The prospect of industrial action at NHS hospital gates is looming once again as doctors warn of dire consequences if they are refused a 30 per cent pay rise. But behind the picket lines, bloody internal battles are also being fought over the future of Britain’s most powerful medical trade union.
Amid rows over sexism, racism and other infighting, a new, left-wing alliance of militant doctors has achieved substantial gains, winning a third of seats on the British Medical Association’s ruling council and hardening its position on pay increases.
What started as an outpouring of anger on websites such as Reddit, with young doctors and medical students venting their fury at poor working conditions, low pay, six-figure student debt and the erosion of their pensions, has coalesced into a grassroots movement to install like-minded people into key positions within the BMA.
One group, Doctors Vote, began on Reddit in January. While it describes itself as apolitical there is crossover with a second group of left-wing junior doctors and medical students called Broad Left. Through social media campaigns Doctors Vote managed to win 26 seats on the BMA council in April, running on a mandate for full pay restoration to reverse real-terms cuts in doctors’ pay since 2008. It co-ordinated a voting campaign to “see the BMA council filled with pro-full pay restoration candidates”.
The culmination came at last week’s BMA conference in Brighton where the call for the 30 per cent rise was backed by members.
While consultants have called for this to happen within the next five years, junior doctors — who went on strike for the first time in four decades in 2016 — have demanded action by the end of March next year or they will ballot for industrial action.
While the BMA is a vocal critic of government health policy, it has rarely resorted to industrial action. In 2012, consultants took strike action for the first time since 1975 over plans by the coalition government to move their NHS pensions from a final salary to career average scheme.
The BMA has more than 160,000 members with a standard annual subscription costing £470. Doctors are not required to join and after the junior doctors’ contract dispute in 2015-16, membership fell from a high of almost 170,000 that year to just under 156,000 in 2019.
That decline has been attributed both to members’ anger at how the BMA went too far in its action and to doctors feeling it didn’t go far enough. A key beneficiary has been the much smaller Hospital Consultants and Specialists Association, founded in 1948 but which was granted negotiating rights with the NHS only in 2017.
On the stage in Brighton, battle lines were drawn for what could prove to be a protracted fight between the nation’s doctors and a government facing many public sector strikes.
Emma Runswick, a junior doctor from Salford, proposed the successful pay rise motion. She is a member of Broad Left and one of the main organisers of the Doctors Vote group.
In her speech she said governments had deliberately cut doctors’ pay since 2008, adding: “Our work has become harder. Services are still facing cuts, demand is increasing and complexity is rising. Over that time, university fees have trebled with obscene interest rates, housing costs up, college fees up, childcare costs up. The list goes on.” She said it was “likely that industrial action will be required”.
Another member of Broad Left now on the union’s council, Dr Joanna Sutton-Klein, 28, an emergency medicine trainee from Sheffield, stood for election on a platform promising to make the BMA a “fighting union” and that she would not “settle for anything less than full pay restoration”.
She told the conference: “Resisting and reversing pay cuts should be the bread and butter of what trade unions do. But sadly the BMA just hasn’t been doing this,” adding: “I’ll see you on the picket lines.”
Not everyone is up for the fight, however. Some older members of the union have complained of being shouted down by what they described as “ideologues”, comparing the youngsters to the Labour Party’s divisive Momentum group under the former Labour leader Jeremy Corbyn.
The rise of the pro-industrial action groups follows a series of damaging claims of racism and sexism within the union and complaints of infighting among senior figures.
Dr Farah Jameel, chairwoman of the BMA’s GP committee in England, took sick leave after receiving sexist comments, and a 2019 report by Daphne Romney QC found that the BMA was an “old boys’ club”, in which women colleagues were referred to as “silly girls” and “little ladies”.
In her outgoing speech as BMA president on Tuesday, Professor Neena Modi warned members: “Don’t waste time fighting internal battles.” At the end of the conference, Dr Latifa Patel, the chairwoman, told delegates that she recognised it had “been a very trying three days” and that she had received “a number of complaints” about comments made during debates.
The BMA was founded in 1832 and has been an influential voice on the nation’s emerging health policies ever since. It opposed the creation of the National Health Service in a fierce row in 1948 with Aneurin Bevan, then health secretary, who said he won doctors’ support only by “stuffing their mouths with gold”— a reference to allowing them to continue seeing private patients and to have contractor status within the embryonic NHS.
The demand for a tougher stance by the BMA follows a decade of austerity and repeated pay restraint, while doctors face rising demands and staff shortages.
