GP leaders have floated a 2% pay rise for doctors in the coming financial year.
Submitting to the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), the BMA stated that “doctors should be treated in line with the wider economy, where pay settlements continue to run at higher than the public sector pay policy cap, at around 2% currently”.
This may cause some conflict, as the government has already stated its intention to keep GPs within its sustained 1% cap on public sector pay rises.
However, the BMA has already indicated that it is disappointed with this recommendation, and that it will seek a better outcome for GPs.
The BMA asserted that the uplift “in line with the public sector pay policy” for 2016/17 was ‘lending credence to the impression that DDRB is no longer acting independently’.
“We believe that DDRB should make its recommendations based on the value of doctors, not within any constraints imposed by governments. Doctors are being unfairly punished by government with continuing real loss of earnings and increasing cost pressures, when pay rises above 1% are still regularly being seen across the economy,” the BMA commented in a statement.
The BMA asserts that this climate of negotiation comes “at a time when doctors are working harder than ever to deliver a safe and quality service to patients, often at the expense of their own health”.
And the organisation also asserted that the NHS “is facing a significant recruitment and retention crisis across the UK, and this will only be worsened by a low or zero pay increase”.
The BMA has thus rejected the recommendations of the Department of health, outlining the importance in offering a decent pay rise in order to retain existing GPs.
“We believe there is a significant lack of data currently available around sessional GPs (salaried and locum) on which to base any firm recommendations, for example around pay ranges, and how GPs choose to take a partnership, salaried or locums post. There is currently insufficient data for DDRB to make recommendations around staff working under new models of care, or as sessional GPs, thus we are again seeking a fair and common recommendation across all doctors, whoever and wherever they are”.
Considering the extent to which GPs in the NHS system are overworked and under pressure, even a 2% rise will be viewed by many as a piecemeal concession.
According to official Government statistics, GP partner earnings increased by nearly 2% in the last year for which statistics were available to £101,500.
However, this figure is not limited to NHS work.
Trainee nurses and midwives are planning a major campaign against government plans to make them pay for their own training with student loans.
The industrial action comes in the context of learning that their earnings will be cut by nearly £1,000 annually.
Chancellor of the Exchequer George Osborne has announced this measure in the Autumn Statement, and after consultation with union representatives, trainee nurses are ready to take action.
Osborne had announced that NHS bursaries, which are paid to student nurses to cover their living costs while studying, will be converted into formal student loans that will have to be repaid, depending on future earnings.
This will make it extremely difficult for people of modest means to enter the nursing profession.
And it contributes to an overall impression that studying at university is becoming prohibitively expensive, as well as something that incurs a huge amount of debt for most students.
Under the controversial reform, nurses will also have to pay £9,000-a-year student tuition fees for the first time.
This means that student nurses are expected to begin their careers in the NHS at least £50,000 in debt, with an immediate demand from the student loans company to begin paying off this amount.
The current starting salary for a nurse is £21,692 – rising to £22,799 by 2020, Meaning that the level of debt will be effectively 250 per cent of the average starting salary.
With the government plans causing a lot of anger among students, it has now been indicated that nurses will indeed protest strongly against these plans.
This is just the latest problem that the Conservative government has experienced with regard to NHS contracts, after similar industrial action was proposed by junior doctors.
Having encountered difficulties with both junior doctors and nurses, there is the overwhelming impression that the Conservative government is out of touch with the requirements and opinions of NHS rank and file.
The organiser of the nurses’ campaign is Danielle Tiplady, 29, who is in the final year of her nursing degree at King’s College London.
Tiplady outlined the financial situation for many people entering the nursing profession.
“People who have had children have told me they cannot afford to become nurses now – they cannot face that much money going out of their wage. It’s daunting having that much debt as well. We really contribute to patient care. It doesn’t just affect students, it affects the whole country because if you don’t have nurses, then who is going to look after people?”
Considering the plans of the Conservative government to switch to a seven-day NHS culture, it is clear that there is a real rift between reality and expectation.
As expected, junior doctors in England have voted almost unanimously in favour of strike action.
The NHS employees were responding to new contractual plans that have been drawn up by the government.
Although it was widely expected that the balloted members would support strike action, the degree of affirmation for this view gave succinct indication of feelings within the health service.
In total, 98 per cent voted in favour of a full strike and 99 per cent in favour of action just short of a full strike.
Walkouts will begin on 1st December, with further dates also set aside for later in the month.
The British Medical Association indicated that disruption would be inevitable in the context of this industrial action.
It is thought that the strike action will lead to the cancellation of thousands of routine appointments, test and operations.
