Message on pay

This year’s unsatisfactory pay award for hospital doctors triggers a moment of critical reflection on the Government's treatment of the profession.

This latest real-terms pay cut underlines clearly the long-term strategy, which makes doctors subsidise the NHS through year-on-year wage erosion.

This devaluing of the profession by the Government can only continue the deepening alienation among medical staff who see no fairness in their treatment.

The average salary of a hospital doctor buys a fifth less than it did a decade ago, with the impact felt in accelerating departures, falling recruitment, rising vacancies, and disruptive short-term steps to plug rota gaps - all of which heap yet more strain on the remaining, permanent hospital doctors.

In the face of widespread calls for a meaningful pay increase, the DDRB did depart slightly from the Government’s demand for a 1 per cent cap this year. However, it still did not recommend real-terms rises in base pay for Consultants and Junior Doctors.

It made an exception for Specialty Doctors and Associate Specialists, reflecting its desire for “pay targeting” in its awards – an approach which we believe could create more problems than it solves.

The subsequent decision of the Secretary of State to tinker with these recommendations, reducing their first-year value by as much as half, was a slap in the face for all hospital doctors. We have been told that this was done because the 2018/19 doctors pay awards have not been fully funded.

The decision to announce this after a month sitting on the DDRB recommendations, and just hours before the parliamentary break, was a disgrace.

HCSA has always stated its belief in partnership working wherever possible, working alongside others who share the aim of excellent health services. However, for a partnership to be successful it requires equity, reciprocity and mutual respect between the parties involved. Yet the Government expects hospital doctors to bear the bulk of the compromising.

It is increasingly apparent to HCSA that the existing pay review mechanism cannot continue like this. In the face of an unravelling workforce crisis, the idea that this dynamic can carry on uninterrupted is fantasy.

Yet this seems to be the current expectation, with the new Secretary of State blithely stating his ambition for a multi-year pay deal for hospital doctors in return for as yet unspecified concessions.

His decision to cut an already inadequate DDRB-recommended award to Consultants and Junior Doctors does not bode well for his aims to conclude such a deal. HCSA will certainly not agree to lock hospital doctors into several years of real-terms pay cuts.

HCSA is formulating our approach to the challenges to come, and we shall be seeking members’ views in coming weeks.

One thing can be made clear now: hospital doctors have put up for too long with the toxic cocktail of eroding pay, workforce crises, and the exhausting strain of making acutely underfunded services deliver high-quality outcomes for their patients.