There has been no progress in the heated wage dispute between junior doctors in England and the government. Therefore they have begun their sixth round of strike action.
The British Medical Association (BMA) made news earlier this year when it claimed that physicians’ salaries had fallen so far behind inflation that its members would be better off working as baristas. The government has criticized this as deceptive, stating that the typical hourly wage for a junior doctor is between £20 and £30.
The phrase “junior doctor” really refers to any physician with less than ten years of experience, including those who are fresh out of medical school. Compensation is also a complex issue, with earnings vastly changing as doctors advance in rank and expertise.
BBC News inquired with two junior physicians at various phases of their careers to provide salary documentation and detail their income.
No more patients, the NHS announces as its physicians go on strike.
Just why it’s too soon to expect a mass exodus of UK doctors
Grey line, short for presentation
The fresh face
Dr Witting’s Likeness
After completing his master’s degree in infectious disease biology, Dr Robert Gittings attended medical school in Liverpool.
He began his first year of medical school in the summer of 2016 and is presently rotating around the infectious diseases ward in London as part of his education.
He explains that his facility treats a wide variety of infectious diseases, including “a lot of TB patients, people with uncontrolled HIV,” as well as “cases of pneumonia” and “occasionally a tropical illness coming in.”
Wage statement for the month, including base pay at £14.09 per hour and London weighting at £1.04 per hour, with premium pay for night hours at an additional 37% of basic income and a flat payment of £122.43 per month for weekend employment. The total hours worked were 189.35, and the gross remuneration was £3,117.36.
Robert receives a gross pay of roughly £2,450 per month, or just over £14 per hour, based on a 40-hour workweek. Then there are the mandatory roster hours that increase his work week to a total of 48 hours.
The government has made him a “last offer,” which includes a 6% raise retroactive to April and a permanent increase of £1,250 to his yearly salary, both of which will take effect in October.
However, it is far less than the 35 per cent increase the BMA has requested to make up for years of below-inflation raises.
Robert’s proposed new salary is around £250 before taxes each month.
In addition, he gets supplemental monthly payments:
Additional £1.04 per hour to account for London’s higher cost of living.
Extra pay of £147 per week for night work, or around $5.30 per hour in June before deductions.
A consistent £122 a month, with the exception that he must work every other weekend.
“Night shifts may be really hectic at times,” he admits. “There have been instances when I’ve had to handle a worsening patient all by myself, with instruction by text message as my only resource.”
Wage statement itemizing monthly deductions, including £362.40 in income tax and £248.32 in national insurance, plus £257.63 in pension payments, £75.00 in student loan repayment, and £10.00 in mess fees, for a grand total of £953.35.
Robert is typical of the junior physicians who spend the first five or six years of their careers completing medical school.
He estimates that his total student loan debt, including tuition, is about £50,000; he paid £75 toward his debts in June.
The NHS contributes 20.7% under the current career average plan, more than most private sector pensions. Thus he loses an additional £257 (or 9.8%) of his pay to the assistance.
After paying taxes and other mandatory deductions, Robert earned a net of £2,164 in June. That’s the equivalent of a yearly income of almost £37,000.
He’s planning to take a year off and find a job in Australia, he claims. I don’t know whether I can count on the compensation increasing to the extent that he would want it to, he adds. I’m really thinking about it as a potential place to stay.
Dr Kiran Rahim, registrar for the speciality,
Dr Kiran Rahim graduated from medical school in 2011 and is currently one of the most senior junior doctor classes, a paediatric registrar treating unwell children.
She claims, “Yesterday at work was quite hectic.” “I was in charge of Accidents and Emergencies, which meant I was responsible for receiving all pediatric referrals and ill children in need of care.
“And then overseeing the acute stay ward, making sure the kids got their care, and scheduling scans for them.”
The wage statement includes monthly payments and allowances, including £27.99 per hour base pay, £1.04 per hour London weighting, and £83.33 per month flexible training payments, with premiums for night shifts equal to 37% of basic income and a flat payment of £132.37 per month for weekend employment. The total hours worked were 118.41, and the gross remuneration was £3,946.34.
Image Credit: AFP
Kiran’s training and time as a junior doctor have been “elongated” since she took three years off to have children and is currently working part-time while caring for her small family.
She receives the same income as a full-time doctor while only working three days a week: around £3,315 a month before taxes, or little about £28 an hour. She, like Robert, is subject to London adjustment.
She earned an additional £292 in July for night hours and £132 for working every sixth or seventh weekend.
She claims that the “great majority” of physicians in her position wind up working unpaid overtime.
When asked why she couldn’t simply leave the ill patient, she said, “I can’t just leave a sick patient because it’s hazardous, and it’s not fair on the folks who are already battling the fire on the next shift.”
Wage statement detailing monthly deductions, including $1,060.46 in income tax, $389.83 in national insurance, $336.93 in pension payments, and a total of $1,787.22 in deductions.
This year, Kiran paid off her school debt, but like other young physicians, she had unforeseen expenses that didn’t appear on her paycheck.
To remain on the GMC’s physicians’ registry, she must pay £433 per year. She spent thousands of pounds on registration and certification exams to join the Royal College of Paediatrics and Child Health.
Personal indemnity insurance to cover her in the event of a medical malpractice lawsuit is around £700 per year.
After paying taxes and other mandatory deductions, Kiran earned £2,159 in July for working 27 hours per week. If she worked full-time, this would amount to a yearly wage of almost $69,000.
There are a lot of factors outside money that make a job worthwhile, she argues. “I’ve witnessed a drop in morale, in our working environment, and in our working circumstances, and this is not the job I joined up for ten years ago.”
Grey line, short for presentation
The government claims it has embraced the recommendations of an independent pay review commission, and its most recent offer would increase the average junior doctor’s salary in England by 8.8 per cent per year.
Health Secretary Steve Barclay said, “Our award balances the need to keep inflation in control while recognizing the crucial service they accomplish.”