I don’t know if you heard Wes Streeting’s response to a resident doctor on LBC recently, if you haven’t, you should. It’s an outstanding piece of communication and shows just how important it is not to accept the buck when it’s being passed to you.
The ongoing dispute between England’s resident doctors and Health Secretary Wes Streeting is fascinating—not just because it’s about pay, but because it’s about narrative, two sides can look at the same set of facts and walk away with completely different stories. If you ever wanted a real-world example of how negotiators selectively choose information to suit their narrative, this is it.
On one side, you have resident doctors who claim their pay. They argue has fallen behind where it should be. To make their case, they use the Retail Price Index (RPI) and go back to 2008/09, based on this the numbers look grim: a real-terms drop of up to 30 percent. If you’re a resident doctor working nights, juggling exams, and feeling the pressure every day, that narrative feels painfully true.
The government is telling a very different story and are using the more normal measure of Consumer Price Index (CPI)—a lower measure of inflation—and look at total earnings rather than just basic pay. With that combination, the pay decline shrinks to something like 4–10 percent. From their point of view, a 29 percent pay rise isn’t “restoration”—it’s inflationary, unfair to other NHS staff, and financially unrealistic.
Here’s the interesting thing: both sides are using real data. Neither is lying. But both are choosing the version of the truth that best supports their argument. This is where negotiation becomes less about facts and more about framing.
Think of it like two people holding the same photograph but shining a torch on different corners of it. Everyone sees what’s lit up. Everyone forgets what’s not.
That’s influence.
And for negotiators—whether you’re mediating a pay dispute or trying to get your child out the door in the morning—the skill is being able to separate the influence (how the information is presented) from the information itself (the facts that actually matter).
This dispute gives us plenty of examples. When Streeting thought he had agreement on non-pay improvements—things like exam fee support, better rostering, and more training opportunities—the BMA’s wider committee said no. Why? Because those improvements, while helpful, shift attention away from the pay narrative they want front and centre.
The government, meanwhile, constantly pulls the focus back to the NHS budget and fairness across all staff—because that framing strengthens their position.
It’s the same set of events. Just two different spotlights.
The resident doctors’ dispute is a reminder that in any tough negotiation, everyone is curating the story they want others to see. They’ll pick the index that helps them, the baseline that advantages them, the definition of pay that flatters their case.
The negotiator’s job is to take a step back and ask: What are the facts, stripped of narrative? And what’s just framing designed to influence me? Ask yourself, is that true? Then ask yourself again and get them to repeat themselves.
If you can do that, you stay anchored in reality—while everyone else is busy building their own version of it.
