Resident doctors across England begin a five-day strike this morning over pay and jobs, marking the 14th walkout by them since March 2023.

It coincides with the record number of flu cases in England and NHS leaders warning of a “huge strain on hospitals” and strikes causing “further disruption and delays”.

Resident doctors are striking in England from 7am today until 7am on Monday 22 December.

Sir Keir Starmer called the action “irresponsible” while Health Secretary Wes Streeting has rejected the British Medical Association’s (BMA) pay demands, accusing the union of a “shocking disregard for patient safety”.

But the BMA insists its strike is “entirely avoidable” and has demanded a “credible offer” to avert “real-terms pay cuts”.

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Streeting: Government has gone ‘as far as we can’ with BMA negotiations

Why are resident doctors on strike?

The government says resident doctors have already received an average pay rise of 28.9% over the past three years (2023-24 to 2025-6).

But the BMA has been demanding an additional 26% pay uplift to restore what they say amounts to erosion in their earnings, once inflation is taken into account. Although there is some dispute about the extent of the real terms fall, because of the BMA’s use of the Retail Price Index (RPI) in its calculation.

Hopes that the strike could be averted were dashed on Monday when the BMA said 83% of resident doctors rejected a fresh proposal from the government.

While it did not include any extra pay, the offer included the fast expansion of specialist training posts; covering out-of-pocket expenses such as exam fees; and offering to extend the union’s strike mandate to enable any walkout to be rescheduled to January.

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BMA boss on decision to go ahead with doctors’ strike

What if I need urgent medical care?

The Department of Health and Social Care says it is important people do not avoid seeking urgent care, and should use 999 if it is a serious or life-threatening emergency. For everything else, there is NHS 111 or the NHS App.

It adds that patients should turn up for planned appointments unless they have been told otherwise. Any appointments that need to be rescheduled will be given priority.

During strikes, there are exemptions or special arrangements, called derogations, which allow certain essential services to continue operating. It means critical services will be maintained to ensure patient safety and prevent serious harm.

How much do resident doctors earn?

There are many different types of resident doctor in England with different levels of pay. Full Fact, which has crunched the numbers, said they currently earn between £38,831 and £73,992 a year, but that does not take into account extra pay for unsociable hours.

Full Fact states that resident doctors typically get between a quarter and a third more than their basic salary from other sources.

This takes estimated average earnings (in the year ending August 2025) to between £45,846 and £81,061 (although the government claims the figures are more like £49,000 to £97,000).

Comparisons with other countries are difficult because of how doctors are categorised. Broadly, resident doctors in England earn about the same as those in Ireland and anything between 1% less and 26% more than in New Zealand.

But doctors in Australia earn somewhere between 23% and 48% more than their counterparts in England.

What has the reaction been?

The prime minister has said the strike comes “on the back of a very substantial pay increase in the last year or so”.

“I think it’s irresponsible action by the BMA,” he told MPs.

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BMA actions ‘irresponsible’, says Starmer

The health secretary called for doctors to ignore the strike and criticised what he called the “fantasy demand for another 26% pay rise,” adding that “it reveals the BMA’s shocking disregard for patient safety”.

Dr Jack Fletcher, chairman of the BMA’s resident doctors’ committee, said the strikes were “entirely avoidable”. He added that “we should start negotiating, and the government should stop game-playing”.

But organisations representing NHS trusts have been scathing about the walkouts. Daniel Elkeles, chief executive of NHS Providers, said: “Trust leaders and staff will be working now to minimise the impact of the strike, but sadly it will mean further disruption and delays.”

Meanwhile, Rory Deighton, acute and community care director at the NHS Confederation, said: “These strikes come at the worst possible time, with rapidly rising flu levels putting huge strain on hospitals.”

What about public support for strikes?

Public support for the strikes is low, according to a YouGov poll released last week.

The results showed 58% of those asked either somewhat or strongly opposed the industrial action, while 33% somewhat or strongly supported it.

The dashcam footage from Paul Doyle’s Ford Galaxy, as he ploughs his way through the crowd at the Liverpool parade, is chilling.

Bodies are thrown left and right, people disappear under the front of the car, for a few seconds some appear to be clinging to the bonnet, terror on their faces.

The sound is equally graphic. The screaming and the shouting from outside of the car. And the thumps: as people bang on the car to get Doyle to stop, and as people are hit by it.

Men, women and children hit. A bike, a baby’s pram.

Throughout those couple of minutes, Doyle lays on the car’s horn, the parking sensors beep constantly, and he shouts.

