Adam Boulton: NHS pessimism creeping up as striking doctors push on with 35% pay demand

Published

2 years ago

January 7, 2024

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In its long and venerable history dating back 192 years, the British Medical Association used to shy away from being called a “trades union”.

Collective bargaining was for “trades people”; the doctors were independent professionals. Their association was there to campaign for best practice and to offer advice to the politicians regulating health treatment.

That was when the reflex of most medical practitioners was to subscribe to the Hippocratic principle often paraphrased as “first do no harm”.

Much has changed. Today the BMA has no qualms about being described as the “doctors’ union”.

It has freely employed strong-arm negotiating tactics, familiar from industrial disputes, in pursuit of better pay for its members – including strikes, walkouts, deadlines and work to rules.

These have culminated in the current “unprecedented” six-day strike by junior doctors in England, which is due to end at 7am on Tuesday.

There can be no doubt that the strikes are doing harm to patient care.

NHS England has just reported that 89,000 “appointments and procedures” had to be put off because of the three-day strike in December.

Since the industrial action started last March, 1.2 million appointments have been cancelled and rescheduled.

The BMA rejected requests from the NHS to keep working in critical areas including fast-progressing cancers, corneal transplants and emergency caesareans.

Heated recriminations broke out as the BMA accused hospital managers of “weaponising” so-called “derogation requests” permitting them to recall staff to work if patient safety is “in jeopardy”.

Meanwhile, some A&E departments declared “critical” incidents with waiting times for treatment stretching as long as 16 hours.

PM failing to fix waiting list backlog

“Cutting NHS waiting lists” was one of the prime minister’s five pledges and this aim is seriously off track. Opinion polls taken during the dispute suggest that just over half of the public back the strikes (53%).

In a survey four months ago, people were more inclined to blame the government for the dispute (45%) than the BMA (21%), although 25% said they were both responsible.

Yet 11 months into the confrontation, the junior doctors, who lose pay on strike days, must be wondering what they are getting out of it. Their demand for a massive 35.3% pay rise still seems out of reach.

Having walked out of negotiations in December, Dr Vivek Trivedi, co-chair of the BMA junior doctors’ committee, now says he might be prepared to engage in more talks, saying “all we want is a credible offer that we can put to our members and we don’t need to strike again”.

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Although discontent over pay is widespread throughout the NHS workforce, most sectors other than junior doctors in England have accepted deals or, at the least, suspended their action.

NHS consultants accepted salary rises of up to 12.8% along with some pay reforms.

The Royal College of Nursing ballot for further strike action failed and a pay rise of 5.5% was imposed.

Health management is devolved. Junior doctors in Scotland accepted a 12.4% pay rise, on top of 4.5% in 2022/23. Junior doctors in Northern Ireland are balloting on a similar offer. In Wales, there is the prospect of a three-day strike from 15-18 January.

When negotiations broke down before Christmas, the government was offering a 3.3% increase on top of the 8.8% already imposed, taking the total for the English juniors above 12%.

Are the strikes really ‘saving the NHS’?

By the standards of the other disputes, a reasonable settlement should be within touching distance were it not for the sense of grievance, embodied in the claim that pay has been cut in real terms by more than a third since 2008.

Few independent analysts accept the BMA’s calculation, which relies heavily on RPI inflation fluctuations. In line with recent trends for national statistics, the independent Institute for Government says the CPIH, the consumer price index, would be a more appropriate indicator, meaning a cut of 11-16%.

This was in the post-credit crunch, austerity period when wages across the public and private sectors stagnated.

The public is sympathetic to junior doctors who help to keep them well, but should they be an exception?

Over time, pay structures change. The youngest and lowest paid of those now on strike were at primary school in 2008; is it rational to restore their pay levels to what they were then?

“Junior doctors” is an unsatisfactory catch-all term for a wide range of hospital doctors. “Doctors in training” – which some Conservative politicians attempted to popularise – hardly does them justice either.

The term covers all hospital doctors who are not consultants, ranging from those just qualified and still effectively indentured, to senior registrars.

First-year junior doctors earn £32,398, rising to £37,303 in the second year and £43,923 in the third. Registrars’ basic pay goes up to £58,000. Full-time NHS consultants earn up to £120,000.

On the picket lines, strikers often argue their action is not about their own pay but to save the NHS because, they say, many of their peers are leaving for better terms in Australia, New Zealand and Canada.

Conversely, as recent special grade immigration figures show, there are many qualified people abroad with conflicting aspirations who are anxious to come here to work in the NHS.

Much to ponder on how the NHS should work

The additional crisis brought on by the strikes has inevitably prompted some rethinking about how the NHS is working.

Speaking to Sarah-Jane Mee on the Sky News Daily’s How To Fix The NHS mini-podcast series, Dr Adrian Boyle, president of the Royal College of Emergency Medicine, observed “that everything flowed better” in A&E departments because senior doctors providing cover had more direct contact with patients and “there were fewer people coming into hospital for elective work and this meant more beds”.

