JDC

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BMA Council has not withdrawn from the DDRB as ARM demanded in 2020, due to concerns about the impact on Devolved Nations and smaller Branches of Practice.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

Time to Withdraw from the Joint Statement?

Opinion, Terms and Conditions

Authors: Emma Runswick and Pete Campbell

On the 30th March, BMA Junior Doctors Committee and NHS Employers published a joint statement which stated that:

“the BMA agree that when not possible to implement, the working hours restrictions and rest requirements in the TCS will be suspended and that the Working Time Regulations 1998 (WTR) will be the fallback position for the duration of the pandemic.”

“Trusts should discuss proposed new patterns of work with affected trainees prior to implementation”

(emphasis ours)

Some supporters of the Broad Left, ordinary members of the BMA and the Junior Doctors Committee representatives strongly objected to this and the joint statement was rewritten reflecting some of our concerns. The up-to-date statement is available here.

We were, and continue to be, in favour of sensible flexibility during the pandemic, with the aims of providing appropriate medical cover particularly during staff sickness. However, we argued that giving employers permission to ignore our contractual rights for an undefined reason without agreement from the affected junior doctors, with no clear endpoint for that position, was dangerous.

We argued for changes, including highlighting the importance of safe working, ensuring consultation of affected trainees, and that trusts would have to prove that breaching our terms and conditions was truly a last resort.

End of “Emergency Covid-19 Measures”

On the 29th April NHS England wrote to all trusts requesting the restart of all urgent non-COVID 19 service and the gradual reintroduction of elective work. This has led to a slow withdrawal of the redeployment of junior doctors, and led us to reconsider the joint statement. The end of redeployment or restarting elective work is evidence that workload is normalising and normal TCS should be met. However, in lots of trusts, this is not happening.

“Step down” rotas are being implemented in some trusts which are designed to ‘catch up’ with delayed NHS services, some of these rotas continue to breach contractual protections with the backing of the joint NHS Employers and BMA statement. These rotas can be nothing like pre-covid rotas, with increased intensity, additional weekend working and additional hours.

Pay and Leave Arrangements

Many representatives working locally are yet to see fulfilment of the promise made by NHS Employers:

“NHS Employers is grateful for the commitment made by junior doctors and the BMA at this time and will take this into account when preparing for future negotiations once the COVID19 pandemic is resolved.”

Local trusts and Programmes are returning rapidly to old tricks, attempting to “charge” a 1.5 days of annual or bereavement leave for the new 12 hour standard day, denying leave requests and creating limits on what leave can be carried over into future rotations. Legislation aimed at allowing key workers to carry over untaken leave during the pandemic specifically excludes junior doctors.  

There is notably no national agreement on payment for untaken leave, and the new version of the contract has been withdrawn from the NHS Employers website – perhaps due to the new section on the value of a day of annual leave.

16.9       On termination of your employment, you will be entitled to pay in lieu of any outstanding entitlement accrued in the leave year in which your employment terminates or be required to repay to the Trust salary received in respect of annual leave taken in excess of entitlement. The amount of the payment or repayment shall be based on accrued salary for the leave year paid at a rate of 1/260th of your salary for each day accrued.

Terms and Conditions of Service for NHS Doctors and Dentists in Training (England) 2016 Version 9 (withdrawn)

There also doesn’t appear to be a pay deal for >1 in 2 weekend frequency, though some local BMA reps have won excellent deals (eg at Liverpool University Teaching Hospitals).

In nursing, the government has withdrawn the deal offering payment to “aspirant nurses” (final year nursing students) leaving many in the lurch, despite thunderously clapping for carers.

We cannot trust the government, or NHS Employers, to treat us fairly or recognise our work with mealy mouthed promises. If there is a second wave, we must not be put in this position again – we need better protections and agreements on pay and training arrangements in advance.

We are shattered

Many of us have had an extremely rough few months. Some of us have lost friends, family, and colleagues to the virus. Some of us have been sick. Some have not been able to see our families – abroad, or living away for protection, or shielded. Most of us have cancelled leave, given up training plans, worked harder rotas and stepped into unfamiliar medicine to play our part in pandemic response.

Now more than ever we need contractual protections for rest and working hours, alongside other positive trade union endeavours like the Fatigue and Facilities Charter. Many of the positive aspects of the response to the pandemic are already being stripped away. If we don’t act now to allow recuperation, there won’t be anything left to give in a second wave.

The BMA must now withdraw from the joint statement and work with local representatives to ensure safe rest and hours limits are implemented across the UK.