The impasse between the government and NHS doctors continues as consultants began their second two-day strikes over pay on Thursday morning.
Meanwhile the British Medical Association (BMA) union further ramped up pressure on ministers by announcing three more days of action that targets the annual Conservative Party Conference.It means senior doctors in England will have walked out for two days every month between July and September and for three more days between October 2 and October 4 unless an agreement is reached.
The union’s junior doctor members, who are also in dispute with the government over pay, has staged a four-day strike last week, but the union can’t legally organiser another strike for them unless members vote to give it a new six-month mandate. BMA is current re-balloting junior doctors until the end of the month.
The government has insisted their offer of a 6 percent rise for consultant doctors is “final” and urged the BMA to call off the strikes, but the union is holding out on their above-inflation pay demand, saying better pay is crucial for the short-staffed NHS to retain doctors.
They have also blamed each other for the skyrocketing hospital waiting list as almost 840,000 appointments have been cancelled in the past nine months.
NHS England: Routine Care Brought To Standstill.
Ahead of Thursday’s strike, NHS England warned that almost all routine care would be brought to a stand still because consultants can’t be replaced.
Compared with other staff groups, consultant strikes are particularly disruptive because planned care that involve junior doctors will als be affected if they need any consultant supervision.
NHS national medical director for secondary care Dr. Vin Diwakar said the effect is compounded by annual leaves and warm weather in parts of the country, and urged people to take the usual precautions.
The NHS has been struggling to deal with its waiting lists for well over a decade amid growing demand that comes with an aging population and new treatment methods. The Conservative government has also been routinely blamed for budget cuts to the health service.
The backlogs soared during the COVID-19 pandemic. Although the NHS had begun to catch up after the lockdowns, back-to-back strikes by doctors, nurses, ambulance staff and other NHS workers in the nine months have added more to the pile.
In June, a record 7.5 million patients were waiting for hospital treatment. According to NHS England, a total of 839,327 appointments have been postponed during the strikes.
Union: Doctors Devalued and Undermined
Dr. Vishal Sharma, BMA consultants committee chair, told ITV’s “Good Morning Britain” that doctors are “incredibly sorry for anyone that’s had their care disrupted.”“We’ve tried everything to try and minimise that impact on patients as much as we possibly can, so we are continuing to provide emergency care as normal today.”
He also said that doctors wanted “fairness,” and blamed the government for NHS waiting lists.
“We don’t want our pay to be cut this year and it’s been cut every year for 14 years, so for this year we were looking for a pay rise above inflation,” he said, referring to salaries in real term.
Dr. Sharma criticised Prime Minister Rishi Sunak, who he said has “blamed COVID and now he attempts to scapegoat doctors for his failure to bring down waiting lists.”
Dr. Sharma said the waiting list growth was “due to the government’s failure to properly invest in the NHS and its staff” and “can only be brought down by recruiting and retaining doctors.”
The BMA has demanded the government “restore” NHS doctors’ salaries, saying they have been cut in real terms since 2008 by more than a quarter for junior doctors and by 35 percent for consultant doctors.
But ministers would be wary that raising pay would add to government debt and risk stoking inflation, which peaked at 11.1 percent in November last year and has slide back down to 6.8 percent in June but still well above the 2 percent target.
Health and Social Care Secretary Steve Barclay said he’s “concerned and disappointed that the BMA pressed ahead with the strikes, which he said ”will continue to affect patients and hamper efforts to cut NHS waiting lists.”
Mr. Barclay said he’s “incredibly grateful” that some consultants have cut short their annual leave to cover junior doctors during their recent strike, but insisted the 6 percent raise is final.
Ebbs and Flows
Nuffield Trust on Thursday published an explainer of doctors’ pay to provide context to the debate.The analysis said that an average full time consultant doctor can expect around £143,100 for a year of work in NHS England, with some earning extra salaries from private practice work.
In the year 2021/22, a consultant’s salary was in the 98th percentile compared with all jobs in England and three times the average salary, although higher earners also have to pay a higher percentage in taxes.
While medical students often take on “considerable student debt” and have hard work cut out for them, previous studies have suggested that “the effect of a medical degree on lifetime earnings ... appears favourable, even controlling for other factors including prior attainment,” Nuffield Trust said.
Authors compared real-term changes in pay for consultants and junior doctors since 1990 and found the pay has gone though ebbs and flows.
“In fact, while the minimum basic starting salary of consultants in 2022/23 (around £88,000) was lower after adjusting for inflation than it was one decade ago (£96,000 for 2012/13 in 2022/23 prices), it is the same as two decades prior (also £88,000 for 2002/03) and higher than three decades earlier (£75,000 for 1992/93),” they said.
Comparing before-taxation pay and purchasing power with some comparable countries, consultant doctors in NHS England are doing as well as their peers in Ireland, Germany, or South Korea, but are faring better than doctors in many countries including New Zealand and Israel, and France.
However, the United States and Australia, where many doctors go to because of higher pay, are not included in the chart because their available data is not directly comparable.
“For other potentially useful comparison (such as with the USA and Australia), it is only available for self-employed doctors, who are typically paid more,” the authors said.
Authors said the pressure from the pandemic and clearing the backlogs have left staff “feeling undervalued and exhausted,” and urged policy makers to “be more creative and proactive” on factors other than pay that would affect staff retention and wellbeing, such as better work-life balance, delivering high-quality care, and appropriate autonomy are all.