Those statements about organisation in the NHS should provide consultants, junior doctors and potential patients with a lot to ponder.

The same goes for politicians, who the public holds primarily responsible for delivering their healthcare.

Steve Barclay took an abrasively inactive approach to the various NHS disputes when he was health secretary. In November he was moved to make way for the more emollient Victoria Atkins.

She says she wants “a fair and reasonable settlement” to end the strikes and is open to further negotiations provided the threat of more strikes is withdrawn.

Is the NHS broken – and would Labour do any better?

Atkins’ position is not much different from Wes Streeting, her Labour opposite number.

He has said for months that the disputes should be sorted out by negotiations with ministers and that a Labour government would not meet the 35% pay claim.

Streeting is of the view that reform, likely to discomfort some of the NHS’s vested interests, is more needed than extra cash.

Whatever view they take of the doctors’ actions, public pessimism about the NHS is on the rise.

Much as they love the NHS, growing numbers of the public say it is “broken” or “not fit for purpose”. There is also a live debate about whether doctors should lose the right to strike, just like the police and members of the armed services.

The pollsters regularly ask the question “should doctors be allowed to strike?”

Last summer, at the height of the consultants’ dispute, 50% said yes, 42% no. By November, support for doctors’ right to strike had dropped to 47% yes, 46% no.

The asking of that question alone would have astonished the founders of the BMA’s precursor, the Provincial Medical and Surgical Association, back in 1832.

Politics

Labour accused of ‘scandalous attempt to subvert democracy’

Published

2 hours ago

December 4, 2025

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Four mayoral elections to be postponed - as Labour accused of 'scandalous attempt to subvert democracy'

Four mayoral elections due to take place in May 2026 are set to be postponed by two years, Sky News understands.

Elections for the new mayoralties of Essex, Hampshire and the Solent, Sussex and Brighton, and Norfolk and Suffolk will be pushed back until 2028.

The decision, first revealed by The Sun, is due to be announced by ministers today.

This is the second time elections are being delayed in these areas. Local elections due in May 2025 were delayed by then communities secretary Angela Rayner for a year in order to convert them into combined authorities led by mayors.

However, it is understood that these councils need more time to complete their reorganisation.

The news has sparked accusations Labour are delaying the elections for political purposes.

Reform UK’s head of policy Zia Yusuf said: “This is a blatant attempt to stop big Reform wins next May.

“It’s an act of a desperate government who are clinging onto power by any means necessary.

“Labour has proven time and time again that they’re not beyond denying democracy to millions of people in order to maintain their cosy status quo.”

The Tories’ shadow housing secretary James Cleverly said it was a “scandalous attempt to subvert democracy by a Labour government whose credibility and popularity are already in tatters”.

“The Conservatives firmly oppose this decision to delay the mayoral elections, especially when candidates have been selected and campaigning is well under way,” he added.

“Democracy is being denied yet again after the council elections cancelled by Labour this year.

“There is no credible justification for this move. The Labour government must reverse it immediately.”

The reorganisation is part of Labour’s manifesto commitment to widen devolution, which it argues will improve local economies.

The government wants to abolish the two-tier system of county and district councils and merge them together to create larger unitary authorities. It also wants more areas to have regional mayors, like Greater Manchester’s Andy Burnham.

Reform UK enjoyed success in the local elections in May, winning more than 600 seats and taking control of 10 councils stretching from Kent to County Durham. The party also toppled a 14,000-strong Labour majority in a parliamentary by-election.

The Liberal Democrats’ local government spokesperson Zoe Franklin called the postponed elections “a disgrace”.

“Democracy delayed is democracy denied,” she added. “We are fighting to end this blatant stitch up between Labour and the Conservatives over local elections.”

Politics

Reeves between a rook and a hard place after claims she ‘made up’ chess championship

Published

2 hours ago

December 4, 2025

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Reeves between a rook and a hard place after claims she 'made up' chess championship

As an opening gambit at PMQs, Kemi Badenoch attacked Labour’s knight, the prime minister, over his Treasury queen, Rachel Reeves.

“We now know the black hole was fake, the chancellor’s book was fake, her CV was fake – even her chess claims are made up,” said the Tory leader.

Politics Live: Labour MP who voted against inheritance tax suspended

“She doesn’t belong in the Treasury; she belongs in la-la land.”

Chess claims made up? Where did that attacking move from Kemi come from? Hasn’t the chancellor told us for years that she was a national chess champion in 1993?

Indeed she has. “I am – I was – a geek. I played chess. I was the British girls’ under-14 champion,” she declared proudly in a 2023 interview with The Guardian.

She posted a video showing her playing chess in parliament and before last week’s budget posed for photos with a chessboard.

But her chess champion claim has been disputed by a former junior champion, Alex Edmans, who has accused her of misrepresenting her credentials.

