PolicyLens

Methodology note

Ban strike action by doctors: calculation note

Scenario assumptions behind the Ban strike action by doctors estimate. The figures are illustrative and exclude unrelated Conservative pledges.

View main policy page: Ban strike action by doctors

Central fiscal result

-GBP 0.1bn - Net fiscal impact in 2028-29

Low case: -GBP 0.5bn. High case: +GBP 0.4bn. Positive numbers are fiscal costs or borrowing pressure. Negative numbers are Exchequer savings or receipts.

Scenario and baseline

  • Model doctors' strike restrictions by 2028-29.
  • Central fiscal effect is GBP 0.1bn saving.
  • Baseline includes legal right to strike with industrial-action rules.
  • No assumed reduction in underlying NHS pay claims.

Affected population

  • Affected population is doctors, NHS patients and hospital managers.
  • Direct effect is lower strike disruption if disputes occur.
  • Indirect exposure includes recruitment, retention and agency staffing.
  • Savings depend on future industrial-action frequency.

Gross impact

  • Central avoided disruption costs: GBP 0.3bn.
  • Retention and legal costs offset GBP 0.2bn.
  • High case assumes workforce costs exceed savings.
  • No waiting-list productivity gain is booked.

Fiscal build-up, central case

  • Avoided strike disruption: -GBP 0.3bn
  • Retention and agency costs: +GBP 0.1bn
  • Legal and administration: +GBP 0.1bn
  • Pay pressure effects: GBP 0.0bn

Central net impact: -GBP 0.1bn in 2028-29.

Behaviour and pass-through

  • Low case assumes frequent strikes are avoided without retention damage.
  • Central case assumes small saving and some workforce offset.
  • High case assumes morale and retention costs exceed disruption savings.
  • Disputes may shift into overtime refusal or exit.
  • Patient benefits are tracked separately from fiscal savings.

Phasing

  • 2026-27: GBP 0.0bn. Preparation or partial implementation.
  • 2027-28: -GBP 0.1bn. Main ramp-up year.
  • 2028-29: -GBP 0.1bn. Target-year central estimate.
  • 2029-30: -GBP 0.1bn. Continuation at steady-state assumptions.

Main source groups

  • con-plan-2026: Conservative live policy page; used to identify current pledge wording.
  • nhs-strikes-2025: DHSC strike-disruption release; appointments and waiting-list effects.
  • nhs-min-service-2023: DHSC minimum-service consultation; hospital strike mechanism.
  • obr-efo-mar-2026: OBR March 2026 forecast; fiscal and macro baseline.
  • botero-et-al-2004: Labour regulation evidence; informs behavioural and incidence assumptions.
  • ramey-2011: Government spending multipliers; informs behavioural and incidence assumptions.