Successive governments since David Cameron took power have also limited the extent of pay rises the so-called independent pay review bodies could recommend, which doctors have said makes a mockery of the process.
After the junior doctors’ strike, the BMA signed a four-year pay deal for trainees which ends in 2023. This will mean most junior doctors will receive less than a 3 per cent pay award this year, which senior NHS figures acknowledged now looks unfair with inflation running at 9 per cent.
The strength of feeling among consultants is no better. Mike Henley, a consultant urologist and deputy chairman of the BMA’s consultants committee, said: “Morale is rock bottom and everybody feels like they’ve been taken for granted for years. We have been boiled frogs since 2008. You cannot expect people to have their pay fall by a third and expect them to carry on regardless.”
He added: “At the moment 10 per cent of NHS vacancies are consultants and by 2033 we will have a 40 per cent increase in activity because of the baby boomers generation getting older. We really need to retain staff but a quarter of consultants are already over the age of 55 and six out of ten are saying they intend to retire before they are 60.”
Doctors are not alone in demanding inflation-busting pay deals. Nurses may join the fray, with the Royal College of Nursing saying it wants a pay rise of up to 14 per cent this year or it too might ballot for industrial action.
Sajid Javid, the health secretary, has made clear he does not support higher spending on the NHS while Simon Clarke, chief secretary to the Treasury, dismissed demands for double-digit pay rises as “wildly excessive”.
It is expected that public sector workers including doctors and nurses will be offered 3 or 4 per cent.
One NHS trust chief executive said there was no chance unions would get a 30 per cent pay deal and that the public would not support it. Any strike action, they added, would have “widespread implications as we are so reliant at the moment on every member of staff to deliver what’s expected of us and also keep emergency care afloat”.
They said the bigger risk for the NHS was not strike action but doctors choosing to retire early or refusing extra work due to limits on their pension contributions that have seen some doctors receive tax bills of tens of thousands of pounds.
The latest NHS workforce statistics show that, on average, more than 500 staff are leaving the NHS in England every week for a better work-life balance.
A total of 26,137 staff cited this as their reason for leaving in the year to March, with the rate increasing in the first three months of this year to 7,045 staff leaving for that reason, equivalent to 587 a week.
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The prospect of industrial action at NHS hospital gates is looming once again as doctors warn of dire consequences if they are refused a 30 per cent pay rise. But behind the picket lines, bloody internal battles are also being fought over the future of Britain’s most powerful medical trade union.
Amid rows over sexism, racism and other infighting, a new, left-wing alliance of militant doctors has achieved substantial gains, winning a third of seats on the British Medical Association’s ruling council and hardening its position on pay increases.
What started as an outpouring of anger on websites such as Reddit, with young doctors and medical students venting their fury at poor working conditions, low pay, six-figure student debt and the erosion of their pensions, has coalesced into a grassroots movement to install like-minded people into key positions within the BMA.
One group, Doctors Vote, began on Reddit in January. While it describes itself as apolitical there is crossover with a second group of left-wing junior doctors and medical students called Broad Left. Through social media campaigns Doctors Vote managed to win 26 seats on the BMA council in April, running on a mandate for full pay restoration to reverse real-terms cuts in doctors’ pay since 2008. It co-ordinated a voting campaign to “see the BMA council filled with pro-full pay restoration candidates”.
The culmination came at last week’s BMA conference in Brighton where the call for the 30 per cent rise was backed by members.
While consultants have called for this to happen within the next five years, junior doctors — who went on strike for the first time in four decades in 2016 — have demanded action by the end of March next year or they will ballot for industrial action.
While the BMA is a vocal critic of government health policy, it has rarely resorted to industrial action. In 2012, consultants took strike action for the first time since 1975 over plans by the coalition government to move their NHS pensions from a final salary to career average scheme.
The BMA has more than 160,000 members with a standard annual subscription costing £470. Doctors are not required to join and after the junior doctors’ contract dispute in 2015-16, membership fell from a high of almost 170,000 that year to just under 156,000 in 2019.
That decline has been attributed both to members’ anger at how the BMA went too far in its action and to doctors feeling it didn’t go far enough. A key beneficiary has been the much smaller Hospital Consultants and Specialists Association, founded in 1948 but which was granted negotiating rights with the NHS only in 2017.
On the stage in Brighton, battle lines were drawn for what could prove to be a protracted fight between the nation’s doctors and a government facing many public sector strikes.
