Health in Focus: Resident Doctors and the Mental Health Bill

The end of 2025 saw the latest resident doctors’ strike, stemming from a long-term dispute over pay, conditions, and job opportunities. Wes Streeting has not been subtle in his disagreements with the BMA over the dispute, from calling resident doctors ‘moaning Minnies’ over complaints on digitisation to likening the BMA to a cartel. The Government has opted to be distinctly aggressive, questioning the ‘morally reprehensible’ decision to strike during an unprecedented winter flu crisis. These efforts were to no avail and the strike took place from 17 to 22 of December following an overwhelming rejection of the offer, with 83% voting no.

Despite the looming calls for restorative pay to real-term levels equivalent to 2008, the strike’s narrative and rationale were focused on job prospects and accessibility. The argument from the BMA proceeds that currently UK medicine graduates face a 4:1 application to job ratio in the NHS, which is seen as a strong disincentive given the multifaceted costs of entering the field. Further, graduates’ applications are assessed equally to foreign applicants, further decreasing the chance of success. Streeting aimed to offer a resolution to this, including emergency legislation in the new year to introduce UK graduate prioritisation, a pledge to create 4,000 new specialty training places, with 1,000 to be brought immediately into the 2,600 intake; a move the Department of Health and Social Care has claimed would reduce the ratio to less than 2:1. Notably, despite this offer being rejected, Streeting has said he will still push through this emergency legislation in the new year, but its progression will be conditional on the BMA’s compliance.

The failure to resolve strikes is a costly reality for Streeting. The Government has positioned the NHS as one of its key focuses, backed up by expanded and protected funding at the Spending Review and the most recent Autumn Budget. With elective waiting lists positioned as a key metric for assessing their performance, the sudden staff absence and administrative burden caused by strikes will only further halt efforts. Recently, the NHS confirmed that only 5% of planned routine care was halted due to the strikes, perhaps highlighting a lack of buy-in from the workforce, the diminishing overall impact of strikes and improved planning and robustness from NHS management.

On the political slant, awkwardly, during previous NHS industrial action that took place in 2022, Streeting said that ‘the power to stop these strikes is squarely with the Government and the Secretary of State’. Opposition to Streeting both online and in the chamber have been sure to repost and regurgitate this statement back to him, pushing the notion of a hypocritical Labour Government. Interestingly, Streeting, in a late surge to win the argument, opted for spouts on X with anonymous accounts over the issues at hand, further sensationalising this fiasco for the Government. Most prominently, this accumulated in a strange (now deleted) video posted by the Department for Health and Social Care with Streeting answering evidently planted questions about the strikes in an orchestrated ‘authenticate’ Q&A. Importantly, this ‘politicking’ pantomime detracts from the reality that strikes are a crisis, not just for Labour’s manifesto targets, but for vulnerable people’s health, who want their taxes to service their needs. Fundamentally, the strikes are good for nobody, but very damaging for the Labour Government.

The Mental Health Bill was passed on the last day of 2025’s parliamentary session having been committed to by Labour in its 2024 manifesto. The Bill sets out to reform the ‘woefully out of date’ Mental Health Act 1983, which has been criticised for its treatment of autistic people and people with a learning disability, and its disparate impact on Black patients. Key provisions in the Act include reforms to the overall decision-making principles of responsible clinicians specifically in detention of individuals under the Act and to provide greater choices and safeguards for the patient and/or their carer or nominated person. The Act also sets out clearer principles for intervention and the involvement of a Second Opinion Appointed Doctor to provide two-stage checks and balances for doctors when administering treatment to patients.

Aside from the aimed improvements to patient care that the Act seeks to put in place, now in statute, the Bill’s passing makes a mockery of the parliamentary process and the delay in delivery, which has been recently highlighted by the Prime Minister at the Liaison Committee. The Bill is predicated on the Independent Review of the Mental Health Act which was conducted in 2017, with most of its recommendations accepted almost a year later. After a white paper, a draft Bill, a committee inquiry, government response, the previous Government failed to introduce the Bill prior to their electoral demise in summer 2024, preempting its inclusion in Labour’s manifesto. The fact it can take almost eight years for recommendations, which were accepted on both sides of the political spectrum, to be passed into a law is a damning image for the legislative process. Cases like the Mental Health Bill call into question the hurdles that legislation must clear, especially when the transformation of recommendations to statute spans five different Prime Ministers.

As the new year rises, the May local elections will no doubt be a vital political milestone. On one hand, it could see Starmer turn the corner and bolster his fragile standing, but on the other, it could further damage any remaining resolve, and deliver more unwanted political uncertainty for the sector, through a shift in policy, cabinet, or leadership. The latter could see the current health secretary vie for a shot at the ultimate power.

For more on what’s happening in UK politics, check out key points covered during Vuelio’s webinar with the Institute for Government, ‘The Trump challenge: Chaos, confusion and government communications’.