Slowly Winning the Arguments on Pay

Pay, Reports, reflections and accountability

It has been almost a year since we won the NHS Pay 15 demand at Junior Doctors Conference last year (watch from 1.54 here). This was in the context of repeated below-inflation pay awards, minimal pay requests from the BMA, a growing NHS Pay 15 campaign across multiple unions, and heavy opposition within the BMA.

This year, our arguments about Pay Restoration have become more widely accepted on the Junior Doctors Committee, and our efforts with Medics4PayRestoration and then Doctors Vote have borne some fruit in terms of doctor-created graphics. We will be proposing a motion for full pay restoration at this year’s conference.

So why has the BMA been so slow to put this demand out on social media? Why have they not written to the government with this demand? What has the Broad Left been doing since it passed?

The BMA centrally is now doing some campaigning work, with a webpage, some graphics, a letter-to-MPs tool. Whilst we remain critical of the inadequacy of this work, it is a significant change. It is worth examining what had to happen to get here.

Sorry – this is a long read!

March 2021 Council Meeting

BMA Council has not withdrawn from the DDRB as ARM demanded in 2020, due to concerns about the impact on Devolved Nations and smaller Branches of Practice. Other elements of that motion have not had action taken on them. 

The Broad Left and some allies on Council submitted a motion and paper to March 2021 Council

Only parts ii) and iii-i) pass.

Junior Doctors Conference May 2021

The North West motion from Emma Runswick is composited (merged/compromised into one motion) with a Yorkshire motion to produce this (31 in the agenda here):

You can watch the debate from 1.54 here. It was proposed by David Smith from Yorkshire. Multiple Broad Left members spoke in favour. Part vi) fell due to a requirement to have a two-thirds majority on issues of significant financial cost.

June 2021 JDC Meeting

Broad Left members of JDC gathered the assent of one-third of JDC members to request an additional meeting of JDC to discuss pay strategy, as required in the Standing Orders. Without evidence or warning, we were publicly accused of including members’ names without consent. and a “Lessons Learnt” review was conducted. Despite requests, no evidence and no report from the “Lessons Learnt” review has been offered to members of the Broad Left. Over half of JDC members subsequently voted to have an additional meeting to discuss pay strategy when offered by the Chair of JDC. Two JDC meetings occurred in June, one wholly devoted to pay strategy discussion.

Usually the first meeting of JDC after the Junior Doctors Conference adopts the policies passed at conference. At this meeting, a motion to reject the pay motion was heard. Devolved Nations representatives made clear they would not uphold the policy regardless of whether it was adopted or not. We won the argument and the policy was adopted.

We voted on a series of options and agreed to survey the membership on industrial action if the DDRB and government gave us nothing additional in the 2021 pay round. 

October 2021 JDC Meeting

In October, we received the results of that survey. Turnout was ~6,000, and while 96% said the pay offer was unacceptable, that turnout didn’t show that we were yet ready for industrial action of the scale needed to win a 15% pay uplift for doctors in England. JDC outlined a good plan of what was required to build a pay campaign and readiness amongst our members, including education on the key issues, and training for reps and activists. This would draw comparisons to costs of living e.g. fuel and food costs to demonstrate losses against inflation. We agreed to discuss balloting again before the end of the session. We also agreed to withdraw from the DDRB process in England. 

December 2021 JDC Meeting

In December, despite the good work JDC and JDC executive had done in outlining what we wanted, the work completed was minimal. We received a short document from the communications team, an outline of a communication and industrial strategy. Key messages included the effect of the pandemic, the lack of award in 2021, and then the pay depreciation we have seen. It planned an activist training session in January, with heavy emphasis on lobbying; member webinars in late Feb/early March, including wider content on financial issues such as coping with higher cost of living and creation of a “strong visual look”; then a campaign for a specific pay ask to the DDRB, which we have withdrawn from.

We were asked whether we should ask the Government not to seek “comments and observations” from the DDRB, and what JDC’s £% ask was for 2022-2023.

We believe the questions were unnecessary and the outline plan misguided: we have withdrawn from DDRB and we knew our ask was 15%. We deserve pay restoration regardless of the pandemic, and many find this focus inappropriate given the widespread trauma. We want to win pay restoration, not just cope with a depreciated income. We know the DDRB will follow the government remit, which is why we have withdrawn from it and are choosing to focus campaigning on the government. Constantly having the same discussions is exhausting.

