What are junior doctors paid - and how much to settle?
2024-01-04 02:48:07+00:00

The second day of a six-day strike by junior doctors is under way in
England on Thursday, causing huge disruption to services. The British
Medical Association (BMA) says if the government makes a credible
offer it will end the walkout - the longest in the history of the
NHS. But how much will it take to settle this dispute?

Junior doctors started their industrial action later than many other
workers.

It was March 2023 by the time they first went on strike. By that
point, walkouts had been going on for months in the NHS and other
sectors.

But their ask - a 35% pay increase - was the largest of all. Unlike
most of the rest, it was not focused on the post-pandemic spike in
inflation.

Instead, it was about - in the words of the BMA - restoring lost pay
after 15 years of below-inflation rises.

The union used a measure of inflation known as RPI, which includes
housing costs, as the basis for its pay claim.

This shows that between 2008-9 and 2021-22, pay for junior doctors
had fallen by 26% once rising costs are taken into account. To
reverse that drop would take a 35% increase.

But that is just one measure of inflation. If the Office for National
Statistics-favoured measure known as CPI is used, the drop in pay is
lower.

Regardless of which measure is used, much has happened both to
inflation and the pay of junior doctors since those sums were done.

Junior doctors have in fact received two pay rises. One in 2022-23
was worth 2%, while another in the current 2023-24 year was worth
8.8% on average (it was structured so the lower-paid junior doctors
received the most - with those in their first year of training
getting in excess of 10%).

It brought the starting salary to more than £32,000, with those
towards the end of their training receiving in excess of £63,000
currently.

And that is just the basic pay. Junior doctors, like other NHS staff,
receive extras on top and these can be worth 25% to 30% more for
things such as unsocial hours and additional work. The junior doctor
contract stipulates that they can be asked to work up to 48 hours a
week rather than the standard 40.

So, given this, what would it take for junior doctors to stop their
strike action?

Walkouts were paused between early October and December to allow
talks to take place. As well as pay, these involved discussions on
working conditions as well - a long-standing issue for junior doctors
has been the amount of debt they build up while studying for five
years at university, as well as the lack of control they have on
where and when they are asked to work.

It is not uncommon to find reports of people being rostered to work
despite giving months of notice for big events like family weddings.

It can also be difficult to put down roots, because they can find
themselves doing placements in different parts of the country.

All this and more was discussed during the talks, alongside the offer
of an extra 3% pay award on top of the 8.8% that has already been
given.

The BMA's junior doctor leaders, Dr Vivek Trivedi and Dr Robert
Laurenson, made it clear this was not enough, and have been urging
ministers to make a "credible" new offer. The demand for pay to be
restored in one go has been toned down - they now say they would be
happy to see it phased in over a number of years.

The BMA says the pay rises seen over the last two years have made no
dent in the amount of lost pay since 2008-09 because of what has been
happening with inflation.

However, there is clearly scope for negotiation. In August, a pay
deal was reached with junior doctors in Scotland. It included a 12.4%
pay increase for 2023-24, which is in a similar ballpark to the 8.8%
plus 3% that appeared to be on the table in England just a month ago.

There are some key differences - junior doctors in Scotland received
more than twice the 2% their peers in England got in 2022-23 and so
started from a higher base, and the BMA says the Scottish deal
included promises on future pay increases with a view to restoring
pay.

Some in government believe the differences are small - and instead
that the junior doctor leaders are being political. An interview Dr
Laurenson gave to the BBC's Today programme over the summer, in which
he said the same deal as Scotland would not be accepted in England
because the governments are different, has been cited by those close
to the negotiations.

Nonetheless, there is hope that once this walkout ends there will be
a return to talks. Behind the scenes, there is a recognition on both
sides that strike action cannot continue for much longer.

Ministers have been adamant they will not talk while strikes are
ongoing - and with no more planned after this stoppage it could just
provide the window of opportunity for the two sides to finally find a
solution.