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  "path": "/2026/04/the-government-is-punishing-the-nhs/",
  "publishedAt": "2026-04-04T11:18:11.000Z",
  "site": "https://tribunemag.co.uk",
  "textContent": "### Despite a year of warnings that strikes would harm patients, ministers have scrapped 1,000 desperately needed NHS training posts to punish doctors for taking industrial action.\n\n* * *\n\nPunatively scrapping training posts will deepen the NHS staffing crisis. (Leon Neal/Getty Images)\n\nAhead of next week’s resident doctors’ strike, Keir Starmer and Health Secretary Wes Streeting issued an extraordinary ultimatum to the doctors’ union, the BMA: call off the planned six-day walkout or lose 1,000 promised training posts.\n\nThe BMA rejected the ultimatum, and the government has now scrapped plans to create the training posts. The six-day strike will begin this Tuesday.\n\nFor those unfamiliar with the system, ‘training posts’ are a key step in doctors’ career progression. Following a five-year medical degree, doctors must secure training posts in order to keep working and progress into specialist and, eventually, consultant roles. This system reflects a basic principle of modern medicine that doctors are expected to keep learning throughout their careers. As such, training posts should not be mistaken simply for development opportunities: they are, in practice, real jobs.\n\nAt present, the NHS is chronically short of training posts, creating bottlenecks in care and worsening staff shortages. The number of training posts available is almost 10 percent less than the total number of medical graduates, meaning that each year, hundreds of newly qualified doctors are unable to find jobs.\n\nThis perverse situation sits alongside chronic staffing shortages. The NHS currently has over 100,000 vacancies, a vacancy rate of nearly 7 percent. This includes a shortage of 4,200 (or 1 in 4) general practitioners, and 40,000 fewer hospital doctors than the EU average per capita.\n\nStaff shortages are the main cause of delays to elective operations, long waiting times in A&E and burnout, driving retention problems and increasing the risk of medical error. In short, they sit behind almost all of the system’s most serious problems.\n\nTraining posts aren’t simply a matter for resident doctors. According to the Royal College of Physicians, six out of ten NHS departments have at least one consultant vacancy. Without junior training posts today, there will not be enough senior clinicians in the future.\n\nDespite the dispute being widely framed as a fight for pay restoration, with resident doctors’ incomes still lower in real terms than in 2008, pay is only part of the picture. Their demands also target the NHS’s poor workforce planning and the wider staffing and retention crisis it has created.\n\nThe proposed expansion of training posts was part of the government’s offer to resolve the dispute, but even this modest plan had problems. Wes Streeting’s now-scrapped proposal was to convert 1,000 existing ‘Locally Employed Doctor’ (LED) roles into training posts, effectively reshuffling positions without increasing the total number of practising doctors. Limited as this proposal was, it at least acknowledged the staffing problem at the heart of the current crisis.\n\nThe absolute minimum to address NHS staffing shortages is ensuring there are enough active vacancies to be filled. It should never have taken industrial action by resident doctors to place the issue of inadequate training posts on the government’s agenda. What is even more remarkable is that, after spending the past year warning that strikes would harm patients, the government is now prepared to inflict that harm itself. The idea that these promised posts could be removed as negotiating leverage is an attack not only on resident doctors and their union, but on the NHS as a whole and the public it serves.\n\nThis deliberate mismanagement should be condemned for what it is. It is an attempt to leverage the performance of the healthcare system against the BMA in its current dispute. It is a reckless move that undermines any serious effort to fix the NHS. They cannot be allowed to get away with it.\n\n* * *",
  "title": "The Government Is Punishing the NHS",
  "updatedAt": "2026-04-04T12:06:01.000Z"
}