There were no materials drafted, no KPIs for comms, and no industrial strategy. The discussions at JDC and exec might as well not have occurred for how little there was of them. We did not want a public facing campaign, but assistance to engage our colleagues with a campaign for partial pay restoration. Members of the Broad Left criticised the ongoing “frontline” branding, the lack of materials and the plan for corporate branding. We requested that member-made materials could be checked and circulated by BMA, including infographics and memes which addressed our issues. We wanted shareable versions of our briefing papers which outline the numbers so members could read and make their own contributions on new/social media. We wanted an FAQ which could develop iteratively with activist feedback.

We needed to talk about the plan to win – the industrial action plan: what we are asking for; what the risks are and how we will mitigate them as a union; what taking action could deliver. We highlighted the complete lack of structure testing – i.e. there was no plan to check how ready we were before deciding whether or not to ballot.

We were told this was taken on board and that we would be closely involved with further development. JDC has seen nothing further.

In late January, Emma Runswick was asked if she was free on 15/2/22 for a planned pay activism webinar. She got more information about this the week prior, with suggestions that we discuss successful local organising in the round. 

The Webinar: mid-February

We promoted the webinar best we could – including on twitter, facebook, reddit, discord, whatsapp cohort groups. We believe the promotion was insufficient. Approximately 80 attended. Questions were understandably hostile given the lack of progress in the campaign, rising inflation and pay depreciation over the last 15 years. Staff worked to pass questions through that were upvoted, regardless of the hostility, which we believe was correct. We have not seen all the questions or comments, but JDC have since been informed that some were abusive. We have asked to see these.

Emma presented a brief upskilling session on Structured Organising Conversations, but the webinar was one-way in the context of mostly information giving. The website landing page has been created and an activism network set up, with materials for sharing with colleagues and educating promised soon. 

The website links to a good briefing and has clear infographics. Do have a look:

Fair pay for junior doctors in England

March 2022 JDC Meeting

In March, JDC was due to have an update on pay campaign activity, see feedback from the webinar event, and discuss what resources were needed. Survey data, requested by other branches of practice, was presented about the public’s view of doctors’ pay campaigning. Communications teams asked JDC some strategy questions about timing, separation from the broader BMA campaigning, straplines and similar.

There were still no materials, no KPIs, no plan for member-led resources, and so on. Industrial strategy is mostly absent from discussion, except to say that industrial action is a tool to get to negotiation. Criticism was heavy.

Now

We are getting progress – graphics with the graph have been released, posters, the webpage and the write-to-MPs tool. Broad Left members of JDC are happy that we are making slow progress and critical of shortcomings of the BMA output. This is now being received well. 

However, we continue to do our own work, which does not rely on the slow internal mechanics of the BMA. That work is primarily in our workplaces. We also continue work with Medics4PayRestoration and Doctors Vote, who have wonderful volunteer graphics-creators.

What Now?

Educating Colleagues Ourselves

  • Medics4PayRestoration has set up some social media and created infographics for sharing, discussing and building on. @Medics4PayRestoration | Linktree
  • Follow Doctors Vote on social media for good graphics to share

Changing policy

  • Junior Doctors Conference is coming up this Saturday! 
  • Please consider lobbying your JDC representatives to vote in favour of “Comp 1” and tell your colleagues about it in work. Having discussions and arguments about this, and convincing colleagues of the need for action on pay is crucial

Elections

  • JDC elections will happen at ARM in June and in regions and devolved nations in the summer

Completing our own Structure Test

Pay When Rotation Has Been Cancelled

News, Organising, Pay

Author: Emma Runswick

For many doctors, the cancellation of April rotations did not just mean loss of training, it also represented significant loss of expected pay. Those doing jobs without out-of-hours work in March would lose thousands by not moving into high-intensity jobs, through no fault of their own.

Colleagues who made financial decisions on the basis of expected pay, or reliant on this for childcare, stood to be particularly badly affected.

Several Broad Left supporters who are Local Negotiating Committee representatives* have won pay increases for trainees at multiple hospitals and we are involved in helping other reps secure this.

In these trusts, doctors are being paid the highest salary from:

  • The rota they are working
  • The rota they were expected to be working from April and had a work schedule for
  • The emergency Covid rota

For some trainees, this is worth £3700. Many more have gained over £2000.

We have argued for this on the basis of Schedule 2 of our contract.

