Rishi Sunak has been accused of personally blocking a deal to end doctors’ strikes
Rishi Sunak has been accused of personally blocking a deal to end doctors’ strikes in England, despite warnings from the Department of Health and NHS England that waiting lists will continue to rise unless the industrial dispute is resolved.
Sources told the Guardian that it had been made clear to the Prime Minister ‘abundantly and repeatedly’ that no progress would be made on his pledge to reduce NHS waiting lists until a deal was reached.
An official said Sunak had been a “blocker” to progress during talks with both consultants and junior doctors late last year over concerns that a more generous offer would result in calls for higher pay deals in the health service, particularly for nurses.
Junior doctors staged a series of strikes after talks between the British Medical Association and the Department of Health and Social Care (DHSC) collapsed, with the doctors’ union saying the government had failed to make a credible offer.
Consultants, meanwhile, rejected the government’s latest pay offer by a narrow margin last month and urged ministers to improve the offer. Discussions between the BMA and the deputy ministers continue.
Sources told the Guardian that Sunak was warned at almost every meeting with NHS England and the DHSC that the government would not meet waiting list targets. Downing Street aides were also told this in their own meetings with health officials.
Documents marked “officially sensitive” sent to Number 10 and seen by the Guardian warn in bold text that “in all scenarios if industrial action continues, waiting lists will not fall”.
Sunak acknowledged on Monday that he had failed to deliver on his pledge to reduce waiting lists, one of the five key pledges he made upon taking office on which he said his own ability would be assessed. The situation in England has even worsened.
“We haven’t made enough progress,” he said when asked about his pledge during an interview with Piers Morgan on TalkTV. When asked if that meant he had failed, he replied: “Yes, we did.” He later appeared to blame the situation on the NHS strikes.
One source suggested that Victoria Atkins, the health secretary, had been ‘reined’ by Downing Street after initially indicating a willingness to meet for further talks and not yet making a final offer from the government.
However, DHSC insiders said Atkins had only offered further talks if the strikes were called off first, adding that both disputes went beyond pay settlements and wider issues including working conditions.
Whitehall sources said Steve Barclay, who was health secretary until he changed posts in November’s reshuffle, urged Sunak to settle the dispute but was not given the autonomy to do so himself.
A senior NHS source said Atkins was being stymied by No 10 in its attempts to end the separate but overlapping disputes between consultants and junior doctors.
“NHS England has made clear to the government the extent to which strikes are seriously hampering efforts to reduce the waiting list,” the source said.
“The Department of Health and Social Care knows that the Prime Minister’s promise will not be kept unless the strikes end. And while there have been some minor improvements in waiting lists, it will be impossible to catch up (while the strikes continue).
“It is clear from the stop-go nature of the talks between the DHSC and BMA that the Secretary of State does not have a free hand to negotiate.”
A second well-placed NHS source said: “NHS leaders are very clear that meeting (Sunak’s) promise on the choice target would be impossible without resolving the strikes.
“NHS England and the Department of Health have both argued that if you want to meet the choice target, it will be very, very, very difficult to do that without sorting out doctors’ strikes.
“The leadership of NHS England believes that the trainee doctors’ strikes and the choice target are clearly closely linked.”
More than 1.3 million NHS appointments in England have been rescheduled due to industrial action, according to the DHSC. Sunak has tried to blame them for the huge waiting list, which stood at 7.6 million in November but fell by 96,000 that month when there were no strikes.
Unions have consistently said ministers can avoid strikes by offering better pay deals and have denied being responsible for the waiting list. They point out that this increased by almost five million between 2010 and 2022, when industrial action was not to blame.
Prof Phil Banfield, chairman of the BMA council, said: “Doctors are already doing their utmost. If the Prime Minister simply allowed his Health Minister to make credible pay offers instead of constant waiting, doctors could reduce waiting lists again. He can no longer shirk his responsibility.”
Government insiders said Sunak believed every pound of taxpayers’ money should be spent carefully, so he was reluctant to sign a more generous settlement.
Others said this was a false cut as the bill for NHS staff to cover the strikes was £2 billion at the start of December and is expected to rise to £3 billion, more than the amount needed to settle the dispute.
A spokesperson for the DHSC said: “Junior doctors have received a fair pay rise of an average of 8.8%. In addition to this pay increase, we also offered further investments for doctors in training during the latest negotiations.
“If they come back to the table with reasonable expectations, we remain hopeful about finding a way forward. We want everyone to focus on patients and reduce waiting times for them, and urge the BMA to work with us in the interests of patients.”