BMA backs subsidies to support junior doctors with cost of living

by Ben Ireland

Pay restoration the priority but benefits touted to boost retention and wellbeing

Location: UK
Published: Thursday 27 June 2024

BMA representatives have called for junior doctors to be given subsidies to help them pay for food on shift, accommodation, utility bills and parking in a bid to improve wellbeing and workforce retention.

A motion passed at the association’s annual representative meeting backing a push for junior doctors – who will be renamed resident doctors from September – to have tailored support to ease cost-of-living pressures.

It was voted through ahead of the latest strike in the campaign calling for restoration of junior doctors’ pay to 2008/09 levels, since when it has eroded by nearly 30 per cent, despite some opposition in debate arguing that if full pay restoration is achieved subsidies would not be needed.

Junior doctors earn as little as £15.53 an hour in England and even less in Wales and Northern Ireland.

GP registrar Nicholas Lucas, who tabled the motion, asked members of the BMA representative body to consider the costs faced by junior doctors forced to move around on rotations.

LUCAS: Juniors 'demoralised and burnt out' LUCAS: Juniors 'demoralised and burnt out'

These, he described using the story of a fictional doctor called Rose as an example of a typical situation for a junior doctor.

She had £100,000 of student debt, was having to find affordable accommodation for a new rotation, was choosing between a two-hour round commute on the bus or paying expensive car parking fees at her hospital’s visitor car park and couldn’t afford to eat at the hospital canteen every day.

‘Rose just wants to be able to focus on her job, and her development. She wants to revise for her post-graduate exams, she wants to be a surgeon. Instead, she feels demoralised and is burnt out,’ said Dr Lucas.

‘She can’t understand why nobody is listening or helping. Maybe things will get better? Should she switch countries? Should she switch careers?

‘This is the reality many resident doctors currently, and will, continue to face.’


Meeting the basics

Dr Lucas said providing such subsidies would represent ‘a significant step forward’ towards improving morale and wellbeing of junior doctors, as well as improving levels of retention.

Eilidh Garrett, a foundation year 1 doctor, said she was ‘absolutely for the sentiment of the motion’ but argued doctors should not have to rely on subsidies.

‘Obviously if you’ve got a six-day, 70-hour work week trying to do the basic things is really quite hard,’ she said.

‘But the subsidy your employer gives you to pay for day-to-day living costs is called a salary. And if that is not sufficient to meet your expenses then you need be paid more. The majority of this motion would be fixed if doctors were just paid fairly.’

Dr Garrett also argued that, in conversations with the public during the pay restoration campaign, an argument often used against doctors is that the job comes with a ‘gold-plated pension’ – so warned that adding subsidies or benefits could undermine the pay campaign.


'Totally obscene'

‘Realistically, we need that money in the pocket of junior doctors. If you start giving subsidies, trusts will find a way to undercut that rather than just paying you fairly,’ she said. ‘I think it brings a substantial amount of risks.’

GP Gill Beck agreed, saying the fact that the motion has been tabled is ‘a very sad reflection of the Government’s refusal to value our resident doctors’.

While she agreed with the principle of highlighting the ‘unacceptable financial pressures’ faced by junior doctors, she said providing subsidies was ‘not the answer’.

‘Resident doctors have been fighting for two years to get paid what they deserve,’ she said. ‘I don’t feel we can bake in the concept that highly qualified professionals should need subsidies to survive. That’s totally obscene.’

She called for free parking and pay for junior doctors which allowed them to afford sufficient housing and hospital canteen meals.


Tools for the job

‘Give resident doctors their needed pay restoration and value them properly, and then work to give them the real income they deserve.’

Hannah Cagney (pictured top), a specialty trainee 1-2 based in Scotland, urged the RB to think of the motion ‘holistically’, as part of a package alongside pay restoration.

This, she said, should be considered ‘as part of giving our resident doctors and trainees the respect they deserve, the resources they deserve and the tools to do their jobs – so they’re not worrying about what they’re going to eat, where they’re going to park and where they’re going to live’.

Dr Cagney added: ‘Doctors, and resident doctors in particular, are uniquely vulnerable and – unlike almost everyone else working in the hospital – are required to move to the other end of the country… and you have no control over that.’

BMA treasurer Trevor Pickersgill said some of the suggestions in the motion were being ‘engaged with’ by national negotiation teams already ‘and will continue to be so’.

PICKERSGILL: Subsidised car parking not enough PICKERSGILL: Subsidised car parking not enough

He warned that asking for subsidised car parking ‘waters down’ existing BMA policy which calls for free staff car parking. ‘If we have to be available in a place of work and go to other clinics or rotations, it is imperative you are able to access car parking, so subsidised parking doesn’t go far enough,’ he said.

Responding to the debate, Dr Lucas said he agreed doctors need full pay restoration.

‘But I think we can have both,’ he said. ‘Pay is one factor, but valuing your workforce is a completely different factor. This is one way of showing a commitment and a value to your workforce.’

He noted that subsidies for doctors exist in other countries, such as New Zealand, on top of fair pay awards – but agreed to take the calls for subsidised car parking as a reference because of the existing BMA policy.

The motion, which included a call for the BMA to encourage dialogue and feedback from junior doctors to ensure any subsidy programmes are tailored to meet their evolving needs and priorities, passed comfortably in all parts.