“F***ing hell, move,” he repeats. “Get out the f***ing way”, “f***ing move”, “get off the f***ing road, you f***ing p***k”.

Those words, prosecutors say, reveal the truth – that Doyle knew he was driving at people.

He was jailed for 21 years and six months – with Judge Andrew Menary KC telling Doyle he acted in an “inexplicable and undiluted fury” when he drove into the crowds.

The judge told him his “disregard for human life defies ordinary understanding”.

“Your actions caused horror and devastation on a scale not previously encountered by this court,” he said.

“The footage is truly shocking… it shows you, quite deliberately, accelerating into groups of fans time and time again.

“You struck people head-on, knocked others onto the bonnet, drove over limbs, crushed prams and forced those nearby to scatter in terror.”

Follow latest as Paul Doyle is sentenced

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Liverpool parade attack explained

“In my 20 years of policing, this is the most graphic and distressing footage I have ever encountered,” said Detective Chief Inspector John Fitzgerald, the senior investigating officer for Merseyside Police.

“Doyle’s total disregard for the safety of others – particularly the many young children present on Dale Street and Water Street that day – is beyond comprehension. It is sheer luck that no lives were lost.”

In the end, that dashcam footage was never shown to a jury as Doyle pleaded guilty on the day his trial was due to begin. The footage will not be released to the public due to its graphic nature.

What motivated his rampage?

“I think Doyle was just determined to get to where he wanted to get to, and there was no stopping him no matter who was in his way,” said DCI Fitzgerald.

“He clearly got angrier and angrier as the dashcam footage rolls on. He was yelling profanities at the people in his way.

“He just clearly got red mist.

“I do not believe that Doyle deliberately set out his journey to injure people on that day, but his actions were deliberate.”

Ex-soldier helped stop attack

Doyle was only stopped by the bravery of former soldier Dan Barr. He managed to climb into the back seat of the car when Doyle briefly paused.

“It was desperation to get him stopped, determination to stop him by whatever means, I think that’s what was going through my head,” Mr Barr said.

“He accelerated off, the door slammed shut and I’d gone from the total chaos of panic and screaming to the relative silence as he’s accelerated off and you can just hear the people being hit and run over.

“It was horrendous, and I could see people’s faces. I could see the looks of them trying to plead but wasting their time, that’s all they could do because there was nowhere to go to get out of the way.

“I do remember seeing he had an automatic and therefore P for park was right at the end so I thought I’ll just jam that forward as far as I could that should stop him, and it did.”

Without Mr Barr’s actions, police say, Doyle would have carried on. They have described him as a hero.

“I don’t think I am,” Mr Barr said. “I think it is standard.

“Who wouldn’t, if they could have, done what I did? I can’t think of anyone, especially on that street.”

It has come at a cost.

“I don’t think I have processed it, to be honest with you,” Mr Barr said.

“I’m not the same since that day. I’m not doing great but I’m getting there.”

By the time it was all over, 134 people had been injured, including two babies and six other children.

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Liverpool parade victim tells of ‘carnage’

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Liverpool parade attack victim recalls ‘carnage’

Tens of thousands of Liverpool fans had been on the streets of the city on that spring bank holiday Monday to celebrate the club’s Premier League triumph.

Doyle had driven to the parade to collect a friend he had earlier dropped off there. On his way into the city, his dashcam had recorded him driving erratically, undertaking other cars and running a red light.

But police say there had been no sign earlier that day of what could have triggered his rage.

Doyle’s violent past

It can now be revealed that Doyle has previous convictions for assault.

In the early 1990s, while serving in the Royal Marines, he was convicted of biting off part of someone’s ear during a fight in a pub. He was discharged from the military at that time.

Police say they believe Doyle is a fan of Liverpool’s city rivals Everton, but that this was not a factor in what happened on 26 May.

In police interviews, Doyle claimed he acted in fear and panic because someone in the crowd with a knife had opened his car door. Investigators say they spoke to 1,500 witnesses and no one else mentioned seeing a knife.

He also claimed he stopped when he hit the first person. In fact, he had hit more than 100 before stopping. His claims, prosecutors say, were lies.

As the incident unfolded, many of those who were there shared their first thoughts.

Debbie Blair said: “People were just screaming, ‘It’s a terrorist, it’s a terrorist, he might have a gun, he might have a knife’.”

“Next minute people were all screaming, ‘kill him, kill him’,” she said.

Her son Mike was with her. Images of car attacks on Christmas markets in Europe, he said, flashed through his mind. His greatest concern was the number of children there.

