Should junior doctors get a vote on the consultant pay offer?

BMA statement

Location: England
Published: Friday 22 December 2023
BMA in the news Illustration

The BMA’s UK consultants committee has recently launched a referendum on a new government offer to settle the ongoing Consultant pay dispute in England. The offer comes about after sustained strike action by consultants brought the government to the table and Consultant members across England are now making the choice of whether it is sufficient to bring strike action to an end.

The offer has led some to ask whether Junior Doctors, particularly those who are ST3+, should also have a say and whether the BMA has policy on this.

There is some history to these questions. In 2015 the BMA was involved in substantial consultant contract renegotiations. This included proposals to implement changes by applying it only to newly appointed consultants, who were at that point in time (junior) doctors. There was fear that current consultants would choose to protect and improve their own conditions at the cost of detriment to younger BMA members. This fear was exacerbated by the changes to pensions, which protected older members only, something now proved to be discriminatory and requiring remedy.

Given the substantial contractual reforms being negotiated, which would have a clear impact on junior doctors specifically at the time the following motion which was carried at that year's ARM:

That this meeting:-

i. believes that members in training at ST3 level and above working in non-GP specialties should be included in BMA consultations, correspondence or ballots relating to the renegotiation of the consultants contract in the UK nation in which they work and;

ii. demands that a vote cast in any consultant contract negotiation ballot by a doctor in training must have the same weight as one cast by a member on a Specialist Register.

In the end, no consultant contract renegotiation was put to members.

Flash forward to today and understandably (junior) doctors have a keen interest in the pay offer which has been negotiated by the UK Consultants Committee. This 2015 policy has been raised by some as the reason why ST3+ doctors should vote in the ongoing referendum on the consultant pay deal.

The BMA has taken advice on whether the 2015 motion applies. It doesn’t, for reasons set out below.

Firstly, because the current offer, which consultants are now deciding whether to accept or to reject, is not a contract renegotiation. It is, and has always been, a pay dispute. The 2015 motion does not say that any small contractual change needed a referendum of junior doctors. In fact, there have been several small contractual changes agreed since then without a referendum of any members (even consultants) – changes of this nature are frequently agreed by committees through the delegated authority which they, as all BMA branches of practices do, hold on behalf of the group of doctors they represent.

This authority is laid out in the BMA’s articles and by-laws which are the rules that govern the Association. There have been several versions of the 2016 Junior Doctors Contract (the current version is the 11th), but only two have come to member referendum – the version rejected in 2016, and the version accepted in 2018. Consultants are on version 13 of their 2003 contract.

Some have made the case that SPA (Supporting Professional Activity) time changes constitute a renegotiation, but in fact (as the Government and NHS Employers have clarified) there in no change in the contract at all in terms of SPA.

The two central aspects of the offer to consultants are both focussed entirely on the BMA’s policy to achieve pay restoration for our members: an additional 4.95% investment into reforming the pay scale structure (this is in addition to the 2023 uplift and whatever uplift is given in 2024); and reform of the pay review body (the DDRB) which advises UK governments on doctors’ pay.

The contractual changes in the offer are to:

  • facilitate the reinvestment of CEA funds into basic pay.
  • change the pay scale structure to introduce fewer pay points, faster progression, and higher rates of pay.
  • update schedule 15 to add statutory and mandatory training to the pay progression requirements.
  • give consultants access to enhanced shared parental leave.

Consultants are being asked whether the proposed offer is sufficient to stop their strike action. That is a decision that only consultants can make. Other doctors should not make a decision that would mean consultants should keep striking. If the referendum made a different decision to most consultants, our industrial action and our leverage would be totally undermined.

It must be those who organised, who were balloted, and who took industrial action who determine whether this pay offer is or is not acceptable. That is what consultants in England are now doing, and they have until 23 January to cast their vote.

Consultants in England can feel secure in knowing that if they vote to reject the offer, they have already delivered another historic mandate to continue industrial action. The Consultants Committee will be led by consultant members. It is, as always, for members to lead our union.