Healthcare strikes and the UK’s low-wage problem

Why undervaluing skilled workers breaks public services and what a fair pay strategy could fix

Resident doctors across England have staged their 14th strike since March 2023, walking out for five days during one of the NHS’s busiest winter periods. With flu hospitalisations at record highs, this disruption was immediate and incredibly visible, yet the strikes should be seen as less of a scheduling headache and instead as a signal that the UK consistently undervalues skilled work, even in the professions we rely on most. The recent strikes highlight a wider problem in the UK: real wages for skilled workers have stagnated, workloads have soared, and the system is struggling to keep people in the jobs that matter most.  

Doctors, nurses, teachers, and social workers all share a common frustration: years of training and responsibility are rewarded with salaries that barely keep pace with inflation, marking the worst pay squeeze in modern history, leaving many skilled professionals worse off in practice. For doctors, the gap is especially stark -  junior doctors in the UK earn significantly less than their peers in countries like Germany or Australia. The result is burnout, vacancies and growing queues for care. According to a BMA report,. In October 2025, the waiting list for consultant-led care rose to approximately 7.3 million, a significantly higher wait list than pre-COVID. At the same time, the wider labour market shows signs of fragility: vacancies are falling, hiring intentions are weak, wage growth for the lowest paid is cooling, and the UK unemployment rate has risen to 5.1%, with younger workers being dealt the worst hand.  

Classical labour economics suggests that scarce skills should command higher wages, reflecting their marginal revenue product. Yet in practice, this logic does not hold up. In healthcare, the NHS acts as a monopsony buyer for healthcare services, with limited alternatives for healthcare professionals, wages can be kept low even when demand for services is rising. Add in the rising cost of living and years of wage stagnation, and you get what economists call a “low-wage equilibrium” people are working harder, investing heavily into their training - but are not paid enough to stay. It is no surprise that many junior doctors are leaving for better pay abroad, where their skills are valued more highly. According to an article published by the Financial Times in 2023, a whopping 18,000 UK-trained doctors are now practising abroad, representing a 50% increase since 2008. More simply, that means 1 in 7 UK-trained doctors have chosen to work outside the nation; the NHS is not just facing a significant crisis, it has a leak.  

The consequences of this brain drain go beyond hospitals. When skilled workers are underpaid, productivity suffers, innovation slows, and public services weaken. The UK is facing a growing crisis as professionals move overseas, leaving gaps that are filled with expensive agency staff. Patients notice the delays and inconsistencies, which erode trust in the UK and other public institutions, only 21% of British adults report being ‘very’ or ‘quite’ satisfied with the way in which the NHS is run, the lowest level off satisfaction recorded since 1983. Strikes are just the visible symptom of a deeper structural problem. If the UK continues to undervalue skilled workers, then this crisis will continue underpayment, drive attrition, attrition drives service decline, and service decline will fuel public dissatisfaction. 

Breaking out of this low-wage equilibrium requires more than a one-off pay rise. A credible strategy could include multi-year deals indexed to inflation, targeted uplifts for shortage specialities, clearer career progression pathways, and more mobility reforms to reduce monopsony power, like flexible contracts, or cross-sector placements. This would signal a move towards wage efficiency, paying enough to retain talent and refuse costly turnover. Politically, it would signal stewardship, the state recognising that sustaining skilled workers is not a luxury but a necessity.  

Healthcare strikes are disruptive, loud, and politically uncomfortable. But they are also a warning siren; they tell us that the UK has undervalued skilled work for too long and that the cost of doing nothing could be far greater than the cost of paying fairly. A fairer pay strategy is not just about justice for workers, but also about safeguarding the future of public services themselves.