In order to ensure that the impact on patients is not too severe, the NHS will operate under the conditions of prioritising emergency cases.
Although the British Medical Association (BMA) indicated that the situation was regrettable, it stated that it fully supported the position of the junior doctors who were balloted, and that ministers have ultimately left them with no choice.
The BMA asserted that the contract floated by Health Secretary Jeremy Hunt was literally unsafe, and that industrial action was essential in this context in order to challenge the proposed arrangements.
Commenting on the decision to strike, BMA leader Dr Mark Porter was resolute in his belief that the industrial action was justified.
“We regret the inevitable disruption that this will cause but it is the government’s adamant insistence on imposing a contract that is unsafe for patients in the future, and unfair for doctors now and in the future, that has brought us to this point,” Porter stated.
Porter also sent a message to Health Secretary Hunt, indicating that negotiation between junior doctors and the government was essential to restore faith both in the Conservative party’s policy towards the NHS and the relationship between the government and junior doctors.
“Our message to him is that junior doctors have today made their views perfectly clear but that it is still possible to get back around the negotiating table to deliver a contract that is safe for patients, contains the necessary contractual safeguards to prevent junior doctors being overworked and properly recognises evening and weekend work.”
The campaigning group Patient Concern was critical of both sides in the dispute, and suggested that junior doctors were wrong to take strike action.
Roger Goss, a spokesman from the group, indicated his belief that the industrial action was incredibly bad news for patients within the health service.
“This is the worst news for patients in the history of the NHS. What happened to the promise that the interests of patients are paramount and we put patients first? Any honourable doctor with a genuine vocation who wants to preserve the high esteem which the medical profession currently enjoys will refuse to cause suffering inherent in a full-scale walk-out.”
Goss did not offer any views on what sort of industrial action would be acceptable, or how junior doctors could contest the enforcement of the contract without engaging in some form of strike.
Scotland and Wales have said they do not want to introduce the contract changes, while Northern Ireland has yet to make a decision.
Meanwhile, the BMA has stated that there are insufficient safeguards to stop hospitals overworking doctors and they could lose out financially in the long-term.
According to figures acquired by the Taxpayers’ Alliance, over 50,000 employees in the NHS earned more than £100,000 during the 2013-14 financial year.
Information acquired under the Freedom of Information Act provided details of pay packages across the health service.
The well-paid individuals worked in numerous fields, with marriages, hospital doctors, dentists, surgeons and GPs all featured.
It is notable that the figures acquired included included bonuses, pension contributions and redundancy payments, as well as salaries.
According to the Taxpayers’ Alliance, the figures acquired are a cause for concern, with particularly lofty sums being paid to senior managers in the NHS.
However, the overwhelming majority of staff receiving six-figure salaries were clinical, with GPs, hospital consultants and dentists particularly prominent.
Nonetheless, the Taxpayers’ Alliance pointed out that around 2,500 of the staff in receipt of salaries in excess of £100,000 were employed in non-clinical roles.
Of these 472 earned more than £150,000.
According to analysis of the figures carried out by the Daily Mail newspaper, the pay bills for NHS directors rose 22 per cent in the last two years alone.
Commenting on the results, Taxpayers’ Alliance chief executive Jonathan Isaby took a rather severe tone.
“No-one begrudges paying doctors and nurses well for the tough jobs they do, but it’s galling to see bosses at failing hospitals continuing to rake in the cash. It’s an insult to taxpayers, but it’s even worse for patients who have suffered because of mismanagement and worse. The rewards-for-failure culture is rife in the NHS and it must be stamped out as a matter of urgency.”
However, despite the remarks of Isaby, separate figures required by the Health and Social Care Information Centre paint a rather different picture.
A study carried out by the organisation indicated that the number of managers in the health service in England, including senior and lower level ones, has actually been falling.
While some hefty salaries are paid to workers within the NHS, it is always worth remembering that these individuals work in extremely pressurised circumstances and literally deal with life or death situations.
Recruiting people of sufficient quality does necessitate some decent salary payments, although it is clear that the NHS must make tough decisions considering its financial position.
Commenting on the figures, Health Minister David Prior stated: “We are absolutely clear that value for money for the taxpayer is vital, every pound that is wasted or spent unnecessarily is a pound that cannot be spent on looking after patients.”
Rob Webster, chief executive of the NHS Confederation, suggested that working as a chief executive in the NHS “was one of the toughest jobs in the country”.
“In the toughest environment for the NHS in a generation, we need good leaders who can transform care. They need the ambition and the skills to take people with them, and have the stability and time to build relationships around a common shared goal for their local population,” Webster commented.
