- By Nick Triggle
- Health correspondent
The second day of a six-day junior doctors strike began in England on Thursday, causing major disruption to services. says the British Medical Association (BMA). If the government makes a credible offer it will end the strike – The longest in the history of the NHS. But how long will it take to resolve this conflict?
Junior doctors began their industrial work later than many other workers.
It was March 2023 when they first went on strike. By that point, strikes had been ongoing for months in the NHS and other sectors.
But their demand – a 35% salary increase – was the largest of all. Unlike most of the rest, the report did not focus on the rise in inflation after the pandemic.
Instead, it was, as the BMA put it, about restoring lost wages after 15 years of below-inflation rises.
The union used a measure of inflation known as RPI, which includes housing costs, as the basis for its wage demands.
This shows that between 2008-09 and 2021-22, junior doctors’ wages fell by 26% once rising costs are taken into account. To reverse this decline would require a 35% increase.
But this is just one measure of inflation. If the Office for National Statistics’ preferred measure known as the Consumer Price Index is used, the fall in wages is smaller.
Whichever measure is used, a lot has happened with respect to inflation and junior doctors’ salaries since these amounts were disbursed.
In fact, junior doctors received two pay increases. The value of one doctor in 2022-2023 was 2%, while the other in the current year 2023-2024 is 8.8% on average (structured so that the lowest-paid junior doctors make the most money – with those in the current year The first training is more than 10%).
It has raised the starting salary to over £32,000, and those at the end of their training currently receive over £63,000.
This is only the basic salary. Junior doctors, like other NHS staff, receive additional top-ups and can be paid 25% to 30% more for things like unsocial hours and overtime. The junior doctor’s contract stipulates that they can be asked to work up to 48 hours per week instead of 40 hours per week.
So, in light of this, what might it take for junior doctors to stop their strike?
Strikes were paused between early October and December to allow talks to take place. As well as pay, these included discussions about working conditions as well – a long-standing issue for junior doctors was the amount of debt they had accumulated during their five years at university, as well as the lack of control over the workplace. When they are asked to work.
It is not uncommon to find reports of people being put on work rosters despite giving months’ notice for large events such as family weddings.
It can also be difficult to establish roots, because they may find themselves doing placements in different parts of the country.
All this and more was discussed during the talks, along with the offer of an additional 3% bonus on top of the 8.8% already offered.
The British Medical Association’s senior junior doctors, Dr Vivek Trivedi and Dr Robert Lawrenson, explained that this was not enough, and urged ministers to make a new, “credible” offer. The demand for a one-shot wage recovery has been watered down, and they now say they would be happy to see it phased in over several years.
The BMA says the wage increases seen over the past two years have not affected the amount of wages lost since 2008-2009 due to what happened with inflation.
Window of opportunity
However, there is clearly room for negotiation. In August, a remuneration agreement was reached with junior doctors in Scotland. It included a 12.4% pay rise for 2023-24, which is similar to the 8.8% plus 3% that appeared to have been on the table in England just a month ago.
There are some key differences – junior doctors in Scotland earned more than double the 2% pay their peers in England in 2022-23, so are starting from a higher base, and the BMA says the Scottish deal included promises about future pay rises with a view to restoring pay.
Some in government believe the differences are small – instead the leaders of junior doctors are political. An interview Dr Lorenson gave to the BBC’s Today program over the summer, in which he said the same deal as Scotland would not be accepted in England because the governments were different, was cited by those close to the negotiations.
However, there is hope that once this withdrawal is over, there will be a return to talks. Behind the scenes, there is recognition on both sides that the strikes cannot continue for much longer.
Ministers have insisted they will not talk while the strikes continue – and with no further talks planned after this pause, it could provide an opportunity for the two sides to finally find a solution.