Pay, a pandemic, racial discrimination and contracts – an extraordinary year

by David Bailey

It gives me great pleasure to present the report of Welsh Council at the end of an extraordinarily challenging year

Location: Wales
Published: Monday 13 September 2021
david bailey

COVID-19 pandemic

Despite a significant drop in acute COVID patients in our hospitals – due to the success of the vaccination programme in Wales – the pandemic has left us with record numbers of patients waiting for treatment.  

As a profession, we went the extra mile to care for our patients as we always have done, but this time with many of us putting our own and our families’ lives at risk to do so. After many months of intense and unfamiliar efforts and as we contemplate the immense task ahead, many of us were extremely disappointed at the DDRB’s recommendation of a 3% pay uplift, and that the Welsh Health Minister chose not to go above and beyond this. I’ve spoken with doctors across Wales who feel demoralised, disillusioned, and unappreciated. 


Following our campaign for fair pay, together with our colleagues in the other health unions, we told the health minister clearly that there has never been a time when the need for an urgent and significant pay rise for NHS staff has been so great. Now is the time to address the years of cuts which have seen doctors become so undervalued. 

A recent survey by BMA Cymru Wales found over half of the doctors polled were considering working fewer hours and over a quarter actually considering early retirement due to the impact of the pandemic – hugely concerning statistics and why the Welsh Government must reward and incentivise this workforce to stay before it is too late.  

Our subsequent meetings with Welsh Government have left us frustrated that the pay uplift is a done deal, but we are continuing to fight on your behalf to ensure that Welsh Government and NHS employers step up their efforts to support doctors by working with us to provide better working conditions, better facilities and better wellbeing services.  

All that said, much has been achieved in Wales since we last met.  

Staff, associate specialist and specialty doctor contract

Earlier this year, SAS doctors voted overwhelmingly to approve a new contract deal, which not only means a new contract for speciality doctors but also the opening of a new specialist grade across Wales. The new contracts represent an important milestone for SAS doctors, further building the grades as a fulfilling and positive career choice. And with the introduction of the specialist grade, there is finally an opportunity for career progression for highly experienced specialty doctors.  

With a record high number of patients waiting for treatment in Wales we have ensured that the efforts of Consultants and SAS doctors are recognised and have agreed an advisory pay notice with the Welsh Government to ensure they are reimbursed for working outside of your pre-COVID job plans. 

Recruitment and retention

We are leading discussions with Welsh Government and Employers at our Recruitment and Retention sub-group, emphasising the need for significant investment in the retention and recruitment of staff, and our number one ask is pension recycling and improvements to retire and return arrangements.  

The safety of our members during the pandemic has been our absolute priority. We have ensured that many colleagues have been protected by the risk assessment and that those suffering long covid have received full sickness pay throughout.  

For GPs, following extended discussions with Welsh Government, GPC Wales secured a series of measures to relax elements of the GMS contract during the second wave of the pandemic which allowed practices to go on to deliver the most successful flu campaign in Welsh history, and to lead the COVID vaccination campaign for the over 60s. Like elsewhere in the UK GPs have been in their practices providing consultations and seeing patients through every week of the pandemic and its only right the financial stability of practices has been protected. 

Junior doctor contract

We have continued our discussions with Welsh Government regarding the junior doctor contract– our opportunity to improve the working lives of junior doctors in Wales and address longstanding concerns around pay, rota monitoring and working hours, and we’ve recently agreed a formal mandate to commence negotiations.  

Tackling race inequality and discrimination

As one of the first organisations in Wales to highlight the disproportionate impact of Covid-19 on Black, Asian and Minority Ethnic doctors, our work has continued to shine a light on unacceptable racial inequalities within our health service. Earlier this year we launched our BAME Forum, chaired by Amol Pandit and Manish Adke – and the group has already begun building relationships with key stakeholders and informing BMA Cymru Wales’ policy work on Welsh Government’s Race Equality Action Plan.  


We’ve negotiated a new NHS Wales ‘respect and resolution’ policy, which will replace the grievance and ‘dignity at work’ procedures; supporting doctors in resolving issues at the earliest opportunity with their employer and avoiding the lengthy processes which can have a significant impact on an individual’s health and career.  

Our LNC’s have been pushing hard to ensure our fatigue and facilities charter, a mandate to health boards across Wales to provide better facilities and provision of wellbeing services, is implemented across Wales.  

You have told us how your own mental health and wellbeing has suffered over the last 18 months, in a recent member survey, 55% of respondents said they are suffering from depression, anxiety or other mental health conditions.  

Of course, none of us were surprised.  As well as providing our own 24h wellbeing services, we have continued to lobby for improved wellbeing support for NHS workers and we’re pleased to be playing an active role in a Welsh Government group aiming to deliver a framework to facilitate meaningful workplace conversations around wellbeing going beyond illness, resilience and coping.  

We hope this will inspire a better working experience within NHS Wales and ensure you are able to access the support you need. All that said it is absolutely not good enough that comprehensive occupational health support for doctors and staff in primary and secondary care has long been promised but is still not in place and we demand that Welsh Government must deliver this without further delay.  

After all, the NHS’s greatest asset is it’s staff. The problem is there are often simply not enough staff available to ensure the quality of care that all professionals strive to provide. That is why we will continue to campaign for safe staffing to be enshrined in legislation - ultimately, the safety of our patients depends on staff working within a safe system. But, due to the recruitment and retention crisis we are facing in the Welsh NHS, we continue to hear from doctors on the ground that they don’t feel the system is safe, with fears that the health of their patients is being put at risk.  

The introduction of Freedom to Speak up Guardians in each health board, reporting to a National Guardian, would, we think, dramatically improve patient safety, allowing staff to report issues anonymously without fear of recrimination and we’ll continue to lobby for their establishment in every Health Board in Wales.  

As the profession continues to go above and beyond to provide the best quality care for our patients and to reduce the backlog in the system, BMA Cymru Wales will continue to ensure your views are heard at the highest levels. Your safety, wellbeing and protection of your rights remains our number one priority.  

I’d like to thank Welsh council for their support, and our fantastic Welsh staff led by Rachel Podolak.

David Bailey is chair of BMA Cymru Wales – and this speech was submitted as a report to the BMA 2021 annual representative meeting – taking place virtually on 13-14 September