The NHS has seen a wave of strike action in 2022/23 – nurses, junior doctors, and most recently in July 2023 consultants and radiographers.

Consultant doctors and hospital-based dentists took strike action for 48 hours from Thursday 20 July until 7am Saturday 22nd. More than 24,000 consultants voted in the BMA ballot for industrial action last month, 86% of whom voted in favour.

On 25th July, the Society of Radiographers took strike action on their own for the first time in its 103-year history. Across England, thousands of radiography professionals started 48-hours of industrial action in order to make their voices heard.

Although the media has focused on the pay demands, the strike is about so much more, including the safety of patients in the NHS, staff shortages, and difficult working conditions.

What pay rise have the consultants and radiographers been offered?

The government has offered the consultants a pay rise of 6% and the radiographers only 5%.

Both the BMA and the Society of Radiographers have described the offers as “derisory”. The BMA noted that consultants have seen real-term take-home pay fall by more than a third (35%) over the last 14 years. The Society of Radiographers also noted that although radiographers work considerably more than their contracted hours, their pay has faced real-terms cuts since 2008. 

But aren’t consultants paid very well already?

The government, and much of the media, has painted consultants as all being in receipt of large six figure salaries, however this is not the case. Consultants in England earn between £88,364 and £119,133 as a base-rate. With added over-time and on-call work, consultants can earn more. The workforce crisis means that consultants now have to work longer hours to fill the gaps in the workforce, which in turn increases the likelihood of burn-out. This then leads to consultants looking for jobs elsewhere with a better work-life balance for more pay.

Although some consultants do also work in the private sector, many do not.

Dr Ben Hockenhull, a consultant anaesthetist at UCH, notes that:

‘They [the media] use figures that include overtime, which we’re getting because we are working to fill in gaps because there aren’t enough of us on a regular basis’.

The BMA has published data that shows that the pay of consultants in England flatlined at just 14% growth in the 14 years to 2022/23. It notes that in contrast, the average pay for the UK went up by around 48% in the same period and those in the professions such as law, accountancy, financial services, architects and engineering, enjoyed growth of nearly 80% in wages. 

The BMA notes that the analysis shows that consultant pay has both failed to keep up with inflation and failed to keep up with comparable professions.

The Chair of the BMA Consultants Committee, Dr Vishal Sharma said:

“This dispute is not just about one year’s pay settlement, it is about the reality of 14 years of consultant pay falling behind, about a loss in our pay in real terms of 35% and the broken pay review system that has allowed this to happen. There is absolutely no justification for the wages of some of the country’s most senior doctors to not have kept pace with those of comparable professions.” 

Dr Vishal Sharma, from the British Medical Association’s UK consultants committee, told a gathering at the BMA headquarters, that while consultants were no doubt paid more than average, “You have to look at the context, the level of training and the level of responsibility that we hold, making hundreds of decisions a day that impact on people’s lives.”

What else is the strike about?

Consultant oncologist Lucy Gossage, published an article on why they were striking, which excellently outlines the issues faced by consultants today due to a lack of staff and investment in resources. 

The article noted: 

“I’m striking because so many of our workforce are burnt-out. The pressures of working in an overstretched service, balancing impossible demands, apologising for a failing system and knowing that, despite our best efforts, we’re not delivering our patients the service they deserve is soul destroying.”

The NHS has thousands of vacancies for doctors and radiology professionals. 

The drain in staff means that services are often not fully staffed, staff are having to take on more work to cover the gaps in the rota, and that creates stress and adds to the high levels of burn-out in the NHS. 

Dr Shanu Datta, a consultant psychiatrist in Preston and deputy chair of the BMA consultant committee, told The Guardian:

“I speak as a consultant psychiatrist, and looking back over the past 10 years, I struggle to think of a time when my organisation was ever fully staffed with consultants. This is because we are one of the most under-doctored economies in the western world, and that inevitably has a bearing on staff morale. We are seeing colleagues with significant amounts of exhaustion and burnout.”

The Society of Radiographers (SoR) reports that one in 10 radiography jobs are unfilled and one million people are on NHS waiting lists for radiography services. Dean Rogers, the executive director of industrial strategy and member relations for the SoR, said: 

“We need to draw attention to the fact that many radiography professionals are feeling burnt out by low pay and increased hours. They’re leaving the NHS, and they are not being replaced in adequate numbers.”

“If the government wants to reduce NHS waiting lists and ensure that patients receive the treatment they need, when they need it, then it must urgently prioritise the recruitment and retention of radiography professionals – and that means talking to us about pay and conditions.”

The Royal College of Radiology has reported that in almost all UK cancer centres patients’ treatments are being delayed due to staff shortages. 

Nick Lowry, a therapeutic radiographer in Bristol said the strike is the result of the government “kicking the can down the road”.

“That’s a combination of not recruiting enough staff, not paying them correctly, not providing enough funding to the NHS and specifically to radiographer services”. 

What do the consultants and radiographers want? 

The BMA’s consultants committee is calling on the government to present a credible pay offer for consultants in England.

The BMA consultants’ committee has previously indicated it would accept the same above-inflation pay deal – a 12.4% rise – offered to junior doctors in Scotland.

A BMA report on the pay review committee for doctors and dentists in the NHS shows its lack of independence with years of government interference, which has led to the erosion of pay for NHS staff. The BMA wants the government to commit to meaningful reform of the broken pay review process

The SoR wants the government to meet and agree on an immediate plan which includes: a good starting salary to attract trainees; pay restoration over a reasonable time to retain colleagues; and an end to the long-hours culture and dependence on expensive agencies. 

The SoR has called on the government to re-open the NHS 2023-24 pay round after the latest rises for public sector workers outstripped the earlier 5% awarded to radiographers in England. 

What is the government doing to solve the dispute?

The Health Secretary, Steve Barclay met the BMA Consultants committee once in February, and has not met them since the consultants voted overwhelmingly for strike action in a ballot last month.

Before the strike the SoR reported that it is willing to meet the government, but the government has refused to meet them. Steve Barclay, has said the pay award for radiographers was final.

As the strike ends Dean Rogers, executive director of industrial strategy and member relations, has sent a letter to the health secretary, Steve Barclay, inviting him to meet to discuss ways of tackling the recruitment and retention problems besetting the profession. 

Vishal Sharma, chair of the British Medical Association’s consultants committee, has said that consultants will not back down in their pay dispute and warned of further strikes next month unless the government offers “meaningful talks” on a settlement.


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