Striking Out: Why This Fight Isn’t About Money Anymore

David Wandless
Jul 17
4 min read

Or: Why I’m Not on the Picket Line (Yet)

Disclaimer time: I’m part of the BMA. Sometimes out of it, sometimes begrudgingly in. I’m pro-union in principle, but I vote with my feet. I think most of us do — agency starts there.

Right now, as I write, industrial action is cropping up again — in different corners of the medical world, in different shapes, but with the same exhausted, desperate pulse. And it’s always the same bloody dilemma: how do you strike when striking might hurt the people you’re supposed to protect?

It’s the firefighter paradox. You don’t get the privilege of protest without consequence when your job is keeping people alive.

But here’s the thing. I’m not convinced this fight — this latest round of placards and picket lines — is about money anymore. And if it is, it shouldn’t be.

Because what’s killing this profession isn’t just frozen pay. It’s what we’ve lost along the way.

Respect Is Dead. Long Live the Job Title.

Once upon a time, being a doctor came with a kind of social capital. Reverence, even. You were seen as someone with a role — someone who mattered. Not just a functionary in a broken system, but a figure worth trusting.

That’s gone. Let’s not pretend otherwise.

The doctor-as-community-asset has been replaced by the doctor-as-service-provider. We are now judged on outcomes, response times, tone of voice, and whether we refill someone’s diazepam fast enough.

We are customer service. Baristas with blood pressure cuffs. No better, no worse.

And with that shift, everything changes. Because if you’re not seen as valuable — as someone whose time and expertise matter — then what exactly are you striking for?

The Generational Shift: Why Boomers Took It and Millennials Won’t

Boomers — the last ones to get anything resembling a stable NHS — were taught to take what they got and be grateful. Community. Security. A mortgage. If you just didn’t take sick leave and didn’t rock the boat, life was supposed to treat you okay.

Millennials? We’re not built like that. We measure worth in hours and pounds. We’ve had enough therapy (or trauma) to know what burnout looks like. We’ve watched friends in tech and finance make double what we do with half the stress. We’re tired of being told our work is “a calling” when it’s clearly become a collision.

And Gen Z? They’re already halfway out the door.

The Pay Argument Is a Red Herring

Don’t get me wrong — pay matters. Especially when you’ve got junior doctors rotating every few months, being moved across the country without warning, chasing unpaid rotas, footing the bill for exams and portfolios just to keep their job titles.

But the real issue isn’t the money.

It’s the devaluation. It’s the erosion. It’s that the financial banding system is so opaque and antiquated that even when you’re upbanded for a rota that breaches the working time directive, you feel like you’ve barely won a war to earn the privilege of surviving the next shift.

You know how many rotas were transparently banded to reflect the actual workload when I was a JHO?

One. Neurosurgery. And only because they couldn’t legally find a way around it.

Everyone else? We fight. And we lose.

Why Striking Feels Like a Losing Game

The public won’t back us. Not now. Not when they’ve been told for years we’re the gatekeepers. That we’re the reason they can’t see their GP. That we’re arrogant, unavailable, or coasting.

Strikes make doctors look greedy — even when what we’re asking for is basic decency.

Because it’s too hard to explain what our job actually entails. The portfolio deadlines. The 2am bleeps. The deaths. The complaints. The relentless fight to prove you’re not a danger to the public just to keep your license. The fact that you could be sent across the country with two weeks’ notice and no housing, no child care, no idea where you’ll be sleeping.

Try putting that on a placard.

So instead, we say: “We want a pay rise.”

Because that’s all the public understands. Numbers. But what they never see is that the money’s just a proxy.

It’s shorthand for:

Stop breaking us.
Start respecting us.
Let us do the job properly.

What Would Make Me Strike?

Not money. Not anymore.

But if someone came with a vision — not a TikTok, not a focus group, not a hollow gesture — but a real, concrete plan to fix the profession?

I’d be there in a heartbeat.

Give me:

Real workforce planning.
Decent systems.
Out-of-hours models that don’t break GPs.
Proper tech.
A world where we’re not guilty until proven Harold Shipman.

Give me a strike about restoring the NHS as a system we’re proud of — not one we’re fleeing — and I’ll march until my boots wear out.

The Real Danger

Here’s what’s coming.

We’re going to strike again.

And the public will turn on us.

And when they do, and we lose — or win something so watered down it may as well be a surrender — the exodus will begin.

Not a trickle.

A flood.

Doctors will leave. They’ll go private, or abroad, or into tech. Or they’ll just quit. Because when smart, capable people are treated like liabilities, they stop showing up.

We will be left with a skeleton crew — those too tired or trapped to move on — and the system will break. Fully, this time.

Not because of a pay dispute.

But because we forgot that expertise is something you have to invest in.