Unions have privately raised concerns about future doctors’ strikes and expressed dissatisfaction with the implementation of consultations and the British Medical Association’s demands.
The BMA is demanding a higher pay rise than the 3.5% the government has offered doctors, and a strike is planned for next week.
But more than one million NHS staff who are not doctors – including nurses, physiotherapists, midwives, medical assistants, ambulance crews and hospital porters – will receive an even lower pay rise of 3.3% set through the Agenda for Change (AfC) scheme.
The BMA’s decision to require more than 3.5% has frustrated some other unions of NHS staff, particularly those whose pay is set through the AfC. “The deal we were able to offer our members is becoming a much tougher sell,” said one union official.
Others said they believed the union was led by trainee doctors rather than professional negotiators, meaning the negotiations were conducted in a chaotic manner. “I don’t think they will take any pragmatic approach.”
Initial union officials said they believed having trainees leading the negotiations would reduce the incentive to reach agreements on pay and conditions that affect people entering the workforce. “Sometimes you have to zoom out and I don’t think they see the big picture.”
A third union leader said there was “definitely some resentment” among unions representing non-doctor NHS workers and a sense that the government always “seems to be trying to listen to doctors”, but added that the BMA was doing its members’ job by pushing for the best possible deal.
Another trade union, the GMB, is in a dispute with the BMA over pay offers it has made to its own staff.
BMA union workers will go on strike to coincide with a six-day trainee strike on April 7th. The latest salary offered by the BMA for staff is 2.75%, lower than the latest recommended salary for trainee doctors of 3.5%.
A BMA spokesperson said: “The BMA is the trade union for doctors and medical students. Doctors’ salaries fell by more than a fifth between 2008 and 2009 and we have been very clear in recent years that our aim is to restore this. “This year’s 3.5% incentive is simply unacceptable as we have made no progress in reversing these real pay cuts. We are taking industrial action to advance the interests of doctors. We cannot speak for anyone else.” The union’s strategy, or why it believes it is the union’s role to justify the government’s inappropriate compensation awards to its members.
“In discussions with government, the BMA will be represented by an elected resident physician leader, alongside the BMA’s expert BMA staff, bringing together valuable on-the-ground insights from working physicians and negotiation expertise.
“Doctors are in a very different position to our staff. Doctors have experienced significant cuts in real pay and overall deterioration of working conditions since 2008. In the UK we are losing doctors because we are underpaid, but at BMA we have very competitive pay and benefits, staff retention is very high and turnover is very low.”
NHS workers under the AfC agreement have yet to begin consultation on the wider structure of pay, and unions are likely to push for reform to the pay structure. A recent analysis by Unison of three years of UK NHS data shows that there has been no noticeable improvement in pay satisfaction among workers on AfC contracts, and in some cases it has fallen.
Medical and dental employees are the only group to see any modest increase in pay satisfaction, increasing by 18 percentage points since 2023. Mr Unison said these findings showed that many NHS workers continue to feel undervalued and that nothing has changed under the new government.
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