Doctors and consultants launch dual strike action
NHS England has been thrown into fresh chaos today, with almost all routine care brought to a standstill, as junior doctors and consultants kickstarted three days of strike action in tandem.
The dual action will add enormous further pressure to the health service as it contends with its record backlog of 7.7 million patients waiting for hospital treatment. Industrial action since December is already estimated to have cost the NHS over £1 billion and led to the cancellation of more than one million appointments.
Worryingly, there is no end to the action in sight. It’s now over 100 days since the Health Secretary held talks with BMA union leaders, and none are planned for the future. Rishi Sunak insists that the pay offer he made to consultants and junior doctors back in July – of 6 per cent and 8.8 per cent respectively – is “final’ and “no amount of strikes will change our decision.”
This offer is wildly out of step with the 35 per cent pay rise junior doctors are demanding – a figure the BMA labels “pay restoration” to make up for their 26 per cent real terms pay cut over the past 15 years. Consultants, meanwhile, are calling for a 12 per cent pay increase.
“Junior doctor” is a broad term covering the entire cohort of staff below consultant level, making it difficult to generalise about salaries. Pay ranges anywhere from £29,000 a year for those fresh out of university to around £77,000 for medics with up to a decade of experience.
Consultants are well paid, with an average median salary of over £93,000 – hence why their strike action garners less public sympathy, with 50 per cent opposed to it and 42 per cent in favour, according to recent YouGov polling.
The government has described the BMA’s 35 per cent figure as “completely out of step with pay settlements in other parts of the public sector” after other health unions agreed to a 5 per cent pay rise for staff back in May. Which begs the question, why is the BMA taking a decidedly tougher stance and have doctors suffered more brutal real-terms pay cuts than their other NHS colleagues?
Crucially, there are different ways to measure inflation. And the BMA has used a contentious one – RPI – to assert that doctors have suffered a 26 per cent real-terms pay cut. The union told Channel 4 FactCheck that it used RPI because this is the measurement the government uses when charging junior doctors interest on student loans. However, the ONS has made its position on RPI clear: “we do not think it is a good measure of inflation and discourage its use.”
According to IFS estimates, made using the ONS’s preferred measurement for inflation of CPI, consultants and junior doctors have suffered real-terms pay cuts of closer to 17 and 15 per cent respectively since 2010.
That said, the IFS’s figures do suggest consultants and doctors have been hit the hardest, perhaps going some way to explain the BMA’s comparatively tougher stance. For instance, nurses have seen pay decline by 12.5% over this same period, senior managers by 9.5 per cent, and ambulance staff by 3.8 per cent.
The fact that the Scottish government has offered doctors a pay rise of 12.4 per cent will also embolden the BMA to keep pushing.
Yet it’s important to pay attention to where the money for these pay rises is coming from.
Sunak has been clear that government departments will need to find the cash from within existing budgets to fund pay rises for NHS staff. “We will not countenance borrowing more money or increasing taxation”, says Number 10 – welcome news to many what with Britain carrying the highest tax burden in 70 years and the largest ratio of debt-to-GDP since World War Two.
Yet NHS leaders have warned it would be “a complete abandonment of reality” to expect them to find the money themselves without cutting services. If the government were to concede to a bigger pay rise for doctors without topping up hospital budgets, NHS bosses would face an even tricker task.
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