After re-entering negotiations with the British Medical Association (BMA) and Hospital Consultants and Specialists Association (HCSA) committees last month, during which the consultants did not take up industrial action, I am pleased to inform the House that I have made a revised formal offer to both unions, which includes a package of reforms to be applied from 1 March 2024. Both unions will recommend this revised offer to their members.
If accepted by their members, this would end the prospect of damaging strike action, benefit patients and deliver for consultants by delivering much-needed reform.
All sides returned to the negotiating table in good faith and in recognition of the narrow margin by which the initial offer was rejected. I would like to thank the unions for their co-operation and willingness to come to a swift resolution.
This demonstrates that approaching negotiations constructively and with reasonable expectations can lead to a good outcome for patients, consultants and the taxpayer.
The principles and aims of the updated offer remain the same. The Government’s position is that the headline pay uplift for 2023-24 was settled through the pay review body process. This updated offer adds further clarity and specificity, as well as addressing concerns that consultants have raised. The Government’s position remained that the headline pay uplift for 2023-24 was settled through the pay review body process.
This is a reform offer. The core contract for consultants has not been updated for 20 years and this offer will deliver reform to reflect modern ways of working, such as enhanced shared parental leave, in line with other NHS staff. It invests in modernising the consultants’ pay structure—reducing the number of pay points and the time it takes to reach the top of the pay scale.
As we originally proposed, this would make it faster for consultants to progress and help mitigate the gender pay gap, which was expressly highlighted in the independent review into gender pay gaps in medicine in England. Under the revised offer, the Government have agreed to include an uplift for consultants with four to seven years of experience, in direct response to members’ concerns.
To enable these reforms, unions have agreed to end local clinical excellence awards going forward—an employer level bonus scheme that has been seen to contribute to pay inequalities.
The updated offer reaffirms our intention to introduce pay progression arrangements, which link pay progression and evidence of skills, competencies and experience, and further clarifies how this will work in practice.
In addition, the Government will enact changes to the operation of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to address matters raised by the BMA and HCSA. This offer sets out the detail of work to improve the process for the appointment of members to the DDRB, and revises the panel’s terms of reference.
The Government have listened carefully to the concerns of consultants and their representatives, particularly around retention, motivation and morale. This revised offer has been carefully balanced to meet those concerns while also ensuring value for the taxpayer. This offer, should it be accepted, will improve the working lives of consultants while ending the prospect of damaging strike action, which has had a detrimental impact on patients and the NHS.
The BMA and HCSA will recommend this offer to their members in a vote in the coming weeks. No further industrial action will be called while this happens.
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