Health unions put NHS on notice for more damaging strikes as ministers recommend a below-inflation pay rise

Unions today put the NHS on notice for more damaging strikes after ministers recommended a below–inflation pay rise.

Doctors, nurses and other healthcare workers reacted with fury to the government's proposal for a 2.4 per cent rise for the 2027/28 financial year.

The British Medical Association, which represents doctors, described the real–terms pay cut as 'derisory' and said it 'beggars belief', while the Royal College of Nursing described it as a 'betrayal'.

The Department of Health and Social Care and NHS England told the NHS Pay Review Body that it could not afford to pay more without 'difficult trade–offs', which may involve cutting services or longer waits for care.

Their joint evidence described NHS pay as 'a significant material pressure' and said every 0.5 per cent increase adds £750 million to the wage bill, which is the 'equivalent of more than 89,000 hip or knee replacement operations'.

Officials, who submitted similar arguments to the Review Body on Doctors' and Dentists' Remuneration (DDRB), said DHSC and the NHS are 'already managing a wide set of material financial risks'.

This includes 'the impact of higher inflation, energy costs, industrial action and reducing immigration health surcharge income,' it added.

The review bodies consider evidence on pay from employers and unions before making a recommendation to ministers, which they can accept or overrule.

Consumer Prices Index (CPI) inflation rose to 3.1 per cent in August 2026 with core inflation (excluding energy, food, alcohol and tobacco) reaching 2.6 per cent.

The Bank of England has said inflation is expected to rise further as a result of global pressures on higher energy prices.

Resident doctors are earning 35.2 per cent more on average than they were four years ago after 15 rounds of strikes that cost the NHS over £3 billion and led to the cancellation of 1.5 million appointments.

BMA Council chairman Dr Tom Dolphin said: 'It beggars belief that at a time when patients are being treated in hospital corridors and car parks, people are waiting too long for a GP appointment and the Government's pledge to bring down waiting lists is stalling, ministers are saying doctors deserve a pay cut.

'In the short–term, when we have groups of doctors in dispute, and with consultants in England having a mandate for strike action, a failure to recognise and value their expertise risks further industrial unrest and disruption.'

In 2026, the Government accepted a 3.5 per cent pay increase recommended by the DDRB, exceeding its initial proposal of 2.5 per cent.

Professor Nicola Ranger, general secretary of the Royal College of Nursing, said a 2.4 per cent pay rise would be a 'betrayal' of nursing staff in the NHS.

'It would see living standards fall for the largest workforce in the health service, doing nothing to address more than a decade of collapsing real terms pay,' she added.

'Our hundreds of thousands of members working in the health service will be furious today, and they are right to be.

'When the prime minister took office, nursing staff said they would back him if he backed them, but his government is in danger of proving it's no different to the ones that came before.

'Our members will give their verdict on an award when it is formally made.

'They will leave ministers in no doubt as to whether it is fair or enough to help recruit and retain the nurses our NHS needs.'

Helga Pile, head of health at union Unison, said more than 200,000 staff in the NHS are paid less than the real living wage.

She said: 'NHS staff will take a very dim view of ministers trying once again to get away with an insulting pay rise, falling well short of expected inflation.

'This Government came into office on a promise of change. Two years later it's pledging hope, but most NHS workers have seen neither.

'With the usual winter pressures just around the corner, and bills set to go through the roof, the suggestion of such a derisory increase is even harder for health staff to take.'