Resident doctors in Scotland could take strike action after the Scottish Government ‘shamefully reneged’ on a pay agreement, BMA Scotland announced today.

The BMA Scottish resident doctors committee has voted to enter formal dispute with the Scottish Government and plans to ballot members on industrial action.

In 2023, resident doctors in Scotland agreed to an offer in which the Scottish Government agreed to make ‘credible progress’ towards pay restoration in each of the following years. The deal was credited with avoiding strike action in Scotland – unlike the other three countries in the UK, where residents (formerly known as junior doctors) held multiple walk-outs, leading to major disruption in health services in England, Wales and Northern Ireland.

This year, however, the Scottish Government has made an offer below the recommendation of the independent pay review body, the Review Body on Doctors' and Dentists' Remuneration. The offer of 4.25 per cent uplift – after months of negotiations – would be the lowest of any of the UK countries, the BMA said.

SRDC chair Chris Smith said they had been left with no choice.

‘In our pay negotiations this year, the Government has shamefully reneged on the deal we agreed in 2023, and we therefore have been left with no choice but to move forward with plans to ballot members for strike action in order to protect that deal.

‘This agreement was the only thing that prevented strike action by resident doctors in Scotland in 2023 and we remain the UK’s only resident doctors not to have gone on strike since it was agreed.

‘But that will be forced to change if our agreed deal is ignored. By going back on the deal, the Scottish Government has knowingly and severely increased the likelihood of us choosing the path of industrial action and the disruption to the NHS that will cause.’

Real terms

He said that resident doctors wanted a negotiated settlement and did not want to strike. ‘There is time to avert this action, but we must see a real improvement on what the Scottish Government is prepared to offer, which is currently the lowest uplift of all resident doctors in the UK for 2025-26.

‘The offer this year is likely to be less even than RPI inflation, which means that it would have constituted a real-terms pay cut – we are already 17 per cent worse off than our peers were in 2008 and this would have made that worse.

‘It is completely unacceptable and it is clear that this is a far cry from the credible progress on the path to pay restoration that we were promised.’

Scottish health secretary Neil Gray said he was disappointed resident doctors had chosen to be in dispute with the Scottish Government. ‘I have made a fair, affordable, equitable pay offer of 4.25 per cent for 2025-26, with a further 3.75 per cent for 2026-27,’ he said.

‘That’s the same offer that nurses and other NHS staff chose to accept earlier this year and shows the value we also place on the role that resident doctors play in our hospitals and health clinics.’

Call to reconsider

Mr Gray added that he did not recognise the BMA’s claim in relation to the 2023 agreement on pay restoration.

‘We have invested significantly in resident doctors’ pay over the last two years, agreeing an uplift of 12.4 per cent for 2023-24 and a cumulative uplift of 11 per cent for 2024-25.

‘These were the highest pay awards across the public sector that, I believe, were justified to begin the process of delivering on the 2023 agreement in good faith. We remain absolutely committed to honouring that agreement.

‘I would ask the BMA resident doctors committee to reconsider to allow their members to receive their deserved pay uplift for this year and to agree the second-year element.’

But Dr Smith said it was important for resident doctors to take a stand not only for the benefit of the profession but also for patients and ensuring the delivery of a sustainable NHS for generations to come.

He added: ‘As resident doctors we are the heart and are the future of the NHS medical workforce. But we risk losing many of us to other professions and countries if the government does not value us properly, with disastrous consequences for a health service already on its knees.

‘We are not asking for more – we trusted the Scottish Government in accepting the pay deal and are simply asking that they now deliver that deal.’

Under BMA processes, SRDC will now request permission from the BMA’s UK council to go ahead with the ballot, which is likely to take place later this year.