Health secretary Jeremy Hunt will try to ward off strike action from junior doctors at one of the NHS’ busiest times of the year, by offering them an 11 per cent pay rise.
Furious at his threat to impose a new contract on them, the junior doctors committee of the British Medical Association is preparing to ballot its members about potential walkouts.
Were England’s 45,000 trainee doctors to strike, it would probably affect a wide range of NHS services and potentially lead to the cancellation of planned operations.
In addition to the pay rise, it is also especially that Hunt will provide new powers and to the Care Quality Commission regulatory agency.
These powers will particularly be aimed at ensuring that junior doctors do not have to work for excessive hours, or under undue pressure.
Ministers had initially drawn up the plans to change junior doctors’ contracts back in 2012, but the new arrangements have been an increasing bone of contention in the NHS.
In particular, proposals that would see evenings and weekend work count as a regular working hours have proved extremely controversial.
Unions have been strongly opposed to the plan, and despite the determination of the government to push it through, there has been something of a stalemate between the two factions.
And The British Medical Association has argued that the deal could mean pay cuts of up to 30 per cent, with “normal hours” reclassified as being from 7am to 10pm, Monday to Saturday.
The Conservative party previously suggested that it would push the contract through at some point next year.
However, the latest action from Holland appears to be something of a climbdown, or at the very least a compromise.
The Health Secretary had previously claimed that the British Medical Association was deliberately misleading members over the reforms planned by the Conservative government.
In an attempt to show some form of magnanimity, Hunt stated that he could understand why the doctors had opposed the contract in this context.
However, despite his conciliatory attempts, thousands of doctors marched through London last month as a form of protest against the proposed changes.
It is evident that unless major concessions take place then when members are balloted on Thursday, industrial action is almost inevitable.
Should junior doctors choose to support such strike measures, it is likely that doctors would provide only emergency care.
The union has warned that it would hold “a withdrawal of all junior doctors’ labour unless Mr Hunt makes further concessions.
In addition to pay promises, Hunt will also pledge that the average working week of 48 hours will remain the same, and propose for the top limit to be reduced from 91 hours to 72.
Junior doctors have engaged in a mass protest in London, as conflicts with the government over proposed contract changes escalates.
The British Medical Association contends that the plans of the Conservative government will lead to a significant drop in the salaries of junior doctors.
However, the Health Secretary Jeremy Hunt, has stated that the union is misleading its members, and that the proposals will be beneficial for junior doctors in terms of reducing their maximum weekly working hours.
Unquestionably there has been huge pressure on doctors of all levels of seniority in terms of their overall working hours.
But the British Medical Association rejects the claims of the Health Secretary, and instead states that the rally in Westminster is a “wake-up call for ministers”.
Aside from the March in London, thousands of junior doctors also attended rallies in Belfast and Nottingham.
Critics of the government scheme believe that it will be extremely detrimental to the living of junior doctors, and may even lead to a ‘brain drain’ of talented individuals to health services overseas.
The British Medical Association asserts that the new contract will involve pay cuts of up to 30 per cent, with the change in normal hours central to this.
Hunt intends to extend this period to 07:00 to 22:00 every day except Sunday.
Speaking to the BBC, the Health Secretary claimed that the motivation for the new contracts was to ensure that hospitals no longer have to incur financial penalties for rostering staff on at weekends.
He was also keen to emphasise that the government would be willing to negotiate over safeguards that will enable doctors to work less hours.
However, the suggestion that removing financial penalties that force hospitals to roster less at weekends is the motivation for this contractual system does appear to be a rather self-defeating argument.
If healthcare services are able to save money under the new contractual scheme, it is hard to see how this could possibly be achieved without paying junior doctors less.
By definition, this is precisely what junior doctors are striking about, so the comments of Hunt will undoubtedly be considered extremely disingenuous by many.
Nonetheless, Hunt called for the British Medical Association to return to the negotiating table, claiming that the contracts represent a good deal for doctors.
In particular, the Health Secretary stated that the maximum hours a doctor can be asked to work for will be reduced from 91 to 72 hours per week.
Weather a 72-hour week can really be considered acceptable, considering that the European Working Hours Directive states that no one should work for longer than 48 hours per week, is debatable.
Naturally this still means that doctors can experience a working week that is 50 per cent more than the supposed European maximum.
Doctors speaking at the protest indicated that the new contractual proposals would represent an unprecedented pay cut for them.
One individual who spoke to the BBC indicated that after diligently assessing the government’s proposals, it had become clear to him that he would experience a 15 per cent reduction in salary.
This was an individual with 11 years of experience dealing with casualty patients on a daily basis.
The issue is set to rumble on, but it certainly appears that the government has an extremely difficult position to defend.
