In 2024 the BMA consultants committee secured an historic pay deal for consultants in England. Pay erosion before that deal was at 35% compared to 2008/09 levels – with a huge knock-on effect for pensions and retirement income. However, pay erosion remains at 26% and the pay uplift of just 4% completely undermines the years of campaigning.
We are immediately entering dispute with the Government. This is not something we take lightly but we cannot let last year’s commitment slide. Our faith in the pay review process has been betrayed; the Government set limits in its remit letter to shackle the pay review body (DDRB) and both ignored our terms of reference. Government must know that they cannot make commitments to doctors and fall at the first hurdle.
We are now reintroducing the rate card
Staying united for a better future
Our collective efforts over the last two years led to significant achievements for consultants in England.
- A new shortened pay scale and improved pay deal.
- Vital reforms to the pay review body (DDRB) – including changes to its Terms of Reference and a commitment to the pay award being known at the start of the financial year.
- A bigger boost to pay for the majority of consultants than delivered by the DDRB for decades.
However, despite negotiating these hard-won reforms, we need to keep up the pressure to ensure that DDRB and government keep to that deal.
In December 2024, Government proposed a below-inflation for this year's pay award. Far from restoring pay, salaries are in danger of being eroded once again.
Currently, pay erosion is at 26%. That means our pay is still down by a quarter compared with 2008/09.
Promises for the independence of the pay review body and its readiness to publish its recommendations to come back with an offer that fairly rewards our work need guarding. In this critical first year of change we need our vigilance and willingness to act to ensure delivery.
On 2 April, we sent a joint letter, with the chairs of the RDC and SAS committees, to the Secretary of State, expressing our dismay at the failure of the DDRB to report back on time with credible pay recommendations for this financial year.
We have not entered a formal trade dispute yet. But if, as we think likely, there is no credible pay offer on the table following the pay review body’s recommendation, we will ballot for renewed industrial action.
Changes to pay
Back in July 2023 DDRB recommended a sub inflation pay uplift of 6%, at a time when inflation was much higher. This led to us entering dispute in late 2023. A first offer, in the midst of members’ industrial action, was rejected. Ongoing action, coupled with direct negotiations with the Government, led to additional increases to pay applied in the successful 2024 pay deal.
The 2024 negotiations shortened the pay scale, enabling consultants to reach the top of the pay scale 5 years earlier, after 14 years. The changes to the pay scale resulted in the uplift individuals received varying depending on the point of the pay scale they were at. Indeed, concerns over a number of consultants receiving no immediate uplift to DDRB original recommendation of 6% were a factor in the initial rejection of the pay offer. Further industrial action led to increases of between 6% and 19.6%, showing that your action worked enormously well.
This work is however unfinished, both in terms of the journey towards pay restoration for all (we are already 17 years in deficit) and specific groups towards the beginning and at the end of the consultant pay scale, it is vital we continue to be ready to fight for fairness if needed.
The chart compares the change in consultants’ average earnings to other sectors’ average earnings in real terms, using RPI inflation from April 2009 to December 2024. Data from NHS digital and the ONS.
Pay body reform
The deal we accepted in 2024 stated that the BMA would have a greater role for the BMA in the process of appointing DDRB members. It also included changes to the terms of reference that guide the panel’s recommendations. These include factoring in long-term pay trends as well as the salaries of comparator professions, including those of our international counterparts.
This meant that the DDRB should no longer be able to ignore past trends in pay when making recommendations. And it also freed the body from having to factor in calculations about the wider economy when determining consultants’ pay.
The sum total of these reforms to the DDRB – the first meaningful reforms since 1998 – was intended to equip the pay review body with the independence and scope it needed to determine a fair pay award for consultants.
However, we are yet to see decisive evidence of the reforms having been implemented. In its remit letter last year, the Government made reference to wider economic factors despite undertakings not to do so. Regrettably, this casts into doubt the government’s seriousness about enacting the reforms we agreed last year.
Fixing pay now and for the future
Last year’s deal was a good first step towards restoring our pay. Changes to pension taxation (AA and LTA) in the March 2023 Budget addressed many of the inequities around pension taxation, but there is still work to do in this area and if action on pay is needed, we will also act to remove or mitigate these remaining issues. Specifically, it is worth noting we should never let pension taxation dissuade us from seeking more pay, in the medium and long term more pay is always better.
The fight must go on. We’ve achieved so much – we must not allow the pace of pay reform to stall.
Let’s unite again, keep the pressure up on fixing pay and pensions now and for the future.
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