20th December 2025
Resident doctors in Scotland have voted overwhelmingly to go on strike in a dispute over pay.
This marks the first national strike action by NHS workers in Scotland.
Nearly 92 % of doctors who took part backed the walkout in a ballot organised by BMA Scotland (British Medical Association), after accusing the Scottish Government of breaking a previous pay agreement and offering the lowest pay rise in the UK for this group.
The strike is scheduled to run from 7 am on 13 January to 7 am on 17 January 2026 unless a negotiated resolution is reached.
Why are doctors striking?
The dispute centres on pay and real-terms pay restoration. BMA Scotland argues that recent pay offers — a **4.25 % increase for 2025/26 and 3.75 % for 2026/27 — are the lowest in the UK and do not make "credible progress" toward restoring pay to levels that keep pace with inflation and past commitments.
The union says the government reneged on parts of a 2023 pay agreement, prompting anger and the strike ballot.
Resident doctors are fully trained doctors in the early stages of their careers previously known as "junior doctors." They make up a substantial portion of the NHS workforce.
Scottish Health Secretary Neil Gray expressed disappointment and has offered further talks with the BMA to try to avoid industrial action.
The strike will take place during a period of high healthcare demand, which could add pressure on services, particularly if other industrial actions or seasonal illnesses (like flu) are also affecting hospitals.
Public attitudes and controversy
There is ongoing debate in the UK about strikes by resident doctors. Some commentators worry about patient safety and the strain strikes place on services, while unions stress the need for fair pay to retain staff and maintain NHS capacity.
Core Pay Demand: Restore Real-Term Pay
The principal demand from the BMA and resident doctors is that their pay should be restored to what it was worth in real terms (after inflation), compared with around 2008-2009 levels. The union argues that, even after recent increases, doctors' pay has not kept pace with inflation and has eroded significantly over more than a decade.
The BMA claims that resident doctors' pay has fallen by about 20-21% in real terms since 2008 when measured against inflation (though independent analysis suggests a smaller real-terms gap).
To address that long-term erosion, the union is calling for a substantial multi-year pay uplift — with figures often cited around a 26-29% increase overall on top of recent rises — to genuinely restore the buying power of doctors' salaries.
Specific Figures the BMA Has Highlighted
While precise numbers can vary by grade and contract discussions, these are the approximate targets and context:
England context: Many resident doctors want roughly a 26–29% pay rise from current levels in order to reverse years of erosion and restore real-term pay.
For example, reports have noted doctors demanding around a 26% additional increase on top of pay already received over the past few years.
In Scotland, the BMA Scotland has rejected the Scottish Government’s offer of 4.25% for 2025/26 and 3.75% for 2026/27, saying it is too low and breaks prior commitments on progress toward pay restoration.
What Governments Have Offered
Governments have responded with smaller increases that the union says are not sufficient to stop real-terms erosion:
In Scotland, the current offer on the table is a 4.25% uplift for 2025/26 and a 3.75% uplift for 2026/27 — which BMA Scotland argues is the lowest average award for resident doctors in the UK and fails to meet earlier pay restoration commitments.
Underlying Union Position
The BMA emphasises that incremental or low increases don’t address the cumulative loss of pay value over years and that without a credible multi-year path back to competitive, real-terms-restored pay, the NHS risks losing doctors or seeing morale decline.
Why This Matters
The dispute is not only about headline percentage increases — it’s about whether pay keeps pace with the rising cost of living and reflects the responsibility and workload of doctors. The union’s overall campaign is framed around:
Ending real-terms pay cuts
Ensuring pay progression is timely and predictable
Protecting the NHS workforce and retention in the long term
Doctors are not the only ones complaining about pay lagging behind inflation
Many workers across the UK (both public and private sector) have been complaining that their pay hasn’t kept up with inflation, and this broader context helps explain why resident doctors are striking and why other unions are also pushing for higher wages.
Here’s a clear overview of the situation:
1. Wages vs Inflation — A Long-running Issue
Although headline figures show average pay rising, real-terms wage growth (after accounting for inflation) has been weak or even negative for many workers over the past decade. Long periods of inflation outpacing pay rises have eroded purchasing power for a large share of employees, not just in healthcare. Studies and union analysis have pointed out that real wages in many sectors haven’t fully recovered to pre-2008 levels in some local areas, reflecting long-term stagnation.
2. Pay Growth Has Often Lagged Inflation
Official data from the Office for National Statistics (ONS) show that while average earnings have grown — for example by around 4.7% in mid-2025 — real-terms gains are small or borderline once inflation is taken into account. In some measures, real wage increases are under 1%, meaning that workers are only marginally better off after price rises.
Surveys of pay settlements also paint a picture of restraint:
Many private sector employers have been offering average pay awards of around 3%, which — with inflation often above that level — effectively means pockets are losing value.
Public sector pay deals are somewhat higher on paper but still perceived as lagging behind cost increases for many occupational groups, particularly where inflation has been higher historically.
3. Public Sector Pay Pressures
In the public sector — including teachers, local government workers, and healthcare staff — unions have repeatedly raised concerns that years of pay restraint or small increases have left pay materially below the cost pressures faced by employees. For example:
Local authority and school staff unions are demanding a significant uplift (e.g., at least £3,000) after below-inflation increases eroded purchasing power.
Analyses show that real public sector earnings have at times lagged behind inflation over several years when cumulative costs are considered.
4. Private Sector Experiences Too
In the private sector, similar frustrations are common:
Surveys indicate that pay awards have stagnated around 3%, which — given inflation running above that level for much of the past few years — means many employees feel like they’re falling behind.
Workers in sectors with little wage growth have voiced that modest annual increases do not compensate for rising living costs, reinforcing a widespread perception of erosion in pay value.
5. Broader Political and Economic Debate
This situation is not unique to healthcare — it’s part of a broader national debate about pay, living costs and economic policy. Many unions argue that inadequate pay growth undermines recruitment and retention in crucial public services, while some employers and economic commentators point to the pressures on business costs and productivity.
In short, resident doctors striking over pay taps into a much wider frustration felt by many workers whose earnings have struggled to keep pace with inflation over recent years — not just in the NHS but across the labour market as a whole.