The government is imposing the increase, which it proposed in July following the review body’s report, despite the offer being immediately rejected by the British Medical Association (BMA). The pay rise will cover the roughly 150,000 doctors covered by the DDRB, which includes consultants, specialty and associate specialist doctors, junior doctors and dentists.
NHS consultants and salaried doctors will receive a straight 6% increase, while junior doctors will receive 6% plus a consolidated payment of £1,250. This translates into an average increase of 8.8% for junior doctors. However, for a junior doctor in their first year of training, the package represents a 10.3% increase, while the most senior junior doctors will receive just 8.1%.
The 6% rise for consultants will increase their basic starting pay to £93,600. The increases are being applied in September and will be backdated to April 2023.
Both junior doctors and consultants remain in dispute with the government over pay. Junior doctors have staged 19 days of strike action since March this year, with six further days planned for September and October. Consultants have taken four days of industrial action so far, with five further days planned this month and next. Four of the planned strike days will involve both junior doctors and consultants.
According to the BMA, junior doctors’ pay has been cut by more than a quarter since 2008 and workloads are at record high levels. Consultants have seen an even larger cut, with real terms pay down 35% since 2008. In addition, neither of these real-term cuts account for losses incurred this year, a period of very high inflation.
The government has stated repeatedly that the pay deal is final. It said again at the beginning of the month that it will not negotiate the award further and has called on the BMA to stop any upcoming strike action.
The strikes themselves have had a devastating effect on services across NHS England. According to Julian Hartley (pictured), chief executive of NHS Providers: ‘The announcement of coordinated strike action is a serious escalation of the doctors’ dispute.’ He added: ‘Nearly one million appointments have already been pushed back since industrial action started in December. The number grows with every strike.’
Matthew Taylor, chief executive of the NHS Confederation, echoed the concerns about the planned joint action: ‘This is the nightmare scenario that NHS leaders have long feared,’ he said. ‘We’re now almost 10 months into strike action and there are no signs of it coming to an end. We warned the government that this cannot become business as usual, but that’s where we are. And the consequences continue to be felt.’
The Scottish government avoided a junior doctors’ strike by negotiating with BMA Scotland for a pay uplift of 12.4% for 2023/24, in addition to a 4.5% increase already in place for last year. While this falls short of the BMA’s goal of compensating for the 28% real terms pay cut faced by junior doctors in Scotland, the deal also includes a commitment to make progress towards full pay restoration and a guarantee of inflation-based increases as a minimum for another three years. Consultants in Scotland have been offered a 6% pay uplift, similar to those in England. In response to this, the BMA consultants’ committee is in the process of arranging a meeting with Scottish cabinet secretary for health Michael Matheson to negotiate a better deal.
Doctors represented by the BMA in Northern Ireland have not yet begun any formal negotiations for pay uplift this year, following a 4.5% increase announced late last year. However, according to the BMA, junior doctors in Northern Ireland have seen their pay eroded by nearly 31% and consultants by over a third since 2008, despite increasing workloads and pressure. In response, the BMA has begun gathering feedback from its members and has called for the Northern Irish government to provide an immediate and substantial pay increase to junior doctors to restore pay to 2008 levels.
The Welsh government has recently made a final offer of a 5% pay uplift for all doctors after lengthy negotiations with the BMA. According to the BMA, this has caused negotiations to break down as committees representing junior doctors, consultants and specialist doctors have all rejected the offer. These committees are now balloting members to vote on whether to take industrial action similar to that seen across the NHS in England.
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