Junior doctors will see an 11% increase to basic pay if the BMA accepts the Government’s contract offer, health secretary Jeremy Hunt has said.
He has outlined his ‘firm offer’ to junior doctors on the eve of the ballot on industrial action the BMA, which is due to launch tomorrow.
Mr Hunt admitted last week that some will see pay decline under proposals. However the detailed offer claims this amounts to ‘a very small minority’ of around 1% of junior doctors receiving pay cuts while ‘around three-quarters’ would see a pay increase.
The Department of Health also said that ’the Government has decided that plain time will be extended until 7pm Saturday instead of 10pm Saturday’.
This meas that doctors ’will receive time and a half for any hours worked Monday – Sunday between 10pm – 7am, and time and a third for any hours worked between 7pm-10pm on Saturday and 7am-10pm on Sunday’.
The offer still abolishes automatic year-on-year pay increases, replacing this instead with progression based on performance.
It also continues to propose an end to the GP training supplement, which would be replaced with a ‘pay premia’ for hard-to-fill training programmes, also including emergency medicine and psychiatry.
Under the proposal, the new abolute limit on hours worked within any week would be 72, while those opted out of the EU working time directive would be allowed to work an average of only 56 hours per week.
Mr Hunt said: ’We again make the guarantee that no junior doctor working within the current limits will see a pay cut compared to their current contract. As we have consistently said, we will reduce the maximum number of hours that can be worked in any one week and are putting in place better safeguards, meaning the firm offer gives the best protection junior doctors have ever had against working long, unsafe hours.
’Our proposals offer better basic pay with increases based on responsibility instead of time served, a shorter working week and improved patient safety. I appeal to the BMA to do the right thing and come back to the table to negotiate for its members.’
But Dr Johann Malawana, BMA junior doctors committee chair, said: ’Junior doctors need facts, not piecemeal announcements and we need to see the full detail of this latest, eleventh hour offer to understand what, in reality, it will mean for junior doctors. We have repeatedly asked for such detail in writing from the secretary of state, but find, instead, that this has been released to media without sharing it with junior doctors’ representatives.
’What we do know, however, is that Jeremy Hunt has repeatedly changed his position on pay and just last week was caught out trying to gloss over the truth when he said that no doctor would have their pay cut, only hours later to admit that those working the longest hours would in fact see a reduction in pay.’
The BMA has said repeatedly that it will negotiate with the Government only when Mr Hunt lifts his threat of a contract imposition.
Dr Malawana said: ‘We are clear that without the assurances we require, the BMA will be left with little option but to continue with our plans to ballot members.’
The Government’s offer
- No junior doctor working within the current limits will receive a pay cut compared to their current contract. Around three-quarters of junior doctors moving to the new contract will see an increase in pay with the remainder getting pay protection. There are a very small minority – around one per cent of junior doctors – who are forced to work excessive hours under the current contract and who will be better protected under the new contract against breaching hours limits.
- Junior doctors will receive an approximate 11 per cent increase to basic pay. A newly qualified junior doctor can expect to start on a basic salary of£25,500, compared to £22,636 in the current contract. As doctors advance through the stages of training and take on increased responsibility they will be rewarded through five pay progression points, reaching £55,000 in the final stage of training, compared to £47,175 in the current contract.
- Pay increases based on successful progress through training and taking up a post at the next level of responsibility will replace automatic annual increments based on time served. The current system means all junior doctors get an automatic pay increase every year, regardless of achievement and performance, leading to examples under the current contract of high flying junior doctors supervising colleagues who are paid at a higher rate because they have progressed more slowly.
- Junior doctors will be paid for all hours worked and will be paid at a higher rate for hours worked in unsocial periods. The Government has decided that plain time will be extended until 7pm Saturday instead of 10pm Saturday. Doctors will receive time and a half for any hours worked Monday – Sunday between 10pm – 7am, and time and a third for any hours worked between 7pm-10pm on Saturday and 7am-10pm on Sunday.
- Junior doctors will receive on-call availability allowances, ranging from two per cent to six per cent of basic pay, as well as payment for work undertaken as a result of being on-call.
- Putting a greater proportion of earnings into increased basic pay mean doctors will benefit from higher pension contributions from the NHS, as basic pay is pensionable, whereas other elements of pay are not counted when calculating pension contributions.
- We will offer new flexible pay premia for those training in hard-to-fill training programmes where there is the most need – general practice, emergency medicine and psychiatry.
- Junior doctors who take time off for academic research that is part of their NHS training, or which contributes to the wider NHS and improvements in patient care, will get additional pay premia to make sure they don’t lose out. But we will stop the existing situation where a junior doctor can take time out to do an unrelated degree and continue to get an automatic pay rise.
- Junior doctors taking maternity/paternity leave will continue to get the same leave and pay entitlement from the NHS as they do already but we will remove the current situation where they continue to get an automatic pay increase, meaning in the future pay on return will be the same level as other trainees working at the same level of responsibility. This is consistent with arrangements for other public sector staff.
- The average amount of hours junior doctors work will remain the same, at around 48 hours per week.
- There will be a new absolute limit of 72 hours in any week, lower than the 91 hours that the current arrangements allow. Alongside this, we are removing the financial incentives in the current contract that encourage doctors to work unsafe hours.
- Junior doctors who opt out of the working time directive will not be able to work more than 56 hours per week on average over the course of a rota.
- No junior doctor will have to work more than four nights in a row – down from the current week of nights – or five long day shifts in a row, compared to the existing seven long day shifts.
- Employers will be banned from scheduling any shifts over 13 hours, down from the current full shift length of 14 hours.
- There will be a limit of seven days or nights on call.
- We will introduce a new system of ‘work scheduling’ agreed between the doctor and their employer, with regular, routine reviews agreed with educational supervisors. Doctors will have the ability to trigger an urgent review if there is significant or regular variation from the work schedule.
Source: Department of Health
04 December 2023