Doctors must be treated equally by the pay review body and a government attempt to restrict pay ignored, the BMA insists.
In its calls to the DDRB (Doctors and Dentists Review Body) for fair pay rises for all, the BMA paints a picture of falling morale, intensifying and increasingly complex workloads and of doctors battling to maintain high-quality care while coping with massive NHS reorganisation, cuts and pension changes.
The BMA, in its submission to the DDRB, says it continues to disagree with the way the government has been instructing the review body to freeze or cap pay over the past few years.
BMA council chair Mark Porter says the arguments for restricting pay rises for doctors do not stand up to scrutiny.
He adds: ‘Maintaining and improving care in the face of probably the biggest ever financial challenge for the NHS requires a more strategic response than just continuing to cut the terms and conditions of its staff.’
NHS Employers would rather see a complete freeze in pay, claiming increases are neither ‘necessary or affordable’.
It also says doctors’ pay has continued to rise by up to 8 per cent a year as a result of incremental pay increases and progression through training, and this has made the challenge of finding efficiency savings all the more difficult.
The BMA disputes this. Its calculation suggest that more than half of consultants do not get an incremental rise in any given year. Annual pay progression for newly-appointed consultants stops after four years and after this they only get pay increases every five years.
The government wants any pay rise for doctors limited to 1 per cent for 2013-14. It also wrote to the DDRB over the summer to say there was no need for any recommendations to be made in relation to GPs.
The BMA’s DDRB evidence says: ‘We believe that GPs should expect to be treated fairly and in line with other doctors in the NHS, so that in this instance they receive the same increase as the rest of the profession in their take home net pay.’
Across the board
It adds that while the association understands the current tough economic climate, it is extremely concerned by the erosion in the real value of contracts for doctors due to relatively high levels of inflation but low or zero [pay] awards, and changes to NHS pensions over the past few years. It also points to a widening pay gap between doctors and other professions.
On pensions, the BMA points out that doctors saw their contributions increase this year and will face further increases for the next two years. It asks the DDRB to take this into account in its recommendations.
The association says: ‘The BMA regards therefore the government’s proposal for a 1 per cent uplift as a minimum on this occasion and asks that any uplift be applied equally to the net incomes of all doctors.’
A BMA survey, undertaken to inform the DDRB submission, finds changes to the NHS pension scheme and NHS restructuring have had a negative or very negative impact on the morale (81 per cent and 76 per cent of respondents, respectively).
Yet despite their plummeting morale, doctors in England helped deliver substantial efficiency savings of £5.8bn in 2011-12. The BMA says: ‘We believe that doctors should be recognised for their part in delivering improved clinical quality and outcomes and service innovation, without unsustainable short-term cost-cutting. This reinforces our belief that the government’s proposals on net pay should be regarded as a minimum.’
Doctors leaders are growing increasingly concerned that medicine is becoming less attractive as a career and serious shortages are starting to emerge in some specialties and regions. While the BMA is opposed to moves towards regional pay, it suggests a case could be made for targeted recruitment and retention incentives in hard-to-fill posts, such as a one-off ‘golden handshake’.
Read the evidence by branch of practice.