by Callum McGoldrick, investigations campaign manager
The junior doctors are striking. Again. Five day walkouts have become a disheartening fixture of the NHS calendar. Despite already having received one of the largest public sector pay settlements in recent history, the British Medical Association (BMA) is once more demanding an inflation-busting increase for its members.
The union's relentless focus on revenue expenditure (day-to-day running costs like salaries) is simply political distraction that actively crowds out real, tangible improvements.
It is frankly laughable to suggest the NHS is underfunded. This financial year, the health service is set to blow past the £200 billion barrier in total spending. According to research we published earlier this year, out of 13 comparable countries, the UK spends one of the largest amounts on healthcare relative to GDP yet performs poorly when it comes to translating that spending into resources.
The BMA is demanding that the Treasury stump up even more money for their members’ pay packets. While this undoubtedly boosts individual doctors, it does absolutely nothing to fix the systemic inefficiencies that cripple our health service. Every major strike is estimated to cost the NHS millions, this one is estimated at £240 million. Money that is pulled directly from already stretched budgets, forcing the cancellation of vital appointments and operations for the very patients doctors claim to be protecting. Since 2022, strikes have forced the rescheduling of over 1.5 million appointments. This is a direct tax on the patients.
The real disease plaguing the NHS is a decades-long addiction to short-term, instant-gratification revenue spending at the direct expense of capital expenditure. Capital spending is the money that builds new hospitals, buys modern scanners and equipment, and installs efficient digital IT systems to replace confusing, paper-based administration.
Out of the 13 most comparable high-income countries, the NHS ranks near the bottom for capital investment. This is why we have crumbling hospital estates, outdated equipment, and woefully inefficient back-office systems. International analysis confirms that had the UK kept pace with the average capital spending of its EU peers between 2010 and 2019, the NHS would have an additional £33 billion invested in its infrastructure today.
The political incentives are rotten: a pay rise or a spending boost (which politicians prefer to call 'investment') delivers an instant, headline-grabbing political win before the next election. Building a new hospital or implementing a modern IT system takes years, often spanning multiple election cycles, making it an unappealing prospect for short-sighted politicians.
With the country's economic situation so dire, the public's patience with the BMA is wearing thin. Doctors have received pay rises over the last few years amounting to nearly 30 per cent in total, well above most in the private sector. Recent polling shows a public increasingly divided on the strikes, with opposition growing, as the cost of the industrial action directly translates into longer waiting lists and greater misery for patients.
It's time for the Health Secretary to change the understanding of NHS spending. We must shift the focus from merely topping up day-to-day pay packets to a serious, long-term commitment to capital investment that will deliver a modern, productive health service that taxpayers deserve for their £200 billion contribution. The BMA’s current strategy is a costly distraction from the structural reforms the NHS truly needs.