FOLLOWING THE UK GOVERNMENT’S DECISION to offer a 4.5 per cent pay award to some doctors this year – far below the rate of inflation – the British Medical Association (BMA) says this is a “brutal pay cut”, which will come as a “bitter blow to doctors”.

The offer, which follows recommendation from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) also does nothing to reverse more than a decade’s worth of sub-inflation pay awards, completely ignoring the BMA’s calls for full pay restoration to 2008/2009 levels.

Junior doctors in England, who are subject to a multi-year pay deal which delivers two per cent a year, agreed before the pandemic, will receive nothing extra this year. The BMA says this disregards their efforts during the Covid-19 response, and soaring rates of inflation. This is despite the agreement within the contract that the DDRB should be able to recommend uplifts outside the contract deal if circumstances change. The BMA says this amounts to “nothing less than a betrayal of the profession”.

BMA council chair Professor Philip Banfield, said: “Today’s announcement represents a brutal pay cut that will come as a bitter blow for doctors across England. Ministers can paint whatever picture they like, but this represents a complete failure to recognise the sacrifices of doctors in the pandemic, through year-on-year real terms cuts going back to 2008.

“That the UK Government has excluded junior doctors in England, even from this year’s paltry offer due to a multi-year agreement made way before we could have anticipated the damage wrought by the pandemic and sky-high inflation, is a disgrace. It exposes their contempt for my already low-paid colleagues who will be rightly furious.

“The NHS is already facing a precarious future due to chronic under-funding, a backlog of patient care that will take years to clear, and punitive pensions rules driving doctors out of the profession, when the Government should be doing all it can to recruit and retain them. Today’s announcement makes the situation worse. In a recent BMA survey, almost half of respondents said that insufficient pay rises would influence their decision to leave the NHS. This comes at a time when a worldwide shortage of doctors means the NHS already risks losing staff to better paid jobs overseas and to other professions.

“This announcement clearly demonstrates the failings of the pay review body. It was established to ensure that doctors’ pay recommendations to Government were independent and free from political interference. This outcome feels neither independent nor fair. Doctors have lost all confidence in the pay review body and its attempts to provide a fig leaf of cover to the Government’s pay slashing agenda. Until Ministers restore the DDRB to its original purpose it will remain pointless, wilfully ignoring the need to secure doctors as the experts that our patients and the NHS depend on.

“The BMA will fight for the full restoration of pay lost since 2008, and that includes the further losses delivered through this announcement. The Government needs to wake up and realise the true cost of keeping the expertise of doctors rather than driving them away from the NHS.

“The different groups of doctors we represent will now consider their next steps but it is clear that we are on a collision course with the Government, the consequences of which will be the responsibility of ministers alone.”

BMA junior doctors committee co-chairs Dr Sarah Hallett and Dr Mike Kemp, said: “Today’s risible pay announcement demonstrates the blatant disregard our politicians have for junior doctors in England. To exclude our members from the 4.5 per cent given to other NHS workers is nothing less than a betrayal of the profession.

“To make matters worse, the Government has said nothing on the issue of full pay restoration. Our members have been clear. Refusal to commit to this by the end of the year leaves junior doctors in England no choice but to press ahead with preparations for a ballot for industrial action. No junior doctor wants this, but the Government’s tone-deaf announcement sadly moves us much closer to this being a reality, and we will now be taking concrete actions towards this end. We are now calling an extraordinary committee meeting to review next steps and reflect upon the anger of our members.

“Junior doctors have experienced a sustained and continued cut of more than a quarter to our salaries since 2008/09. Today’s announcement is yet another cut and will come as a blow to a workforce that is demoralised, significantly burned out, and facing a future in an NHS that is increasingly overstretched and unfunded. That junior doctors were yet again left out of the higher, though still paltry, amount given to the rest of the profession is yet another devastating hit to our morale, already at an all-time low after recent years.

“Ministers had the chance today to send a different signal to our members: a signal that their work and their sacrifice is appreciated; that the burden of being saddled with debts of almost £100,000 is recognised; and that full pay restoration is the fair and right thing to do.

“As the figures released today by the GMC show, two-thirds of junior doctors say they are ‘always’ or ‘often’ worn out at the end of the working day. The Government cannot expect our members to operate on good will alone. Overworked and underpaid junior doctors cannot and will not tolerate being ignored any more. They deserve to be paid fairly. They are not seeking a pay rise, but for their pay to be put right to what they are worth.

“The Government may choose to look the other way but continued pay erosion is likely to start forcing junior doctors out of the NHS, especially when a worldwide shortage of doctors means the UK risks losing staff to better paid jobs with working conditions overseas. Ministers must act now to avoid the resulting workforce crisis which will see record waiting lists grow longer and patient care suffer.”

BMA consultants committee chair Dr Vishal Sharma said: “This insulting pay cut, which is the biggest single-year pay cut in recent memory, is the clearest indication yet that the Government does not value NHS consultants.

