Doctors’ pay has been eroded in real terms since 2008 with our buying power significantly reduced. Sub-inflationary pay rises combined with punishing rotas, rotational training and increasing training costs has resulted in a career as a doctor not being as attractive and rewarding as it once was.
The BMA JDC had a record-breaking turnout when it successfully balloted members on whether to undertake industrial action 2 years ago. Since then we’ve had multiple strikes and a Conservative Government that has been unwilling to engage with or acknowledge the impact of strike action on the NHS or its patients. Following the recent general election and new Labour Government, talks between the JDC and the Health Secretary have been swift and there has been progress. The JDC has opted to present the Government’s latest pay offer to its members with a recommendation to accept. Let’s review the offer and ascertain why.
Who influences our pay?
- The Government: it takes advice from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) on what the rates of pay are for doctors and dentists. They do not have to accept the advice but they most usually do. They can choose to increase or decrease the uplifts.
- Review Body on Doctors’ and Dentists’ Remuneration (DDRB): an advisory non-department public body sponsored by the Department of Health and Social Care to review and recommend rates of pay for Doctors and Dentists.
What is the pay offer?
- The headlines in the media have been rather misleading so let’s breakdown the offer
- The DDRB recommended an 8.8% uplift (significantly higher than historical uplifts) in 23/24, which was implemented last year.
- The pay offer applies a further 4.05% average uplift retrospectively, bringing the average uplift for 23/24 to 13.2%.
- The DDRB has then recommended a further 6% uplift plus £1k for 24/25 which would result in an average uplift of 12.4% to our pay compared to 23/24. If we rejected this offer, the uplift would be 8% rather than 12.4%.
- Over the two years (23/24-24/25) this would result in a cumulative uplift of 22.3%, 17.7% of this is awarded by the DDRB (demonstrating that our strike action has influenced their decision) and the rest from the Government offer.
- The offer also includes uplifting Flexible Pay Premia (FPP) to prevent further erosion of these pay elements.
What non-pay factors does the offer address?
- Not only does the offer include uplifts to pay, the Government has also committed to addressing certain non-pay factors that are significantly impacting on resident doctors’ lives. There are plenty more things they could address but this is a start.
- Exception reporting: this process was formally introduced following implementation of the 2016 Resident Doctors’ Contract for doctors to report and claim leave or payment for additional hours worked. It has been taken up with mixed effect due to a culture in the NHS discouraging reporting. One of the barriers that has been identified is that the trainee must submit the exception report to their supervising Consultant and each exception report results in the Department being penalised due to inadequate staffing or provision for breaks. As such there is a vested interest for the Consultant to discourage exception reporting. The deal being put forward will include removing the supervising consultant from the process.
- Rotational training: there has also been a commitment to review the issues associated with rotational training and training bottlenecks.
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Why are the JDC recommending we accept this offer?
- This is an uplift compared to the offer in December where we were offered 2.99% in 23/24 rather than the 4.05% now.
- The talks with the new Government have been progressive but doctors have a limited amount of leverage in this early stage of the Government’s term. They are able to blame much of their financial limitations on the outgoing Government.
- This offer will not only apply to doctors on the 2016 Contract but also JCFs/ locally employed/Trust grades, which the offer in December would not have done. The offer in December also excluded FY2s and the ST3/4/5 uplifts were below inflation.
- Accepting this deal now would bank thousands of ££ in backpay for many Resident doctors, including those who have recently cct’ed or left the profession.
- The JDC will have a low threshold to re-ballot members in April 2025 if the Government does not deliver on their deal. They will also re-ballot in future, when we have more leverage and the Government has had more time in office to achieve Full Pay Restoration. There is nothing binding the JDC from re-entering the dispute in the future.
- It is important to note that one of the stipulations in this deal is that the JDC has to recommend the offer when it puts it forward. There is no stipulation that they have to do so passionately. Therefore, their impassioned recommendation to accept the offer is genuinely because they believe it is the best deal for now. If they didn’t believe that, they could easily have put out a tweet and stayed quiet.
There is lots more detail about the offer and its impact here: https://www.bma.org.uk/our-campaigns/junior-doctor-campaigns/pay/offer-from-government-for-junior-doctors-in-england-faqs
At Medics’ Money, we’re interested in knowing your thoughts on the matter and would welcome your feedback at [email protected].
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