The British Medical Association has been accused of taking an ‘untenable position’ in refusing to accept that changes to NHS redundancy pay apply to doctors.
In an interview with HSJ, NHS Employers chief executive Danny Mortimer also said there were concerns over what he called “the perception of fairness” in widening differences between medical staff and the more than 1 million workers covered by the separate Agenda for Change pay framework.
Non-medical trade unions agreed a deal with the government earlier this month to end a pay dispute after the government rejected proposals for a 1 per cent pay rise last year. As part of the deal unions agreed to cap the maximum amount of salary used to calculate redundancy at £80,000, with a minimum floor of £23,000 to help the lower paid.
Employers can also no longer make “top-up” payments for those made redundant over the age of 50 and who choose to retire early.
The BMA has said that as doctors are not covered by Agenda for Change and were not part of the discussions the cap does not apply to its members.
However, Mr Mortimer told HSJ the association had historically accepted changes agreed with other unions on redundancy, adding: “Employers aren’t happy that doctors are in a different place in terms of cost of living and redundancy than other staff.”
He said the BMA’s stance was an “untenable position”, adding: “The largest group of highest paid staff have the most generous redundancy entitlements. The Department of Health can’t leave this issue unresolved.”
He also raised what he called the “perception of fairness” over the fact doctors were continuing to receive pay rises and increment progression while Agenda for Change unions had agreed to concessions.
Earlier this month the independent pay review body for medical staff recommended doctors receive a 1 per cent increase in pay.
Mr Mortimer, who joined NHS Employers from Nottingham University Hospitals Trust last year, said: “It’s about some equality of approach across the workforce.
“People understand consultants will be the highest paid members of the team, but in the same way that there is a perception of different accountability for chief executives’ pay and the workforce in any sector, the same is true for consultants; it’s about that perception of fairness. I think many doctors feel uncomfortable about that to be honest.”
He said the current differences between staff added further “impetus” to reform medical contracts.
Negotiations collapsed in October when the BMA unilaterally walked away. The government has asked the pay review bodies to consider medical contract reform and to report after the election in May.
As part of the pay deal with the government, trade unions agreed to further talks on reform of Agenda for Change.
Mr Mortimer said NHS Employers was not seeking a total renegotiation of the deal and said changes to unsocial hours payments, worth £1.8bn, “was one part of the conversation”.
He said: “We are agreeing a timetable with unions for talks and we see a commitment on their part to have those discussions.
“We have always wanted a rounded conversation about the contract. Unsocial hours are a priority area for us but that’s not the only conversation we want to have.
“This is about taking a pay system that is 12-15 years old and updating it and reforming it. I don’t think that is an unreasonable conversation for us or the unions to want to have.”
He rejected the suggestion employers had failed to properly implement past deals, arguing this was often as a result of a failure to achieve agreement locally with trade unions.
On pay increments for Agenda for Change staff - one of the main areas of dispute between the government and unions, Mr Mortimer said: “The idea that we aren’t able to have a mature conversation about how increments can be changed or made part of the pay deal isn’t consistent with what’s happened over the years.”
A spokeswoman for the BMA said: “Given medical staff are not covered by Agenda for Change talks, the BMA does not believe the provisions on redundancies automatically apply to medical contracts. The proposals would have a different, more punitive effect on medical staff and as such separate negotiations would be needed on any proposed changes.”
She added: “Doctors’ pay, in real terms, is now back at where it was almost a decade ago.
“There is nothing fair about what the government is trying to do - deliberately conflating the annual cost of living uplift with incremental pay, which is intended to recognise experienced gained and learning and development in a role.”