Has Jeremy Hunt really offered a 11 per cent pay rise to junior doctors?

In real terms, junior doctors will likely still be worse off.

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In a last-minute move to persuade junior doctors not to go on strike, Jeremy Hunt has offered medics an 11 per cent pay rise, Denis Campbell reports in the Guardian.  The move will see all doctors below consultant level given an increase to their basic rate of pay - but will in reality see professionals have their incomes cut by at least nine per cent. Why?

At the heart of the dispute are changes to "out of hours" payments and the abolition of incremental pay rises. The normal working week - 7am to 7pm weekdays - will be extended to 10pm. (Doctors working out of hours are paid 50 per cent more per hour). Medics will be able to earn more if they move to "in demand" areas like Accident & Emergency, psychiatry or general practice - but other areas of medicine, also incurring large amounts of weekend work, like anaesthesiology, will not be included in the new arrangements. Medical professionals estimate that in practice, the changes will mean that junior doctors see their incomes fall by 20 to 30 per cent - meaning that the increase in basic pay will fall far short of the pay cut.

As such, it seems likely that the British Medical Association will be forced to go ahead with its plans for a strike by junior doctors, unless further changes from the Department of Health are forthcoming.

Update: The Department of Health's press office have been in touch.

Are they right? I'm not convinced. (Full details are here and here). 

The department argues that scrapping the banding system will be made up through the 11 per cent increase, plus the increased pay for "in demand sectors". See the Department's own chart below:

Are they right? The concern among junior doctors is that three of those "new" bars - on-call availability allowance, unsocial hours enhancements, additional rostered hours - are simply a reduced version of what is offered by "banding". And their central objection - the reduction in overtime pay, from 50 per cent extra, now down to a third, is still in place. That crucial final bar - the flexible pay premia for "in demand" sectors of the NHS - will be variable across the medical profession. For anesthetists and radiologists, the loss of the overtime payments won't be made up by new pay premia. And for those in general practice and A&E, the fear will linger: what happens if the new pay incentives mean they are no longer "in demand" sectors? A pay cut?   

The Department of Health itself insists that no doctor will lose out, that their hours will be better, and that this new contract is more sustainable than the one it is set to replace. In which case, why make the change? Where's the saving?

Stephen Bush is political editor of the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to domestic and global politics.

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