With a new pay offer on the table for junior doctors in England, BMA Scotland has said pay negotiations for their counterparts up north have now begun, with the professional body urging the Scottish government to deliver on the promises it made last year.

Responding to the latest report from the Doctors and Dentists’ Review Body (DDRB) which influences government pay offers, BMA Scotland said pay awards must be sufficient to address the “considerable challenges” across the workforce.

Last week, BMA Scotland said it had met with the Health and Social Care Secretary to begin pay negotiations – and they are set to meet again next week.

With a 22% on average pay deal over two years on offer for junior doctors in England, BMA Scotland says that the Scottish government must develop on the “real progress” made last year and deliver improved pay and conditions for doctors.

Junior doctors in Scotland accepted a pay uplift of 17.5% over two years, with the government agreeing to work towards pay restoration in line with inflation – a commitment not yet offered in England.

However, BMA Scotland has since warned that Scotland is ‘sleepwalking’ into private healthcare as the government has so far failed to deliver on its promises over pay and conditions this year.

Dr Iain Kennedy, Chair of BMA Scotland Council, said that yesterday’s review comes after “years of poor pay awards”, leading many doctors bodies’ to take pay concerns directly to the Scottish government for negotiations:

“The medical workforce crisis we face in Scotland is testament to the years of neglect of doctors' pay which has left the profession demoralised and devalued.

“Last year, real progress was made for junior – soon to be known as resident – doctors with both an above-inflation pay award and an agreement on a framework for progress, which beyond simple numbers, also acknowledged the need to deliver full pay restoration after years of pay increases that failed to keep up with inflation.

“This year, that step in the right direction must be built on across the profession: honouring and advancing the commitment to junior doctors and working for GPs and hospital doctors at all stages of their careers.

“For junior doctors the multi-year framework agreement made last summer means that credible progress towards full pay restoration must be made this year.

“Pay negotiations opened just last week and it is clear there is still work to be done to deliver on the promises made.”

Constructive talks

Cabinet Secretary Neil Gray told healthandcare.scot that the government is looking for “urgent clarification” from Westminster before next week’s meeting:

“I held constructive talks with BMA Junior Doctors last week over a pay deal for 2024/25 and we will meet again next week.

“Ahead of these talks, we are seeking urgent clarification from the UK government on any potential Barnett consequential funding relating to the pay deal announcements they made on Monday.”

Impact on GPs

The Scottish GP committee (SGPC) decided to participate in the DDRB process this year, GP practice expenses are not covered by its pay rise recommendations instead determined differently to pay awards for other parts of the profession.

BMA Scotland also said the latest DDRB report reflects a ‘clear shortage of GPs’ which must be addressed.

While the report outlined a ‘high public concern’ over access to GPs and ‘very low growth’ in full-time GPs, it recognised that Scotland has ‘gone further than the other nations’ on contract reform for GPs.

Mr Gray said:

“My officials and I meet regularly with the Scottish General Practitioners Commission to discuss issues in General Practice in Scotland including pay, expenses and other contractual matters.”

Dr Andrew Buist, Chair of the SGPC, said “much more” must be done to recruit and retain GPs and talks with the government around supporting practice running costs will begin soon:

“While yesterday’s recommendations are relevant for GPs in Scotland, there is now a further and detailed process to go through with the Scottish government to ensure GP practice running costs are fairly met, because unless we do that any pay award will not be achieved.

“That process will be getting underway and we will keep GPs up to date with progress.

“The dire workforce picture we have seen over recent years means this full package must deliver fully for GPs as it sadly hasn’t done in recent years.”

A competitive disadvantage for senior doctors

The latest GMC medical training survey revealed that Scotland continues to have the highest overall satisfaction scores among medical trainees in the UK.

However, Dr Kennedy said Scotland must continue to deliver for all doctors when it comes to pay – highlighting a “competitive disadvantage” across the country when it comes to consultants and speciality ‘SAS’ doctors:

“Negotiations are due to begin in August for consultants and September for SAS doctors.

“This is the first year of direct negotiations for both of these parts of the profession – and with fresh deals made in the other nations, our senior doctors are now the worst paid anywhere in the UK, putting Scotland’s NHS at a serious competitive disadvantage.

"From being the best paid doctors in the UK – something our government has boasted about – that position has been completely reversed and can only be rectified by Scottish ministers now acting decisively.”

Dr Kennedy said the wait for negotiations to begin has “already taken too long” and must now take place urgently to deliver the results needed to retain doctors at all levels across Scotland:

“As I have often repeated, the only way we will address the perpetual crisis our NHS faces, including unacceptably long waiting lists, is through proper investment in our medical workforce, with retention as big a priority as recruitment.”

Read more: GPs in ‘moral distress’ over drug shortage crisis; NHS is not a ‘political football’, warns BMA; Snapshot of NHS recovery revealed; Scheme for GPs to help lost patients extended