President's view: The government ignores our precarious situation at its peril

The government's attempt to pre-empt the pay review process represents a dangerous misreading of the current state of the NHS workforce, warns HCSA President Dr Claudia Paoloni

HCSA joined other NHS unions last week in condemning the government’s attempt to pre-empt the annual pay review process by stating that it had already budgeted for a 1 percent salary increase.

The decision to do so at the very start of the DDRB pay review body’s deliberations on remuneration sends a message of contempt to that body.

It also sends precisely the wrong message to the medical staff and their other NHS colleagues who have given so much to meet the challenges of the pandemic and take on the huge backlog of non-Covid work we now face.

Last autumn, when the Chancellor announced a pay freeze for all public-sector workers apart from those in the NHS, HCSA was quick to point out that given the state of the workforce this could not just be in technical terms only. Our suspicion was that the government, fearing a PR backlash, would ultimately seek to kick the can down the road. We feared it was hoping that by the summer, when the government has taken to announcing its belated award for April, the public would have “moved on”, making a tokenistic offering easier to push through without resistance.

The fact it has stated its intent even before the starting gun is fired on the pay review process smacks of total disregard for the impact of its actions on what we know is a volatile workforce.

We have previously stated our concern that a return to so-called pay restraint (actually further real-terms salary cuts) would reflect a dangerous misreading of the current landscape within our NHS.

If the DDRB’s role is to conduct a forensic assessment of the current state of morale and retention and make recommendations, no matter how unpalatable to us, the government’s approach appears more akin to a nursery child who has not yet learned to read.

Coming hours after the Chancellor signalled a freeze of pensions lifetime allowance which will incentivise our most senior doctors to leave the service, it represents a totally illiterate strategy.

HCSA’s evidence to the DDRB, based on research with you as members which showed pay and pensions as your top campaigning issues, painted a clear picture of a profession going through profound changes as a result of the pandemic. One in 20 were considering exiting the NHS as a result of the pandemic, with a similar number looking to reduce to less-than-full-time.

The government ignores this precarious situation at its peril. It seems employers, which have joined calls for a rethink of the 1 percent figure, are keenly aware of the threat to the stability of staffing and the scale of the catch-up challenge they now face.

As we are confronted by a huge backlog of elective work, HCSA’s clear message is that we need all hands to the pump. Setting aside moral or emotive arguments about the Covid-19 response, in this context any steps which work against the retention of hospital doctors are at best cavalier and ill-judged.

This pandemic has been a period like no other in living memory. I am clear that the coming year will be one in which we, as a profession, have a chance to put down a marker for the current generation of doctors, and the generations to come.

HCSA will be attending an oral hearing of the DDRB where we shall be stating our rejection of the government’s approach.

The association convened an emergency meeting of the executive on Monday night to agree our next steps, which we have subsequently outlined in an urgent statement.

I anticipate that we shall shortly be calling on HCSA members to give their views on the steps they would be willing to take in order to press home the case for a meaningful pay rise for hospital doctors.