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There are two main components of junior doctors pay: basic pay which is pensionable and banding, and the system of rewarding additional and antisocial hours, which is not. We’ve previously heard concerns about the fairness of pay banding and many of you have been calling for major changes to the system, or for a total overhaul, for some time.
One consequence of moving from the current banding system could be an increase in employer and employee pension contributions and therefore higher pension accrual under the new career average pension scheme.
Herein lies the dilemma. Junior doctors could face a short term reduction in take-home pay, as trainees pay more into their NHS pension, however, when they get their pension on retirement, every pound put in will be returned several times over. We asked juniors doctors how they felt about this. Here’s what you told us.
Many doctors are indeed worried that changes to pay banding could result in an erosion of take-home pay. Indeed, for some this is a reason to reform, rather than abolish the banding system.
Some are concerned about future ‘raids’ on doctors’ pension pots by the government; particularly in the light of the changes imposed on NHS pensions in 2012. For other juniors, pensions are just not a priority: they would simply rather have the money now.
However, there is also a sizeable minority who are happy to pay higher contributions on the understanding that they will subsequently receive a larger pension. Some doctors felt very strongly that banding should always have been pensionable, as additional and anti-social hours are expected of doctors as part of the job.
Where you stand on this dilemma? Would you rather have money now or money later. There are no easy answers but I’d be keen to hear what you think.
Money now. That way if you want to invest for a future pension you still have the opportunity to do so. If you'd rather have the money right now you also have this option. The "money later" idea means that there is no choice, and everyone's forced to take less pay now.
With the rising cost of living and no real increment in pay which reflects this, ultimately many of us cannot afford to have a reduction in pay now. Those of us who will want to buy a house and raise a family, any deficit in take home pay will mean many of us will struggle for the forsee able future.
Banding should be pensionable, if I'm taxed for my banded hours then it should be pensionable as well.
Money now. However, i suspect this isn't actually a real "choice" at all. What's coming, i suspect, is a dishonest deal whereby we have to pay more in "pension contributions" now, for a pension that we will never get to see because - by the time the current generation of juniors get to retirement age - the government will have taken the lot.
The good times are over. Recent cohorts of consultants have essentially been bought off by government, and have sacrificed power to the managers. As a result, today's medical profession is almost totally emasculated: terrified of standing up for itself and patients, and content to sit back and take assault after assault on its pay and conditions, and on patient care. This is what MMC is all about: subjecting us to "360" managerial surveillance, and turning us into little more than protocol monkeys. This might not all be such a bad thing is "austerity" really was a problem in which "we are all in it together", but the decline in pay and conditions of doctors has been accompanied by a period of huge salary hikes for senior corporate managers who contribute nothing to patient care, and indeed - in the grand scheme of things -actually cause a great deal of harm. Doctors need to start standing up for themselves and patients once again.
The government has made three major changes to the pension since i went to medical school. We now pay much more for less, but keep getting told this is the best deal. but in 5 years they,ll change things again, and it won't be for the better! Another vote for money now.
Please don't patronise junior doctors by telling us that the contributions we make now are being 'saved-up' for later. We all know that NHS pensions contributions go directly into the government's current account and that in turn NHS pensions are paid directly from taxes. There is NO NHS PENSIONS SAVINGS POT. Why would we trust the government to keep to their word and maintain even the current, vastly reduced, level of pensions? Remember when Gordon Brown told us in 2006 that we were making once-in-a-lifetime changes to the NHS pension scheme that made it sustainable and affordable?
We should take the best take-home package that we can get now. Negotiating a decrease in junior doctor's take-home pay whilst we have faced 6 years of pay freezes or below inflation rises would be an appalling betrayal of some of the hardest working staff in the NHS, and would demonstrate how terribly out of touch with the frontline that the BMA has become.
Stop trying to talk us into a pay cut and instead use the leverage of the government's desire for 7 day working to improve and maintain our financial package.
Money now. Paying in more now does not mean you will be guaranteed a higher pension pot at the end. I trust myself a lot more with the money than I do government in 10-25 years.
