Pay uplift: there is still a long way to go…

As most of you will hopefully know by now, this week the Scottish Government announced it would meet this year’s recommendations from the DDRB report in full and provide all doctors across Scotland with a 2.8% pay uplift, backdated to 1 April this year.

The background is that many doctors in Scotland have had a major real-term decline in their pay over the last decade or so, and in that context all recent pay uplifts have fallen well short.

We know that this has had a cumulative detrimental effect on recruitment and retention and morale. Over this time our jobs have become more intensive with spiralling demand, with rising and under-reported medical vacancies exacerbating that. The huge efforts of doctors during the COVID-19 pandemic have only emphasised the obvious need to reverse the decline in our pay and the quality of our working lives.

The unfairness of this and the now long-term effects might simply lead us to a conclusion that we should demand much more. Some of you might ask why the BMA hasn’t simply asked for progressively higher pay rises. And I know that being told that we must be reasonable and realistic in the face of current circumstances can seem both frustrating and potentially patronising.

The process of determining our pay through detailed evidence to the DDRB, who then produce a report which runs to well over 200 pages given the huge volume of evidence they demand and gather, which then has to go to the relevant government, can seem unwieldy and many might say it hasn’t done us any favours recently. Whether or not we should continue with it is debated almost every year, but the prospect of direct negotiation with governments or individual employers is not a route to go down lightly, or one we could reverse. It may be that day will come, but for now the DDRB is how our pay is determined for good or ill.

A single year big pay rise request is intuitively attractive, but cumulative decline in pay can really only be addressed by cumulative, year on year, above inflation pay awards, if we are genuinely being realistic. And I know I said saying that might be frustrating, but I do believe it’s true. The reality is a grandstanding request for a 10, 20 or 30% pay rise just wouldn’t be listened to, even if it would seem right and just to some of us.

So, yesterday’s announcement is a just one step in the right direction after a marginal pay uplift last year. I wouldn’t want to overinterpret it, but perhaps it acknowledges our efforts as a profession in leading the response to COVID-19. The point is that our efforts year in year out need recognition. If this year’s pay rise is just “Because of Covid” with resumption of pay decline next year then our government will have completely missed that point.

The BMA can be criticised for forever surveying and never doing. But those of you who have replied to our surveys in your thousands over these last few months have told us that whilst pay is incredibly important, work life balance, working conditions, and being treated with respect are just as important. Recruitment and retention, workplace culture, being able to get decent downtime and even car parking are all part of the problems that need fixing, as well as pay. Any pay rise has to be measured against concrete actions to improve all of those things too.

There’s a long way to go and I know that.

The fact that the Scottish Government has listened and accepted this year’s DDRB recommendations in full, and this year much quicker than of late, is a good thing, or at least a good start. Particularly when they didn’t punish many senior doctors by capping that pay rise as they have done in the past. It demonstrates some understanding and recognition of the huge contribution doctors make, and also I hope reflects the value of the working relationship with government we’ve developed during the pandemic. Unlike some politicians I generally don’t much like making comparisons with other parts of the UK, but for once I might allow myself to say that we have done better for the whole profession in Scotland than in some other places.

To conclude, this year’s pay announcement isn’t as much as we would have wanted, and it is only a start. But I genuinely hope it is one.

Dr Lewis Morrison is Chair of BMA Scotland

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