Emma Runswick, a junior doctor from Salford, proposed the successful pay rise motion. She is a member of Broad Left and one of the main organisers of the Doctors Vote group.
In her speech she said governments had deliberately cut doctors’ pay since 2008, adding: “Our work has become harder. Services are still facing cuts, demand is increasing and complexity is rising. Over that time, university fees have trebled with obscene interest rates, housing costs up, college fees up, childcare costs up. The list goes on.” She said it was “likely that industrial action will be required”.
Another member of Broad Left now on the union’s council, Dr Joanna Sutton-Klein, 28, an emergency medicine trainee from Sheffield, stood for election on a platform promising to make the BMA a “fighting union” and that she would not “settle for anything less than full pay restoration”.
She told the conference: “Resisting and reversing pay cuts should be the bread and butter of what trade unions do. But sadly the BMA just hasn’t been doing this,” adding: “I’ll see you on the picket lines.”
Not everyone is up for the fight, however. Some older members of the union have complained of being shouted down by what they described as “ideologues”, comparing the youngsters to the Labour Party’s divisive Momentum group under the former Labour leader Jeremy Corbyn.
The rise of the pro-industrial action groups follows a series of damaging claims of racism and sexism within the union and complaints of infighting among senior figures.
Dr Farah Jameel, chairwoman of the BMA’s GP committee in England, took sick leave after receiving sexist comments, and a 2019 report by Daphne Romney QC found that the BMA was an “old boys’ club”, in which women colleagues were referred to as “silly girls” and “little ladies”.
In her outgoing speech as BMA president on Tuesday, Professor Neena Modi warned members: “Don’t waste time fighting internal battles.” At the end of the conference, Dr Latifa Patel, the chairwoman, told delegates that she recognised it had “been a very trying three days” and that she had received “a number of complaints” about comments made during debates.
The BMA was founded in 1832 and has been an influential voice on the nation’s emerging health policies ever since. It opposed the creation of the National Health Service in a fierce row in 1948 with Aneurin Bevan, then health secretary, who said he won doctors’ support only by “stuffing their mouths with gold”— a reference to allowing them to continue seeing private patients and to have contractor status within the embryonic NHS.
The demand for a tougher stance by the BMA follows a decade of austerity and repeated pay restraint, while doctors face rising demands and staff shortages.
Successive governments since David Cameron took power have also limited the extent of pay rises the so-called independent pay review bodies could recommend, which doctors have said makes a mockery of the process.
After the junior doctors’ strike, the BMA signed a four-year pay deal for trainees which ends in 2023. This will mean most junior doctors will receive less than a 3 per cent pay award this year, which senior NHS figures acknowledged now looks unfair with inflation running at 9 per cent.
The strength of feeling among consultants is no better. Mike Henley, a consultant urologist and deputy chairman of the BMA’s consultants committee, said: “Morale is rock bottom and everybody feels like they’ve been taken for granted for years. We have been boiled frogs since 2008. You cannot expect people to have their pay fall by a third and expect them to carry on regardless.”
He added: “At the moment 10 per cent of NHS vacancies are consultants and by 2033 we will have a 40 per cent increase in activity because of the baby boomers generation getting older. We really need to retain staff but a quarter of consultants are already over the age of 55 and six out of ten are saying they intend to retire before they are 60.”
Doctors are not alone in demanding inflation-busting pay deals. Nurses may join the fray, with the Royal College of Nursing saying it wants a pay rise of up to 14 per cent this year or it too might ballot for industrial action.
Sajid Javid, the health secretary, has made clear he does not support higher spending on the NHS while Simon Clarke, chief secretary to the Treasury, dismissed demands for double-digit pay rises as “wildly excessive”.
It is expected that public sector workers including doctors and nurses will be offered 3 or 4 per cent.
One NHS trust chief executive said there was no chance unions would get a 30 per cent pay deal and that the public would not support it. Any strike action, they added, would have “widespread implications as we are so reliant at the moment on every member of staff to deliver what’s expected of us and also keep emergency care afloat”.
They said the bigger risk for the NHS was not strike action but doctors choosing to retire early or refusing extra work due to limits on their pension contributions that have seen some doctors receive tax bills of tens of thousands of pounds.
The latest NHS workforce statistics show that, on average, more than 500 staff are leaving the NHS in England every week for a better work-life balance.
A total of 26,137 staff cited this as their reason for leaving in the year to March, with the rate increasing in the first three months of this year to 7,045 staff leaving for that reason, equivalent to 587 a week.