It’s been clear to both consultants and junior doctors that Mr Sunak has been imposing decisions without empowering his Secretary of State for Health to negotiate properly and has refused permission to meet with us to discuss pay. So we have no option but to coordinate and escalate our action to bring the Government to the table to discuss fifteen years of pay erosion that both consultants and junior doctors have faced.

We have been told that the decisions are coming directly from No 10. Mr Sunak is taking on all this responsibility and setting his red lines. It was his unilateral decision to impose yet another deal, which we have not consented to. He should be held accountable for the outcomes: a failing healthcare system and further strike action.

In October, we will hold a rally of striking consultants and junior doctors during Conservative Party Conference. They will have to explain to the people they are looking to persuade to let them run the country why consultants and junior doctors are leaving the country, leaving the profession and taking strike action. We encourage people to join us at 1 pm on 3 October at St. Peter’s Square in Manchester to ask the Prime Minister why he’s blocking talks and why he won’t sit down and build a healthy relationship with doctors. A sick population is an unproductive population and an unproductive population is a sick economy.

Before our last round of action, they invited us in for an informal talk about non-pay-related issues. When we sat down and said, ‘Okay, well, what would you like to talk about?’ They turned around and said, ‘We’re not allowed to say.’

No, it was civil servants — people who are not empowered or given a mandate to talk about non-pay-related things. It was a pointless meeting. The cynic in me thinks they were just playing political games because I believe they leaked the occurrence of that meeting to selected media. 

Those negotiations in May have proven to be a sham. They had the pay review body report, which they refused to share with us during negotiations. They offered us even less than the pay review body recommendations. So those negotiations were not an effort to come to a resolution. It was an effort to undercut the pay review body. It was a complete sham. And it goes to show how disrespectful they were in that they weren’t interested in coming to a negotiated agreement. They were only interested in being pennywise and pound-foolish. Presiding over a broken NHS has a dramatic impact on the economy.

The BMA has not had confidence in the pay review bodies for the last four years. We don’t submit evidence to the independent pay review board because we don’t believe in their independence. The Prime Minister selects the chair of the body of the review board, so they’re not actually independent. They used to be independent. And in fact, in the 1970s, they once recommended a 30 percent uplift. So there is precedent for it. What I find fascinating is how all of the allegedly independent pay review bodies came to almost exactly the same conclusion for every single public sector industry, no matter how different our circumstances are. I think that goes to show that this was not an independent process.

That 5 percent offer from the Welsh Government was after they committed to full pay restoration. So that was a betrayal. And I think all doctors need to be cognizant that it doesn’t matter what people say — it matters what is written down in black and white. The message from the BMA is that we’re here to represent doctors to ensure that we can protect the profession and deliver high-quality health care. It doesn’t matter if it’s Labour in Wales, the SNP in Scotland, or whether it’s whatever party is in power next year. And the last thing to say is that privatisation is not going to resolve our issues. If the employment of doctors is outsourced to private companies, we would have to fight those private companies over pay too.

We need to recognise that the NHS was in a good place just over a decade ago, and people were very happy with how it was working. Of course, there are always issues and things that need to be changed. And so when people say that the NHS needs reform, I don’t think anyone can disagree because it is not working at the moment. But it cannot be a public-private partnership where the public are excluded from conversations.

The BMA has undergone a grassroots revolution, and ordinary doctors have taken up their free time to spread the message and build networks. The BMA and doctors have never been more interlinked. I have access to about 40,000 people at the end of my phone. I read all the messages from doctors and what people have to say and I respond. And it’s not just me. All of our reps are constantly engaging and communicating. We tried to be extremely transparent throughout the negotiation process, telling people what was being said because, at the end of the day, this is their pay that’s being negotiated.

Doctors believe in the BMA. They have trust and faith, which is why our mandate has been so strong. But it’s also because doctors do not trust this government. This is a government that imposed the public sector wage freeze, that imposed the contract on us. They’ve reneged on an agreement in our multi-year pay deal. And then they’ve demonstrated contempt for health unions and the BMA in their approach to the negotiations.

Unfortunately, this is, again, the kind of broad brushstrokes and lack of nuance and detail that Mr Sunak has. We are all in different industries, sectors, and professions with different pay and conditions that have been eroded from different points. The 2016 junior doctors dispute was so bitter. It left a scar on our profession. And our profession feels like we lost that dispute badly. So doctors feel not only a sense of injustice that needs to be rectified because of how the contract imposition went down, but we are also people who see behind the curtain in terms of access to high-quality healthcare. 

Many doctors are now beginning to understand and realise that our backs really are up against the wall regarding the future of our profession and the future of high-quality healthcare. It is absolutely unacceptable for people to wait two years for an outpatient appointment. The waiting times to see GPs in many areas across the country are unacceptable. And the basic economics of it is a mismatch in supply and demand. We don’t want to be working in those circumstances. But, most importantly, we don’t want to be living in those circumstances. We are human too. We are subject to disease, sickness and ill health too. And, as people who know what happens behind the curtain, we don’t want to be sick. It is not a good time to be sick in this country because of the last fifteen years of erosion that’s occurred.

It would be to sit down with us. We can help him with four of his five priorities. We can help him reduce inflation, which his government has said is being fuelled by long-term sickness. We can help him grow the economy. We can help them reduce debt. And we can help him reduce the waiting list. There are many ways for us to work together to build the country back up. We believe in a high-skilled, high-wage economy. So let’s do it together in partnership. Don’t treat us with such contempt — or the strikes will never end.