“It was carnage, total carnage,” he said.

He was treated in hospital for injuries that still affect him.

“It shouldn’t have happened. But for someone to intentionally do that, it’s quite sick really.”

Police say Doyle has never shown any remorse for his actions. He told officers: “I’ve ruined my family’s lives.”

What he did on 26 May, prosecutors say, devastated lots of people’s lives.

A “hero” pedestrian climbed into the car of Liverpool parade attacker Paul Doyle and stopped him, a court has heard.

Doyle, who used a car as a “weapon” to plough through more than 100 people celebrating Liverpool’s Premier League title win, told officers “I’ve just ruined my family’s life”, the court heard.

The sentencing hearing was told the 54-year-old was “in a rage” and his “anger had completely taken hold of him”.

Doyle is due to be sentenced on Tuesday after pleading guilty to 31 offences relating to seriously injuring people during the victory parade on 26 May.

Doyle, described as a “family man” by prosecutors, wept as footage of the horrific rampage was shown to the city’s crown court several times on Monday.

Paul Greaney KC, prosecuting, described the actions of Daniel Barr, who he called the “hero” of the day.

Mr Barr, an ex-soldier, had “bravely” jumped into the back of Doyle’s Ford Galaxy and placed the vehicle into park.

He was walking up Water Street when he noted the defendant’s Ford Galaxy in the distance, said Mr Greaney, noting the crowd’s attitude changed from “joyous to desperate”.

Doyle’s vehicle then stopped next to Mr Barr “all of a sudden”.

“Daniel Barr instinctively pulled open the rear passenger-side door and climbed in. He did so with the intention of stopping the driver,” the prosecutor said.

Mr Barr leaned forward and moved the gear into “park” and “held it as hard as he could”.

Mr Greaney added: “The Galaxy did not stop immediately, but in the end it did.”

The prosecutor said police officers forced Doyle into a police van after the attack.

This, he said, was done “in the midst of a hostile crowd”, adding that officers’ behaviour was both “brave and effective”.

When Doyle was securely in the van, Mr Greaney said police body-worn camera footage picked up him saying: “I’ve just ruined my family’s life.”

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Doyle admitted dangerous driving, affray, 17 charges of attempting to cause grievous bodily harm (GBH) with intent, nine counts of causing GBH with intent, and three counts of wounding with intent last month.

He had previously denied the offences, which relate to 29 victims aged between six months old and 77 years old.

The court was shown dashcam footage taken from the defendant’s car showing the attack.

Mr Greaney warned the court: “What we are about to display on the screens is truly shocking.”

There were audible gasps in the courtroom as the footage played.

Doyle could be heard repeatedly shouting at pedestrians to “move out the f****** way” as he drove through crowds.

Consistently using his vehicle’s horn, people could be seen trying to jump out of the way, with some forced on to the bonnet of the car.

“F****** pr****,” Doyle shouts as the footage continues.

By the end of the footage, people begin to attempt to run up to the vehicle.

When the car stops, one man shouts, “get the f*** out of the car”.

Mr Greaney also detailed some of the injuries sustained by victims on the day of the attack.

One woman, aged 66, spent four nights in hospital after breaking six ribs and suffering fractures to her fingers on her left hand and her left wrist.

Another woman, aged 77 at the time, spent 27 days in hospital.

The prosecutor said she suffered a fractured left forearm, fractured left collar bone, three fractured ribs, a fractured pelvis, a broken nose, as well as multiple abrasions and bruising to her head, knees and back.

Another victim, who was 17, suffered bruising to their legs, shoulder and had a small fracture to their tibia.

After suffering wound infections, it took two months before the victim regained mobility, the prosecutor added.

Mr Greaney said some people at the scene on 26 May “thought that what was taking place was a terrorist attack”.

However, the prosecution ruled out that the defendant’s actions were “driven by ideology”.

Police investigations showed there was no problem with the vehicle, and Doyle was completely sober and “free of all drugs”, Mr Greaney said.

“The truth is a simple one – Paul Doyle just lost his temper in his desire to get to where he wanted to get to.

“In a rage, he drove into the crowd,” he added.

Doyle was arrested at the scene in Water Street just after 6pm and charged later that week.

The youngest victim was six-month-old Teddy Eveson, whose parents later told media he was thrown about 15ft down the road in his pram when the crash happened.

Doyle, of Croxteth, Liverpool, admitted attempting to cause grievous bodily harm to the baby.

Five other children, whom Doyle either injured or attempted to injure, cannot be named for legal reasons.