“Her claim was quite specific,” Edmans, now a professor of finance at the London Business School, told Ali Fortescue on the Politics Hub on Sky News.

“She said she was the British girls’ under-14 champion. There was one event that can go on that title, which is the British Championship. And in the year that she claimed, it was Emily Howard who won that title instead.

“She did indeed win a quite different title. There was a British Women’s Chess Association championship, but that’s a more minor title. I’ve won titles like the British squad title, but that’s not the same.

“Just like running a marathon in London is not the same as the London Marathon, there was one event which is very prestigious, which is the British Championship.

“So the dispute is not whether she was a good or bad chess player. That shouldn’t be the criterion for a chancellor. But if you weren’t the British champion, you shouldn’t make that statement.”

Oh dear! So now, along with allegations of plagiarism, a dodgy CV and “lying” – according to Ms Badenoch – about the nation’s finances, the chancellor is between a rook and a hard place.

Or is she? “This story is absolute nonsense,” a Treasury mate told Sky News. No word from the No.10 knight, Sir Keir Starmer, or his Downing Street ranks, however.

Emily Howard, as it happens, is now an accomplished composer, having graduated from the chessboard to the keyboard.

The chancellor’s opponents, meanwhile, claim her budget blunders means the Treasury queen has now become a pawn, there for the taking.

But since Rachel Reeves did indeed win a chess title, just not the one she claimed, her supporters insist she can justifiably claim to have been a champion.

So it’s too soon for Kemi Badenoch and the Conservatives to claim checkmate. The dispute remains a stalemate. For now.

Politics

Connecticut orders Robinhood, Crypto.com, Kalshi to stop prediction markets

Published

4 hours ago

December 4, 2025

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Connecticut orders Robinhood, Crypto.com, Kalshi to stop prediction markets

The US state of Connecticut has hit Robinhood, Kalshi and Crypto.com with cease and desist orders, accusing the platforms of offering unlicensed sports betting through event contracts.

The Connecticut Department of Consumer Protection sent letters to the three platforms on Wednesday, claiming they were “conducting unlicensed online gambling, more specifically sports wagering,” with event contracts available online.

“None of these entities possess a license to offer wagering in our state, and even if they did, their contracts violate numerous other state laws and policies, including offering wagers to individuals under the age of 21,” said DCP Commissioner Bryan Cafferelli.

DCP Gaming Director Kris Gilman accused the platforms of “deceptively advertising that their services are legal,” adding that they operate outside of the state’s regulatory environment, “posing a serious risk to consumers who may not realize that wagers placed on these illegal platforms offer no protections for their money or information.”

Prediction markets have come under legal scrutiny in several US states, as the use of these platforms has skyrocketed this year and attracted billions of dollars in investment for allowing users to bet on the outcome of a variety of events.

*Prediction markets saw huge volumes in November. Source:* *Token Terminal*

Kalshi fires back in court

A Kalshi spokesperson told Cointelegraph that it is “a regulated, nationwide exchange for real-world events, and it is subject to exclusive federal jurisdiction.

“It’s very different from what state-regulated sportsbooks and casinos offer their customers. We are confident in our legal arguments and have filed suit in federal court,” Kalshi added.

In a complaint filed on Wednesday against the DCP, Kalshi claimed that “Connecticut’s attempt to regulate Kalshi intrudes upon the federal regulatory framework that Congress established for regulating derivatives on designated exchanges.”

It added that its platform was subject to the Commodity Futures Trading Commission’s “exclusive jurisdiction” and its sports event contracts “are lawful under federal law.”

“As we’ve previously shared, Robinhood’s event contracts are federally regulated by the CFTC and offered through Robinhood Derivatives, LLC, a CFTC-registered entity, allowing retail customers to access prediction markets in a safe, compliant, and regulated manner,” a Robinhood spokesperson told Cointelegraph.

Crypto.com did not immediately respond to requests for comment.

In its statement, Connecticut’s DCP said that prediction market platforms pose serious risks to consumers because they lack the required technical standards and security protections for financial and personal data.

*Source:* *Connecticut Department of Consumer Protection*

The agency claimed that such platforms also lack integrity controls to prevent insider betting or manipulation, operate without regulatory oversight of their payout rules, advertise to self-excluded gamblers and on college campuses, and permit betting on events with known outcomes, thereby giving insiders unfair advantages.

Only three platforms are legally licensed for sports wagering in Connecticut: DraftKings, FanDuel and Fanatics, all of which require users to be at least 21 years old.

Kalshi under fire in at least 10 US states

Connecticut is not the only state to take a hard stance on prediction platforms; regulators in two neighboring states have previously taken action.

New York sent a cease and desist to Kalshi in late October, and the company responded on Oct. 27 by suing the state. Meanwhile, the Massachusetts state attorney general sued Kalshi in the state court in September.