“It is an altogether too familiar story. It is one of a broken pay review body subservient to its political masters and a government with nothing but contempt for doctors. This pay cut is on the back of a fall in take-home pay of 34.9 per cent in real terms for the average consultant in England since 2008/09. This means that, even prior to this latest pay cut, consultants were in effect working for four months of the year for free. To widen this gap even further – which is what today’s announcement will do – is a political choice by a government that once again fails to appreciate the message this sends to those on the frontline.

“While the Government obviously does not agree, the BMA is clear that consultants deserve to be paid what they are worth and if the Government won’t value consultants, consultants need to start valuing themselves. Consultants do huge amounts of work outside their contract of employment and frequently this is done for woefully low rates of pay; rates that do not reflect the skills, experience and responsibility of a consultant.

“Enough is enough and the BMA is now advising all NHS consultants to insist on being paid fairly for any extra-contractual work by ensuring that it is paid at the BMA minimum recommended rate and to decline the offer of extra-contractual work that doesn’t value them appropriately.

“To make matters worse, due to the absurdity of the Government’s current pensions rules, the NHS already faces a possible exodus of its most senior and most experienced doctors. Today, the Government has shown just out of touch it is with doctors on the frontline by making the situation much worse. It also shows just how ignorant they are of the consequences to patient care if pay and pensions cuts further drive consultants out of the NHS.

“Ministers have a choice. They can start to treat its workforce with the respect it deserves by reforming and making fit for purpose the pay review process and awarding consultants a real and fair pay uplift. Or they can choose to do nothing and watch as the impact of their decision results in a worsening of the workforce crisis, as waiting lists grow longer and patients suffer. However, this announcement clearly demonstrates that the pay review process is unfit for purpose and the BMA will be writing to consultants to seek their views on our next steps.”

BMA England GP committee chair Dr Farah Jameel, said: “Today’s announcement is a kick in the teeth to both GP partners and salaried GPs in England, who have spent the last two years going above and beyond, against all odds to protect and care for their communities.

“For GP partners, locked in a five-year pay deal that was agreed pre-pandemic, and now with inflation sky-rocketing, to offer nothing in addition to recognise their intense efforts and transformation of services during Covid-19, nor to pay their staff the recommended uplift, or meet the increased costs of running practices, is a complete insult.

“GPs and their teams have been at the forefront of the fight against Covid-19 and in May alone delivered an estimated 28.3 million patient appointments. To, therefore, fail to recognise these efforts with a fair and substantial pay uplift demonstrates just how little Ministers think of GPs.

“And as was made clear in the BMA’s evidence to the DDRB, the current pay ranges for salaried GPs have ceased to meaningfully reflect reality. In the face of rampant inflation, the decision to only give them a 4.5 per cent increase this year – another real-terms pay cut – the gap between what salaried GPs should be paid and what they are being paid will widen even further.

“The truth is that GP shortages are compromising patient safety, and today’s announcement of another real-terms pay cut for our members is likely to speed up, not slow down, the number of GPs leaving the profession when we need them the most.

“With a worldwide shortage of doctors, the NHS faces an uphill struggle to retain the GPs it has when there are better paid jobs overseas. It is time that Ministers woke up to this reality and acted to stop the crisis they want to pretend doesn’t exist from getting any worse.

“We cannot afford to lose a single GP from the NHS, and we need to bring back GPs that have left the NHS as quickly as possible. The Government must act urgently to address this exodus if it wishes to prioritise patient safety.”

BMA sessional GP committee co-chairs Dr Samira Anane and Dr Bethan Roberts, said: “The BMA has been concerned for some time that the current DDRB salary model for sessional GPs is not for purpose, and undermines the ability of sessional GPs to negotiate appropriate salaries. It fails to reflect the reality of salaried GPs’ pay which can, in turn, suppress remuneration for this group of doctors and misleads employers regarding the market rate for sessional doctors.

“This is all the more significant given there is a large gender pay gap in the salaried GP workforce with female salaried GPs making up the majority – over 70 per cent in England. As part of addressing this, GP practice core investment needs an uplift to enable the appropriate remuneration of sessional GPs, which is key to the recruitment and retention of the GP workforce as a whole.

“The BMA believes that an evidence-driven basis for pay ranges for sessional GPs will go some way towards reducing the pay disparity and challenging the gender pay gap. The BMA is in the process of expanding our dataset for sessional GPs to be used as evidence in the 2023 DDRB pay round, including conducting a comprehensive survey in the coming months.”

Dr Rajesh Kumar, BMA staff, associate specialist and specialty doctors committee (SASC) chair, said: “SASC believes that the 4.5 per cent award is a pay cut which does not adequately reward SAS doctors in England, particularly in the context of rising inflation and against a backdrop of doctors working harder than ever to address the growing backlog of care. Nevertheless, SASC is willing to engage with the Government to agree how this increase should be implemented across the different SAS contracts to ensure that as many SAS doctors as possible can benefit from the funding.”

* Read: Recommendations from the Review Body on Doctors’ and Dentists’ Remuneration on doctors’ and dentists’ pay in England, Wales, Scotland and Northern Ireland. here.

* Read the Government announcement here.

* Source: British Medical Association