Soon, resident doctors and final-year medical students working in Wales will begin voting on a proposed contract package. As a reminder, the package consists of four main elements:
– A 4% additional investment in resident doctors on top of the 5.4% average pay uplift this year
– A reformed, bespoke resident doctor contract
– Study budget and leave reform
– Measures to tackle medical unemployment.
Detailed information is available on our contract web page. This blog aims to summarise our recommendation to vote yes as well as addressing some of the concerns raised by members.
Before I do that, I wanted to extend our support to colleagues striking or balloting in England and Scotland, respectively. Welsh resident doctors stand firmly behind you, and, despite the opportunities offered by this proposed contract, we could be joining you again in future as we continue toward our pay restoration goal. I encourage everyone to donate to our joint strike fund.
Committee views
Your elected resident doctor reps have been engaged in the contract debate throughout and have carefully listened to your views. On balance, we feel this package makes progress towards our pay restoration goals, improves our terms, and conditions, and sets out a clear path to addressing medical unemployment. Accordingly, we have voted to recommend the package and that you vote to accept it.
However, the decision is yours and we will implement what you tell us to. As a reminder, the BMA Welsh resident doctors committee feels this is the best package that could be negotiated with our current leverage. If you vote to reject this package, then we will decide on the next steps, but this would likely involve balloting for industrial action.
Comparisons
Diolch to everyone who has attended a webinar, workplace event or has just got involved via our social media questions. It’s been great to see the discussions and your contributions have been invaluable. Generally, we’ve found members to be positive about the deal with little outright opposition. However, with such a large and complex package, technical questions have been plentiful.
The biggest set of questions has been around pay and people wanting reassurance over their future pay levels compared to now, especially those who have calculated a potential drop in pay. To reassure yourselves, given the extra 4% investment, we have found that the vast majority of rotas pay out more on the proposed contract when modelled. When pension earnings are accounted for, we anticipate that the net financial impact for all residents will be positive. The most common reasons for a negative pay calculation have been incorrectly applying the pay systems or failing to account for leave.
A common issue has been people training flexibly (less than full time) pro-rating their basic pay by their LTFT% rather than their actual total hours per week as a % of the nominal 40-hour week. Additionally, for accurate calculations, all leave allowance should be deducted from a rota (whether taken or not) if your employer will not let you take leave against shifts containing unsocial hours. This effectively compresses your unsocial work into the remaining days, raising both your average hours and unsocial hours per week, meaning higher pay.
More information on these issues is available on our contract webpage and FAQs, including several resources on pay, leave deductions and webinar recordings. This also covers the unique circumstances where some current rotas would drop in pay for some residents, why that is, and the pay protection you would have. We also cover how this contract compares to both the current 2002 contract here and the 2016 contract in England.
The move from banding to hours worked
Related to pay, there has been a lot of commentary on banding, both generally and more specifically for GP registrars. Membership was mixed on whether to move on or retain banding when we engaged you. The advantages of banding cited included higher out of hours pay and simpler pay slips. The disadvantages included lower pensionable basic pay (especially for unbanded rota or doctors training flexibly), no frontloading of pay to early career, and scenarios where people getting the same money for doing different work and vice versa.
There was, however, much more consensus on the current rota monitoring system not working, on wanting to be paid for overtime or busy on-calls, and on getting personalised pay. For the GP premium, fixing the premium to one point rather than whatever pay point someone is on means a higher % amount can be given, effectively frontloading pay to GP registrars when they are earlier in their career rather.
Given all of this, we opted to move away from banding. However, the choice is yours: increased basic pay and additional pay that rises linearly with total and unsocial hours worked, or retention of the current system which has lower basic pay and large jumps, and drops in additional pay around specific rostering criteria.
Medical unemployment
Finally, we had a lot of questions on the pressing jobs crisis on the post-foundation year 2, academic and the post-certificate of completion of training bottlenecks, especially for GP registrars. HEIW (Health Education and Improvement Wales) has already recommended significant post expansion following our lobbying. However, the proposed bottlenecks review will bring HEIW, NHS Wales employers, government and ourselves together to examine the issue properly and develop sustainable solutions, starting from the principle that any new posts must not cause bottlenecks further down the line. If the package is voted for, then we’ll be engaging with you early and extensively to get your views.
There is still time for you to read and consider the deal before voting. If you want to read more or have any questions, we’d encourage you to read our webpage and FAQs. If your question still isn’t answered, then please email us at [email protected]
The contract referendum takes place from 24 November to 15 December. You must join the BMA by 9 December to have your say. It is vital that as many of you vote as possible to ensure that we take the right next step for the profession here. Please vote as soon as possible and encourage your colleagues to do the same.
Deiniol Jones is BMA Welsh resident doctors committee deputy chair (terms and conditions)