“Of course we all regret the course that this dispute has taken, but it would not have done so had the BMA taken a responsible position from the beginning. If people lie to their members and say that they will have their pay cut and their hours raised, of course doctors will be angry.”—Ben Gummer, Health Minister
“Yesterday, the Secretary of State for Health accused the BMA of misleading junior doctors. Today, the Minister comes to the House and accuses the BMA of lying.”—Julie Cooper MP
“If a trusted body, such as the BMA, tells its members that they will have a pay cut of 30% and an increase in hours, but that statement is incorrect, does it constitute a lie? That is the question I would put back to her.”—Ben Gummer, 8 February 2016
There are two fights here. One is about a pay calculator the BMA released last summer, which according to the government is the source of suggestions that some doctors would get a 30% pay cut. The other is about whether it was fair back then to say the government intended to cut pay at all.
Although pay for evenings and Saturdays has been described as the ‘substantive’ area of dispute between the BMA and the government at this stage, there’s also been significant disagreement over the contract’s effects on working hours.
The BMA’s pay calculator got it wrong on recommended pay, according to the government
The Department of Health told us the best example of misleading information on pay was the ‘ready reckoner’ pay calculator released by the BMA over the summer.
At the time NHS Employers, the body behind the pay recommendations the calculator was based on, said it was one of a few that had issues:
“Most calculators that we have seen are underestimating what junior doctor earnings would be, either through errors, or because they are not including all aspects of pay.”
“For example, most do not include the on call availability supplement… which could be a significant amount, or include any flexible pay premia, which could further boost some junior doctors earnings. It is inevitable that pay calculators will show a trend towards reduction in pay if they compare 100 per cent of current earnings against less than 100 per cent of new earnings.”
We don’t know exactly which of these problems applied to the BMA’s calculator specifically, or the 30% figure. The full statement doesn’t seem to be available online any more so we’ve asked NHS Employers for a copy of it.
The calculator was later taken down by the BMA. We’ve asked it for a response to the government’s allegation that the calculator was inaccurate, and that doctors were misled on their pay as a result. We haven’t had a response at the time of writing.
The road to “pay protection”
Putting the specific 30% figure to one side, whether the BMA was right to say that some level of pay cut was coming down the line depends on divining the government’s intentions.
In July the body tasked with reviewing proposed contracts recommended that ‘scenarios’ in which pay would fall for some doctors be used “as the basis for further discussion/negotiation between the parties”.
In August, the BMA said it wouldn’t negotiate on the recommendations because they represented a worse offer for doctors than when it had walked away from talks the previous October.
The government had already said that if the BMA wasn’t prepared to negotiate, it was ready to impose a contract.
The question is whether this meant it was determined to impose the recommendations more or less intact, which would entail a pay cut for some doctors, or whether at this point it was prepared to change the parts of the contract to protect pay.
The government says that the option of pay protection was always on the table.
When he first announced the contract would contain pay protection in October, Health Secretary Jeremy Hunt said:
“I made it clear to the BMA at the beginning of September that that was a possible outcome of negotiations, in an attempt to encourage it to return to the negotiating table. Rather than negotiating, it chose to wind up its own members and create a huge amount of unnecessary anger.”
The BMA felt differently about where the pay protection proposal had come from, saying “it has taken the threat of industrial action and the sight of thousands of junior doctors taking to the streets to reach this point.”
Pay protection eventually appeared in a formal contract proposal made by NHS Employers at the start of November. This itself has been controversial—there are more details of the current state of play for junior doctors’ pay in our longer guide to the issue.