Shwmae pawb,
We’ve reached a deal with NHS Wales employers on a new resident doctor contract. As part of the deal, Welsh Government will invest additional money into the resident doctor workforce and our pay.
We’ve also agreed the first stage of ongoing study budget reform ambitions as well as measures to tackle medical unemployment. I’ll be writing two blogs on this: this first one will detail the journey so far, and the second will set out the contract once we’ve had formal approval from the cabinet secretary for health and social care in Wales.
So how did we get here? In Wales, we still work on a 2002 contract introduced to deal with what was then, the new European Working Time Directive. There were less doctors, most worked full-time and duty periods were often far longer with varying intensity. The medical workforce has completely changed since but our contract hasn’t and many quirks have emerged that can see doctors that do similar work earn vastly different pay.
The growing intensity and complexity of medicine also means that some of the patterns permitted under the contract and still seen in Wales, such as 12-day runs, are profoundly unsafe for doctors and patients.
In 2019, the then BMA Welsh junior doctor committee agreed a Fatigue and Facilities Charter with NHS Wales employers and began a process of contract reform. The BMA and membership were in a very different place. Pay erosion was nowhere near its peak; in fact, pay had started to recover in 2019. Contract talks took three years and focused on rest and safety but in the interim, we had a pandemic, further workforce change, and, crucially, severe pay erosion.
In 2022, the contract was rejected, and a radically different committee was elected on a pay restoration mandate. Since then, BMA Cymru has strengthened our trade union work, our member density has grown to record levels, and we undertook successful industrial action that secured a 12.4 per cent pay deal that began pay restoration.
As part of that deal, we agreed to re-enter contract talks with Welsh Government and NHS Wales employers. This time it was going to be very different. We began with why the 2022 contract was rejected and you had told us unequivocally it was because there was too little investment, you want to retain the current definition of plain time, you want out of hours work appropriately valued and you want experience rather than grade to set your pay.
Candidly, we also realised that member engagement had not been good enough previously. So, we began a massive engagement exercise. This involved workplace events across Wales, face-to-face conversations by reps, a survey, and a virtual all-member meeting.
We also reviewed various doctor contracts across different countries and existing resident doctor policy voted through the annual BMA resident doctor conference. Further insights emerged out of this with members generally being in favour of better safety limits, higher basic pay with front loading, and an hours worked model of pay specific to the individual.
New priorities were flagged around poor study budgets, low staffing, late rotas and lack of access to development time. Members also want an end to unpaid overtime amidst deep scepticism around the rota monitoring system currently in use and the exception reporting system seen in England.
Your elected committee developed a negotiation mandate, and a team of negotiators was put together and trained. Negotiations began in March this year and lasted until the end of July and were very constructive with respect from both sides. During this time, we also had a pay award uplift confirmed, the study budget review from our pay deal was completed and a medical unemployment crisis became apparent in Wales.
Eventually, all of that would be wrapped up into negotiations too and the end-result is a comprehensive package that seeks to address all the issues I’ve written about. Your elected committee feels this is a good package and represents the limit of what we can achieve in this pay year without re-entering a trade dispute and undertaking industrial action. So, they have now unanimously agreed to put the package out to you for consultation and vote.
As soon as we have government approval, the full package will be published, and BMA Cymru will be undertaking a whole series of workplace and virtual events to brief you. You will have several weeks to review the deal, ask questions, and let us know what you think. After that, there will be a referendum on the deal for all resident doctors and final year medical students in Wales. You must be a member to vote, and you must ensure your details on your BMA account are up to date.
Whatever happens, our pay restoration campaign will continue. The pay uplift for this pay year was not good enough and, even with reforms, it is apparent the Doctors and Dentists Remuneration Body is still being politicised. We have stated this to the cabinet secretary, called for the resignation of the board, and will not be participating in the process until further reform is achieved.
The body has already been remitted to provide pay recommendations for the '26/'27 pay year and, regardless of whether the contract is accepted or not, we will be expecting an award in April 2026 that further restores our pay and will be seeking direct pay talks if it doesn’t. You will get your say on any pay award next year.
Ymlaen.
Deiniol Jones is BMA Welsh resident doctors committee deputy chair (terms and conditions)