This week our Health Secretary – and possible next prime minister – Wes Streeting described the union behind NHS doctors who are currently on a five-day strike as behaving like a “cartel”.
What does that word, “cartel”, suggest to you? Politicians or businesspeople binding together to artificially reduce competition? Or, perhaps, independent South American drug lords cooperating with each other to control the illegal drug trade?
But no: Streeting is talking about healthcare professionals. Why would Streeting use such emotive language which, as an English teacher, I would mark down as “inappropriate to the context”?
The Government is skewing the debate around the latest resident doctors’ strike. Though it might point to the British Medical Association’s rejection of a government offer two weeks ago over Streeting’s unwillingness to offer more money, this stand-off is not fundamentally about pay, nor even wholly about morale. It is about job security, the most basic expectation of any profession.
It is rapidly disappearing from the medical career pathway. In 2024, just 62 per cent of Foundation Year 2 (F2) doctors who applied for core or specialty training secured a post. A quarter were deemed appointable but left without a place, and 11 per cent were rejected entirely. That’s thousands of young doctors who, after five years-plus of medical school, enormous debts, and two punishing foundation years on the job, find that their career in medicine can end abruptly – at 25.
The 2025 application cycle reveals the stark problem: 92,000 applications for fewer than 13,000 training posts. It has prompted the Royal College of Physicians to issue a blunt warning: the system is “sending a deeply worrying message to the next generation”. Yet government talking points present this as a temporary pressure or the result of disorganised doctors, greedy for more salary too.
The truth is simpler: we are training more medical students without expanding the system they need to progress into. A conveyor belt has become a bottleneck; that bottleneck is turning into a brick wall. All this against a backdrop of a failing NHS that must deal with an inexorably ageing population.
The consequences are now measurable. In 2023, 797 doctors said they were planning to leave for Australia and 345 for New Zealand, alone, two-thirds of them only recently completing F2. These aren’t shirkers or sun-seekers; they’re the very doctors the NHS needs to shape into future consultants. In Australia and New Zealand, training pathways are secure, teaching time is protected, and obtaining a specialist role is the natural, not exceptional, outcome.
Their governments treat young doctors as long-term investments, and they truly value NHS training. Our own government treats them as an expendable workforce.
Instead, the Government should expand training posts at the same rate as it expands medical school places. Without progression, you are creating frustration, not doctors. NHS Trusts and Royal Colleges should also be honest with applicants. Publish real-time competition ratios, crucial regional availability and projected future posts.
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You cannot retain talent by keeping it in the dark. And the public should resist a manufactured narrative that these strikes are about greed. They are about whether, in a decade, our children and parents will have enough doctors to care for them. A doctor who cannot complete their training is one lost to us all.
If we continue as we are, we will watch more young doctors disappear overseas, not because they are uncommitted, but because the NHS has left them without a future. Resident doctors are actually fighting for a viable NHS workforce, something no government strategy has yet delivered.
Supporting this strike is, ultimately, supporting their futures – and our own.
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