Junior doctors' pay offer concerns hospital leaders

By Hugh Pym and Chloe Hayward
BBC News

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Media caption,

Medical students and junior doctors were protesting outside Department of Health and Social Care last week

Hospital leaders are concerned by the government's decision not to offer junior doctors in England the same pay rise as other NHS staff.

Junior doctors are entitled to a 2% annual pay rise as part of a four-year deal but other staff are getting 4.5%.

NHS Providers, representing trusts in England, says this undermines morale in an already overstretched workforce.

The Department of Health and Social Care says junior doctors' pay will be looked at next year.

It maintains the current pay deal, which ends then, provides the most experienced junior doctors with higher pay and increases allowances for those working the most weekends.

But junior doctors say the strain of working through the worst of the pandemic has not eased and the pay decision is deeply unfair.

Scotland, Wales and Northern Ireland have separate deals with junior doctors and have offered pay rises more in line with other staff.

'Student debts'

The British Medical Association (BMA), the main union representing all doctors, says industrial action is inevitable if the government does not change its stance.

One junior doctor told BBC News: "The 2% offer is just a slap in the face.

"Doctors are working long night shifts, saving people's lives, for not much more than minimum wage.

"We also have exams and training that is mandatory that we have to pay for with this paltry salary.

"And after six years of medical school, we have huge student debts as well."

'Drastic change'

Another said: "I don't understand why the junior doctors were left out of the higher pay award.

"They will use some excuse that it was some pre-arranged pay deal - but that had a caveat that if there was a drastic change in circumstance, then this would be reviewed.

"Surely, Covid and inflation of 9% should be considered drastic."

Image caption,
The Department of Health and Social Care says junior doctors' pay in England will be looked at next year, when their pay deal ends

A third, who graduated from medical school five years ago, said: "I'm a new dad and with the cost-of-living crisis, we're struggling to make ends meet.

"It's not right that full-time working professionals deal with these conditions - it is driving people away from the profession."

Junior doctors, which includes anyone who has finished medical school but not yet become a consultant, say their wages have fallen for several years running in real terms (once inflation is accounted for).

First-year junior doctors currently earn £14.13 an hour, assuming a 40-hour week - but they regularly work much longer hours.

Many cited poor working conditions where sickness and burnout meant a junior doctor was often doing the work of two or three doctors in a shift, without the necessary guidance and support.

Intense pressure

Dr Sarah Hallett and Dr Mike Kemp, who jointly chair the BMA junior doctors committee, said: "Overworked, underpaid and undervalued junior doctors cannot and will not tolerate being ignored any longer - and ministers are seemingly oblivious to the crisis in front of them.

"They are angry and an extraordinary committee meeting has been called to review next steps."

There is intense pressure across the health system.

Patients cannot be quickly admitted to hospital because of crowded accident-and-emergency departments and delays transferring patients from ambulances due to a shortage of staff and beds.

Problems with social care prevent some medically-fit patients from being discharged and sent back to their communities.

'Hugely overstretched'

NHS Providers interim chief executive Saffron Cordery said: "Trust leaders are frustrated and concerned by the decision to exclude junior doctors and other specific staff groups from the recent NHS pay award.

"Like so many people, junior doctors are being hit hard by the cost-of-living crisis.

"Trust leaders are seeing first hand how the decision to award pay increases to some staff and not others is undermining staff morale, seeding unnecessary division at a time when the workforce is already hugely overstretched and it is a struggle to recruit and retain staff."

The Institute for Fiscal Studies has made the point multi-year pay awards are part of the Treasury's long-term public-spending plans and unpicking them is not straightforward and could set a precedent for other public-sector workers.

"Pay awards are based on what you expect to happen to inflation. And then if inflation turns out lower than expected, the workers do better - but if inflation is higher than expected, they do worse," Ben Zaranko, an economist at the institute, said.

A Department of Health and Social Care official said: "Junior doctors are already in a pre-existing multi-year pay and contract-reform deal, which ends next year - this will be the right time to consider pay."