The DDRB’s failings have been laid bare

It’s no wonder doctors have had the worst pay erosion of any sector, writes consultants committee chair Vishal Sharma

Location: England
Published: Friday 20 January 2023
vish sharma

We don’t need to tell you that real-terms consultant take-home pay was down by 34.9% last April – you can no doubt feel this in your pocket. But we might need to tell you why: the mechanism that was introduced with the sole purpose of ensuring our pay kept up with the cost of living, kept pace with pay in comparable professions and ensured the quality of recruitment and retention has been corrupted by Government to the point of being nothing more than a puppet, with the Government pulling the strings.

The BMA has published a detailed report into the failings of the DDRB (the Review Body for Doctors’ and Dentists’ Remuneration). It details multiple instances of meddling and interference by the Government in the pay review process – something we have been raising concerns about for a very long time. The report lays bare just how the DDRB is not independent. The Government repeatedly froze or capped pay awards, continues to send binding letters tightly defining the DDRB’s remit, unilaterally appoints the members of the DDRB and is free to disregard or modify the recommendations as they see fit. No such process can be reasonably defined as independent and it’s no wonder that doctors in general and consultants in particular have had the worst pay erosion across any sector.

Last week the consultants executive subcommittee of the BMA met and remains extremely disappointed that there has been no movement from the Government in addressing our concerns about our pay, and in the ongoing pension scandal that is driving people to reduce hours and retire early, and the failure to engage in reform of the DDRB. The executive subcommittee was extremely concerned by recent suggestions that the Government is considering increased pay offers for NHS staff – except for doctors, and was clear that such a move is completely unacceptable.

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Supporting junior doctors

As you know, our junior doctor colleagues are currently balloting on whether to take action to address their own 26.7% fall in pay since 2008. It is essential that consultants support our junior colleagues as we really are all in this together. Their fight is also our fight. Speak to your juniors, tell them that you not only understand their concerns about pay, but that you share them. Please do as much as you can to support them with their training and completing their portfolios so our juniors are in the best place possible if their training is disrupted by future strike action.

It’s also important for juniors to be reassured that voting ‘yes’ in a ballot is confidential, and if they ultimately do take strike action, that this will not harm future career progression.

You may have seen that the intended initial action from juniors is a full withdrawal of labour for 72 hours. This was not a decision taken lightly and the choice has been informed by their last period of industrial action in 2016. Consultants will undoubtedly have an incredibly important role in maintaining patient safety during any periods of industrial action. However, it is important to note that ultimately it is the responsibility of employers to maintain safe services and that they must plan appropriately to cover this action by releasing additional staff through the cancellation of routine activity.

Covering absent juniors is also clearly extra-contractual activity and this view is consistent with NHS Employers’ own legal advice. So, any cover arrangements require your agreement and if you are asked to cover absent juniors, you should be paid appropriately or given appropriate time off in lieu. We recommend that you use the BMA rate card for such work to ensure you are fairly compensated for agreeing to cover juniors during periods of industrial action.

Vishal Sharma is chair of the BMA consultants committee