BMA Scotland plans to ballot junior Doctors on strike action

Fourteen years is a long time. For some doctors, it could be the culmination of a career path, from medical student to GP partner. For others it may be longer than their entire stint as a practicing doctor. Fourteen years ago Cabinet Secretary for Health Nicola Sturgeon was named “Politician of the Year” – and her political career has taken quite a few twists and turns since then.

In that time, since 2008, the take home pay of junior doctors has been cut by almost a quarter. As demand for NHS services soared, the amount that successive governments were willing to compensate the staff providing them plummeted.

This year Scottish Junior Doctors’ Committee officers met with the cabinet secretary, and then his team. We wrote to him in November to reiterate that the issues facing junior doctors were at a critical point. At this point we were rebuffed, told that there was nothing he could do to improve on the 4.5% pay offer – a real terms pay cut – that we were slapped with in the summer. An offer that 97% of us declared too low. An offer that 93% of us said did not recognise our contribution to the NHS. An offer that nearly 70% of us said made it more likely for us to leave the NHS.

No-one enters medical school driven purely by financial reward – we want what’s best for the public and for our patients. But right now, we can see that, without halting the burnout, demoralisation and resulting exodus of talented and compassionate staff, we will not be able to provide that for much longer. Better pay may stop us being poached in an international marketplace and will allow people the financial security to go less than full time to avoid burning out to a point where they leave a career they once loved. Reinstating fair reward for our work, which is simply in line with what junior doctors earned in 2008, will demonstrate the Scottish Government genuinely does value us and our contribution beyond the warm words we often hear repeated.

As the health service limps through the end of a pandemic that it entered already at breaking point, junior doctors are being asked to do more and more. We are burning out and struggling to afford our heating bills in the process. Some FY1s in Scotland – making life or death decisions and staffing wards across the country – earn a basic salary that equates to around £14 an hour. After years at university, and after some of us have incurred huge debts, this is not good enough – and it is not sustainable. I would ask members of the public if they are really happy that those you entrust with the care of their loved ones are paid such a paltry amount to work in a system that is collapsing around them. We have given the Scottish Government ample opportunity to act and take meaningful and urgent action in line with the seriousness of the situation – but they have yet to take that chance.

Despite having been rebuffed in November and told there was no more money available for to improve the 22/23 pay “award”, we once again approached Scottish Government last week following our SJDC meeting on 1 December to request assurances that we can work together to get a better agreement for the future to take some initial steps towards a long term restoration of pay levels. This was effectively a last warning – and hence why we have waited between SJDC and today’s announcement. But there has not been any concrete undertaking that gives us confidence that Scottish Government are serious about resolving these critical issues for junior doctors in Scotland.  It is why – today, after pushing all avenues open to us – the Scottish Junior Doctors Committee have now and reluctantly entered into a trade dispute with the Scottish Government, and why we are now forced to plan to ballot Scottish junior doctors on strike action over pay in the first quarter of next year.

Like our English counterparts, we know that we do not deserve the pay erosion imposed upon us. Like our English counterparts, we see staffing shrink before our eyes as the resulting rota gaps go unfilled. We all know people who have left the NHS for Australia, New Zealand or Canada. If we don’t know people who stayed out there, we know people who regret coming back.

Despite our common cause the Scottish ballot will be a separate ballot, held at a different time, to that in England. Junior doctors in Scotland will not be receiving their ballots in January but we will of course, be showing our absolute solidarity with our English colleagues. And we will be using the time to organise, and campaign and ensure that as juniors in Scotland we are in the best possible place to secure the support we need to win – and make the transformative impact on junior doctor pay we know is needed. In that period we will also need to go through the proper process both internally, by securing the necessary BMA Council support and externally in considering any further substantial or serious offer the Scottish Government may or may not make.

Until then we need to show the Scottish Government that now is the time that junior doctors in Scotland say enough is enough. BMA Scotland’s junior doctor membership is the highest it has ever been right now, because people are confident that their union is ready to stand up and fight on their behalf. But we need everyone to have their say in the upcoming Scottish ballot. So, if you’re in the minority who haven’t already, join us. If you’re already with us, update your details and tell us where you work and where you stay. There is power in a union, and we’ve been forced into showing the Scottish Government how we can use it.

Dr Chris Smith is Chair of BMA Scotland’s Junior Doctor Committee