Money now. There is no pension pot, it's a Ponzi scheme. Pension deals now will in no way resemble what we actually receive at retirement given the number of times the scheme has already been changed during my short career. The BMA failed miserably to stand up against the government during the last raid on our pensions, I have no reason to think they'll do any better in future.
My vote is for money now. There's absolutely no guarantee that the pensions money pot will be there in the future when we need it. It's our hard earned money - let us decide how else we'd like to invest it for our future. We are, after all, adults who are able to take responsibility for planning our own future. Don't dish out yet another blow for our autonomy as a profession.
Money now - most definitely. The goverment can't wait to get their hands on our extra contributions. While it galls me that so much extra work is done for so relatively little and not reflected in the average salary scheme, pay banding at least limits the contributions. I am loathed to donate more money into the pot when I still spend on average 1/5th salary on training costs each month.
Money now. The government are not trustworthy enough to take care of my pension. The government of the day when I come to retire may have a polar opposite view of the whole system too. As mentioned earlier we can choose to invest the cash in a pension fund ourselves if thats how we feel. Having the choice is crucial.
Money now, in the strongest possible terms. There is absolutely no guarantee that taking a pay cut now will mean 'every pound put in will be returned several times over' in our pensions. I would not be happy paying even higher pension contributions than at present.
These discussions are taking place after 7 years of significant reductions in wages for doctors in training and at a significant nadir in take-home pay. This excel document compares the take-home pay for any chosen training post since 2007:
As you can see our ST3 band 1A training post has had a reduction in take-home pay of almost a quarter since 2007.
As has been pointed out, the NHS pension scheme is not funded forward from our contributions. As such the large increases in pension contribution rates effectively constitute a reduction in current trainee remuneration for a promise of future payment.
If doctors’ full wages are going to be pensionable this will lead to a significant further reduction in take-home pay and effectively a reduction in current government spend on doctors’ wages. The promise of an increased future pension has the caveat of likely increases in pensionable age and the uncertainty of many future government changes. The recent renegotiation included government rhetoric about rich NHS pensions for doctors, the change to fully pensionable would reinvigorate those arguments and likely form the basis for further increased contributions or reduced accrual rate.
For example, under the current banding system were the wages of an ST3 band 1A trainee to become fully pensionable their annual contributions would rise from ~£3,200 to ~£6,450 (based on published 2015 CARE plans).
You talk about a potential reduction in take-home pay and negotiations that are based on static overall remuneration for doctors in training. What you are really talking about is a potential doubling of pension contributions on a base of historically low take-home pay.
To hear that a reduction in take home pay is even being considered as a satisfactory outcome to these negotiations is deeply concerning.
As those above have said, the BMA has presided over a continual erosion of junior doctors' income over recent years, despite our professional bodies and colleges increasing fees and examination costs year on year. There is an expectation that we will self-fund various courses and additional qualifications as a matter of course. Trusts have devised various wheezes to stop juniors from claiming the considerable expenses associated with rotating placements. The cost of living is skyrocketing which is a major concern for those of us at the early stages of our careers. Do the negotiating committee not appreciate any of this? Of course I would like any banding supplement to be pensionable - but as other have described, this will almost certainly be negated by ongoing 'reforms' to the scheme over our (already substantially lengthened) working lives.
As Dr Molyneux mentions, this is coming at a time when the upper echelons of the NHS are flying in the face of 'NHS efficiencies' and setting themselves corporate level salaries and lucrative benefits packages behind closed doors - like the clown who is somehow managing to be chief executive of two ambulance trusts at once with a salary of £230,000 (his own justification: "I work a lot of extra hours"). He also claimed more in expenses last year than my entire PRE-tax salary.
I digress. However to re-iterate: Money Now. If the BMA lands us with a contract that further reduces pay, it will be a catastrophic outcome for all juniors, not least its paying members.
I personally believe the NHS pension pot (which I've heard is currently in surplus), will soon become far too tempting a honey-pot for the government and will get absorbed either into the national employer pension scheme or the government deficit (rather like the Royal Mail pension scheme). So I'm for the money-now option.
I think our entire salary is should be pensionable and personally I would take a reduction in take home pay for a greater pay off latter