes – Streeting's denouncement of the BMA is the closest Labour has come to picking a fight with the unions. Is this the government's industrial shot across the bows?
While on the face of it, the row might seem like the first real sign of confrontation between Labour and the unions, it's worth taking a closer look at what is happening. Underlying Streeting's intervention are a number of factors that make the BMA an easy target for a government that's keen to display that it can be tough on unions and not in the pocket of its 'union paymasters'.
The BMA is not affiliated to Labour, nor is it part of the Trades Union Congress, making Labour's institutional link to it much weaker. There's also the fact that resistance to the strike isn't coming only from the government's side: other healthcare unions have expressed unease over existing discrepancies in NHS pay offers. Last month, the Royal College of Nursing called the government's decision to award resident doctors a 5.4% pay increase while offering nursing staff 3.6% 'grotesque'.
In a video posted on X about the strike, Streeting plays into those divisions within the movement, stoking tension between resident doctors and other NHS workers. He talks about 'working hard with … staff that aren't paid as much as doctors to make sure that your pay and your career progression and the conditions that you work in are also good for you'.
Add to that the older consultants and medical professionals who have been having their say: that a strike would 'further diminish the ability of the NHS to deliver', that 'it is too soon to go again', or simply that resident doctors are being 'very greedy'.
Then there's the drastic lurch by the Tories – both in government and opposition – to the right on industrial matters, with Kemi Badenoch proposing this week to ban doctors from taking strike action, putting them under the same rules that apply to police, prison officers and soldiers. This approach gives Streeting more room to present himself as tough but reasonable.
This isn't to defend Streeting, who is probably more than happy to use strike action to justify further NHS privatisation. Nor is it to undermine how galling his comments are for those standing out on the picket lines. One doctor has called them a 'slap in the face', while another asked where the Streeting of 2022 had gone: 'He was making some good points.'
But government condemnation of the strike does not necessarily reflect a wider shift in its strategy towards unions. Amid frenzied attacks by Tories and their media allies on Labour's link with the unions, the reality of the relationship is all too often drowned out. That makes it harder to understand key dynamics: it's likely to be transport unions that the government hopes to take on, not only industrially but politically.
It also makes it harder to spot how unions' different industrial priorities inform their relationship with the government. With so much of Labour's employment rights bill left to secondary legislation, general secretaries still have eyes on the prize of getting their sectoral needs met, whether that's Unison pushing for fair pay agreements or the Union of Shop, Distributive and Allied Workers for zero-hours contract reform. Then there's the fact that there are those in Labour who are itching to embrace the spirit of the 1980s and launch a full-frontal attack on the movement.
The country is once again facing the prospect of widespread public sector industrial action, with nurses and teachers potentially set to join the strike action. A decade of suppressed public sector pay, inflation and increases in the cost of living has challenged the idea that certain professions' wages are always guarantees of a good life. On a basic starting salary of £38,831 and saddled with as much as £100,000 of student debt, it's no longer enough for new resident doctor recruits to simply wait to earn more at some distant point in the future.
While there are grievances specific to the resident doctors' strikes – a shortage of speciality training posts and having to spend thousands of pounds on exam fees, courses and equipment such as stethoscopes – many of their concerns are felt deeply across the movement. Stubborn mountains of student debt, housing costs that utterly eclipse wages and crumbling public services that drive down working conditions are not unique to the BMA.
For this dispute, Labour has used inter-union tensions over NHS pay – as well as the outdated idea that all resident doctors are middle-class professionals – as a political opportunity to dodge blame for the strike. But that strategy won't work for all strikes. As public sector unrest continues to unfold, the government's battle with the unions might well begin in earnest.
Polly Smythe is labour movement correspondent at Novara Media