Michael Simmons Michael Simmons

Wes Streeting is right to take on the doctors

Doctors outside St Thomas' hospital demand pay rises (Getty images)

The public won’t forgive and nor will I, said Health Secretary Wes Streeting of plans by junior doctors to strike over his refusal to cave to demands for 29 per cent pay rises. Speaking to the Times he said: ‘There are no grounds for strike action now. Resident doctors have just received the highest pay award across the entire public sector. The Government can’t afford to offer more and it wouldn’t be fair to other NHS workers either, many of whom are paid less’. He’s completely right. 

Just shy of half of the British Medical Association’s (BMA) junior doctors (they’re now called resident doctors) voted for strike action, but because of low turnout it meant an overwhelming majority of those who did vote backed walking out. Their gripe centres around a claim from their union that their pay has fallen in real terms by 21 per cent in the last 17 years. But the claim is nonsense.

They get to this figure using the Retail Price Index to measure inflation rather than the CPI measure that literally everyone else uses. Switch to the CPI metric and their pay has only fallen by around 5 per cent. But even that, as the Times points out, is a result of statistical jiggerypockery. If you took 2015 as the base year to measure the pay of junior doctors it has risen faster than inflation.

More generally, those in the public sector are out performing their private sector counterparts, with public sector pay rising 5.6 per cent in the public sector vs 5.1 per cent at the last reading. Though it is fair to note this has come after a period of private sector wage packets growing far faster than public sector.

The truth is that our doctors, even those just starting out, are not badly paid at all. The average salary for a full-time employee in the UK is just over £37,000. For a first year junior doctor, their average basic pay is just over £33,000. But add in all the additional payments they’re entitled to (for overtime, additional work and payments etc) and it quickly jumps to over £43,000. Once they reach core training, they’re easily earning £67,000 – nearly twice the average Brit.

The truth is that our doctors, even those just starting out, are not badly paid at all

What's more, as the Office for Budget Responsibility set out yesterday, there ain't any money left. If the doctors are to win, if Streeting were to cave, then any pay rise would have to come out of the money assigned to the NHS in the spending review. That means money for improving hospitals, buying new medicines, innovating diagnostic equipment would instead go to a group of well paid individuals who you can guarantee will be back for more before too long.

Streeting has a battle on his hands. After the election Labour's top priority was to stop the strikes that had hobbled the dying years of Tory rule. To a large extent they achieved this: unions were paid off and the strikes stopped. Junior doctors were the biggest winners from this round of pay bungs and Keir Starmer set out to say he had improved the NHS. In truth, appointments are being added at a slower rate than they were under Rishi Sunak, so the last thing the Prime Minister will want is disruptive and unnecessary strike action that grinds hospitals to a halt. But Streeting must stand firm and we should all stand firmly behind him.

If the junior doctors really want a massive pay rise, to stop them striking or jetting off to Australia, there is a solution the Health Secretary could look at: their whopping great pensions. NHS employer pension contributions sit at an eye-watering 23.7 per cent, vastly higher than the 3 to 5 per cent typically offered in the private sector. One potential reform would be to restructure this benefit, front-loading a portion of that contribution as direct salary, while gradually rebalancing the ratio as doctors advance through their careers. It would put more money in their pockets now without increasing the overall cost to the taxpayer. If fairness and sustainability really are the priorities, that’s the conversation we should be having.

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