71. Where changes to the work schedule are required by the employer and total pay would be decreased as a result, the doctor’s total pay will be protected and so remain unchanged until the end of the particular placement covered by that work schedule. This protection will not extend to any subsequent placement, including a placement where the doctor returns at a later date to the same post.

2016 Junior Doctor Contact in England, Version 8

Or 21h in the 2002 Contract, which says similar.

If you had a work schedule for April-August rotation before they announced rotation was cancelled, then you have experienced “changes to the work schedule” “required by the employer” “and total pay would be decreased as a result”. As such, you are entitled to the pay “until the end of the particular placement covered by that work schedule” (April-August).

If some trainees in your trust had a work schedule and some did not – i.e. a department didn’t get their work schedule out in line with the guidelines – then you have an argument that the department’s failure to send out work schedules should not disadvantage those trainees.

We gained support by emphasising our contractual rights, sharing the stories of doctors who were badly affected, building alliances with supportive members of management, and later by using examples of other trusts who had agreed this.

If you would like support to negotiate with your workplace or want to know more about becoming an effective BMA representative, contact us!

*Local Negotiating Committees (LNCs) are your local BMA representation. We encourage all Broad Left supporters who are hospital doctors to become LNC reps.

Pay and BMA Surveys

News, Pay, Terms and Conditions
The BMA does not have the best track record with surveys, or their response to them. We have been accused in the past of subjecting our members to death-by-survey, and of hiding results, or ignoring them where they are not convenient. It is difficult to know what is true without being on the inside.

Now, however, we have great need for a survey. At the Annual Representative Meeting, the BMA was instructed to ‘identify actions to reflect the feeling of the profession’ on pay.

When the government made the pay ‘award’ last week, the need to survey our members and their willingness to take action became even more apparent.

In order to do this well, we need to explain the effects of prolonged pay restraint and the current offer, then suggest actions and ask if members would be willing to take that action.

We also need to show some leadership – by educating our members, who have had a slow-acting pay cut of around 20% over recent years. To add insult to injury, the latest pay cut offer is less than half of its apparent value. All doctors will lose out due to inflation, and the lack of backdating makes us suffer more. This year’s NHS staff survey has laid bare the realities of working life for doctors in the NHS, as detailed in the latest report of the Review Body of Doctors and Dentists Remuneration (DDRB):
• 80% of medical staff report regularly working unpaid extra hours
• 60% of doctors don’t feel they have enough time to do their job properly
• 30% of medics report their work is making them sick

We should say that we were disappointed by the DDRB recommended rises of 2% to doctors’ pay, which was wholly insufficient to address pay erosion across all doctor groups. Our confidence in the DDRB’s continued independence and utility has been shattered. We are further dismayed that the government has – in bad faith – gone further and halved the DDRBs miserable recommendation. The situation is untenable. We need to officially assess what our members are willing to do about it.

The survey sent via email to members this evening to has failed to do that. Only asking questions that are already asked via the NHS Staff Survey and we already know the answers to. It is embarrassing that the BMA feels the need to ask members if they are angry. As this survey was not run past elected Council representatives before it was sent, we have been left out of the strategic planning of the BMA’s response to another real terms pay cut.

 

We are demanding better, perhaps with a further survey, but definitely with a clear call for genuine action in response to the DDRB and Government failings.

Here are the kind of questions we would like to be asking you now:

 Would you:
  • write to your MP asking them to support the DDRB recommendation?

  • want the BMA to disengage from the DDRB and negotiate directly with government?

  • take action short of a strike – working to contract, refusing overtime and refusing to fill rota gaps? For how long?

  • take action short of a strike – refusing to collaborate with coding practices to damage the financial flow of the hospital without affecting patient care? For how long?

  • take half-day or late-start strike action? For how long?

  • take strike action to end elective treatment? For how long?

  • take strike action to bank holiday cover? For how long?

  • take all-out strike action for just your Branch of Practice (allowing other BoPs to cover)? For how long?

  • take ‘rolling’ strike action where your branch of practice takes strike action one day, and another branch of practice does the next day, and another the next day and so on? For how long?

  • take all-out strike action alongside other branches of practice? For how long?

We recommend members fill out the survey and use the free text comment box to tell the BMA what action you would be willing to take. Lobby Council members and branch of practice reps for a determined response to the pay offer.

Email us at broadleft[at]doctorsbroadsheet.org  if you’d like to get more involved in our campaign.