Doctors branded ‘delusional’ for 30pc pay rise demand

·6 min read
industrial action nhs doctors
industrial action nhs doctors

After rail workers and barristers took to the picket lines in an effort to prevent their pay from falling far behind inflation, doctors are preparing industrial action of their own.

At the British Medical Association’s annual conference, doctors said a real-terms pay cut in the last 12 years means they have effectively lost millions of pounds.

GPs have also voted in favour of industrial action over a new contract that forces practices to open on Saturdays, expressing solidarity with rail unions by urging fellow medics to “channel our inner Mick Lynch” in protest at the new terms.

But rather than seeking a pay rise slightly higher than the 3pc public sector cap sought by the Government, in exceptional cases — or even in line with the 11pc figure that inflation is expected to hit in October — the BMA is preparing to call for a 30pc increase over the next five years, one of the biggest demands in the history of industrial relations.

“Calls for pay rises of up to 30pc are completely unrealistic,” argues independent economist Julian Jessop, adding that while it is of course important to retain staff in the sector, pressure on the public finances cannot be completely ignored.

“Pay rises that are not justified by productivity gains would divert money from other frontline services and add to inflationary pressures.”

For the average consultant — who already earns £119,000, almost four times the UK's median salary, of £31,285 — this would equate to an increase of £36,000 a year, more than the typical worker takes home in 12 months.

It would also cost the Government many billions of pounds in wages at a time of brutal pressure on the public purse. Total NHS salaries and wages cost the Government £50.5bn in 2020-21. Although many of these staff are not covered by BMA negotiations, an across the board increase of 30pc would add £15bn to this bill.

Statisticians might also take issue with the way the 30pc figure has been calculated. The BMA says this is equal to the real-terms pay cut that doctors have suffered since 2008. However, they have based this argument on a failure of pay to keep up with the retail prices index measure of inflation, an outdated metric that typically overestimates increases and has been described by the UK Statistics Authority as "flawed".

If the more up to date consumer prices index is used to track inflation, doctors’ pay has reduced by a less severe — although still stark — 22pc.

These figures also obscure the face that consultants' pay is actually up £9,700 over the past 11 years in cash terms according to NHS Digital figures. Over the same time frame, the median pay for all workers has climbed by £5,400.

The potential action will leave Andrew Bailey, Governor of the Bank of England, with his head in his hands. His plea for UK workers not to demand large wage increases — remarks which were heavily criticised by unions and politicians earlier this year — have unsurprisingly been ignored.

The Bank’s policymakers have long feared that a surge in pay packets will fuel a wage-price spiral that prolongs painfully high inflation, but it’s unlikely that they ever expected pay demands to end up being three times the current 9.1pc inflation rate.

As Dr Joanna Sutton-Klein put it at the BMA conference on Tuesday: “All around us, workers are coming together in trade unions and winning big — last month bin men in Manchester 22pc; Gatwick airport workers won a 21pc pay increase two weeks ago, and in March cleaners and porters at Croydon hospital won a 24pc pay rise”.

In all these cases, the cash pay increases at stake were rather lower than those being sought by doctors.

The bin drivers in Manchester secured an increase from £11.40 to £13.90 an hour — equal to an extra £5,200 a year for someone on a typical eight-hour day. A consultant getting a 22pc pay rise would earn an extra £24,000.

There is no doubt that doctors' morale is low after years of Covid.

London-based Amy*, who has worked for five years in the NHS, says she works 47.5 hours per week and takes home £2,750 a month after tax.

“So if you work that out we get paid about £13.40 an hour — an average caesarean takes me about 35 minutes so my pay to deliver one baby is about £7.80,” she says.

Andrew*, a trainee doctor due to qualify this summer, argues that a fight for doctors’ pay is also a “fight for patient care” as overworked, badly paid medics quit the industry for good.

Shadow health secretary Wes Streeting argued at a conference on Tuesday that while he doesn’t think doctors don't deserve a pay rise and understands where they are coming from, he’s not “lying awake at night, worried about people on my salary or high salaries”.

“I am worried about people on low incomes who are struggling to get by, I'm really worried about a social care workforce where we lose people because Amazon offers better pay and conditions than doing an important, vital care role,” he said.

Others agree. “Nobody doubts that doctors have worked extremely hard in recent years, but demanding such a gigantic pay rise is delusional,” says Matthew Lesh, head of public policy at the Institute of Economic Affairs.

“This would cost taxpayers billions, wiping away money earmarked to get on top of waiting lists, while doing little to improve patient care. Doctors should work productively with the government to improve working practices and deliver better outcomes for patients that would justify higher pay.”

Punitive pensions rules also means that doctors should be careful what they wish for. A sudden increase in salary would hit thousands with “astronomical” tax bills, pension experts warn.

A consultant with a £120,000 income would be forced to pay £87,000 if their pay increased by 30pc, according to calculations from wealth manager Quilter, while a GP earning the average £100,000 would receive an immediate pension tax charge of £34,500. While that would be a huge blow, the public are unlikely to sympathise with those earning significantly more than them.

“Many NHS staff did go the extra mile during the pandemic and are still facing huge challenges now,” adds Jessop.

“But public sympathy is not unlimited. Doctors are already relatively well-paid and have better job security and pensions than many of their patients.”

*Names have been changed