The British Medical Association (BMA) has announced that junior doctors are to be balloted regarding strike action.
Industrial action from the registered trade union for doctors comes in the context of new government proposals related to the contracts of trainees.
The government intends to impose these new conditions starting from August, but the BMA had indicated its opposition to the proposals.
Reforms outlined by the government have been described by the BMA as “unsafe and unfair”.
The ballot will only be distributed among trainees in England, as Scottish and Welsh trainee doctors will not face changes to their existing contracts.
Speaking on the subject, Dr Johann Malawana, the recently appointed leader of the BMA junior doctors committee, described the decision as “a reflection of the anger felt by the thousands of junior doctors who have told us that the government’s position is not acceptable”.
Malawana suggested that the government had given insufficient consideration to whether the new contract system will provide sufficient patient safety.
There are also question marks regarding whether junior doctors are being fairly remunerated for their work, and on the impact over the functioning of the health service as a whole.
“The contract they want to impose will remove vital protections on safe working patterns, devalue evening and weekend work and make specialities such as emergency medicine and general practice less attractive, even though the NHS is already struggling to recruit and retain doctors to these areas of medicine,” Malwana asserted.
It has been suggested by critics of the new proposals that trainee doctors and they could be could buy as much as 30 per cent under the government guidelines.”
In addition, under government proposals overtime rates will be scrapped for all junior doctors between 7am and 10pm except on Sundays.
With strong feeling present within the BMA, the form of industrial action that the trade union will recommend to its members is still under discussion.
Predictably the Department of Health was critical of the decision to ballot for industrial action.
A spokesman conveying the views of the department stated that it was “disappointing that the junior doctors’ committee has decided to ballot for industrial action in advance of receiving a formal offer from the government. We urge the BMA to reconsider this decision and come back to the table, because there is a great deal to discuss about how we reward the profession.”
Reporting on the issue today, The Guardian newspaper spoke to several junior doctors, all of whom painted a picture of declining pay and increasingly pressurised conditions within the NHS.
One individual suggested that once mandatory expenses were taken into consideration, she was receiving no more than £10 per hour.
Considering the extent to which qualified medical professionals are sought-after, the plans of the government could contribute to the existing ‘brain drain’.
Many qualified doctors already seek employment in pastures new, and there will be suggestions that the government’s proposals will inevitably exacerbate this existing process.
With public sector pay and austerity still a thorny issue, one NHS trust has taken the law into its own hands.
Kingston Hospital NHS Foundation Trust has decided to award its senior staff a 1% pay rise in line with lower paid staff, in clear defiance of government guidance.
In making the decision, the trust evidently considered the potential impact on staff retention of freezing salaries across pay bands.
In a note on the decision, the trust’s papers stated that the “rationale was that in the light of the recent staff survey results and staff able to work at local trusts who would pay inner London weighting, it was thought that it would improve the retention of staff”.
Earlier this year, the government had agreed to a 1 per cent pay rise for all staff salaried below £57,069, as part of its Agenda for Change pay framework.
But the trust has now defied this decision and become the first to offer an improvement in pay to those ranked above the band 8C grade.
Staff surveys conducted last year certainly indicated that employees working for the NHS in the Kingston region were not overly enamoured with the existing situation.
Forty-seven per cent of the trust’s staff who completed the survey stated that they were either “dissatisfied” or “very dissatisfied” with their pay level.
In this context, it was deemed to much of a risk to freeze the pay of valued employees within the trust, and thus Kingston Hospital NHS Foundation Trust acted in order to retain talent.
Releasing the information into the public domain, the trust also provided data on the potential cost to the public purse.
Increasing pay for staff above the band 8C mid-point will cost the trust £22,000 this year; a relatively trivial figure considering that the trust anticipates a deficit of £8.8 million in 2015 in its overall financial figures.
A spokeswoman on behalf of Kingston Hospital NHS Foundation Trust stated: “While the majority of staff, approximately 2,250, received the nationally agreed 1% unconsolidated pay rise this year, 22 members of staff at the bands 8C mid-point and above, did not.
“To maintain good staff morale and retention within this small group of staff, and to achieve a level of equity against their colleagues, a decision was made by the trust board that staff at band 8C mid-point and above would receive a 1% pay rise for one year only.”
Managers in Partnership, the British Trades Union for healthcare managers, also welcomed the move. Chief executive Jon Restell asserted that “Kingston FT has made a wise decision in the face of increasing pressure on recruitment and retention as the economy improves”, and stated his belief that the move “is the only logical way to push back on agency and interim costs. I hope and believe that others will follow Kingston FT’s example.”