Junior Doctors’ Pay Dispute: Examining the Wage Slips

Junior doctors in England are embarking on their fifth round of strike action, highlighting the ongoing deadlock in their contentious pay dispute with the government. This issue has gained significant attention, with the British Medical Association (BMA) claiming earlier this year that doctors’ pay had significantly lagged behind inflation, to the extent that they’d be financially better off working in a coffee shop rather than providing medical care. The government responded by disputing this assertion, stating that the average junior doctor earns between £20 and £30 per hour.

The term “junior doctor” encompasses a wide spectrum of experience, ranging from fresh medical school graduates to those with over a decade of experience. Salary structures for these doctors are intricate and vary significantly as they progress through different skill levels and areas of specialization.

To provide a clearer perspective on the financial realities faced by junior doctors, BBC News engaged with two doctors at different stages of their careers, requesting them to share their wage slips and offer insights into their earnings.

One of the doctors featured is Dr. Robert Gittings, who completed his medical studies in Liverpool and holds a master’s degree in infectious disease biology. Last summer, he embarked on his first year as a junior doctor, known as FY1, in London. In his current rotation, he works in the infectious diseases ward, where he gains experience in various medical disciplines, including handling tuberculosis, patients with uncontrolled HIV, pneumonias, and even tropical infections. His basic monthly salary before taxes is approximately £2,450 for a standard 40-hour workweek, which equates to slightly over £14 per hour. This figure does not account for the additional roster hours, which are mandatory, pushing his average working week to 48 hours. Under the government’s “final offer,” his pay is set to increase in October, with a 6% pay raise and a permanent addition of £1,250 to annual salaries, both retroactive to April. However, this proposal falls far short of the British Medical Association’s demand for a 35% increase to compensate for years of pay rises below the inflation rate. For Dr. Gittings, the latest offer would translate to an extra £250 per month before taxes. He also receives supplementary payments, particularly for night shifts, which can be exceptionally demanding.

Junior doctors, like Dr. Gittings, typically invest five or six years in medical school, accumulating significant student debt, which includes tuition fees. In June, he paid back £75 in student loans from his salary, demonstrating the financial burden borne by these healthcare professionals.

Additionally, there are other financial deductions, such as a £257 pension contribution, equivalent to 9.8% of his wages, with the NHS contributing 20.6% under the latest career average scheme—a contribution higher than many private sector pensions. In June, Dr. Gittings took home around £2,164 after tax and various deductions, resulting in an approximate annual salary of £37,000. With concerns about the prospects for pay improvement in the UK, he is contemplating taking a year to work abroad, possibly in Australia.

The second doctor featured, Dr. Kiran Rahim, completed medical school in 2011 and now works as a pediatric registrar, representing one of the most experienced junior doctor grades. Her job involves managing A&E and ensuring that sick children receive the care they need. Kiran has taken time off to have children, which has extended her training and tenure as a junior doctor. For an average three-day workweek, her basic monthly salary before taxes is approximately £3,315, which equates to just under £28 per hour, the same rate as a full-time doctor. She also receives London weighting. In July, she earned an additional £292 for night shifts and £132 for working one weekend every six or seven. However, the vast majority of junior doctors at her level find themselves working extra unpaid hours due to the demands of patient care.

Dr. Rahim’s payslip reflects the significant impact of unavoidable costs that do not appear on her earnings statement. She pays £433 per year to the General Medical Council (GMC) to maintain her registration, incurs charges as a member of the Royal College of Paediatrics and Child Health, and faces thousands of pounds in exam fees. Moreover, there’s the cost of personal indemnity insurance, amounting to just under £700 per year to safeguard her against medical negligence lawsuits.

In a typical month, Dr. Kiran Rahim takes home around £2,400 after tax and various deductions for a 27-hour workweek. If she were working full-time, her annual earnings would amount to roughly £69,000.

While pay is a significant concern for junior doctors, they also stress the importance of other factors, such as morale, working conditions, and the overall environment that affects their motivation and job satisfaction. The government contends that it has accepted the latest recommendations from an independent pay review body, offering an 8.8% annual pay increase for the average junior doctor in England. Health Secretary Steve Barclay emphasized the government’s effort to balance controlling inflation while acknowledging the essential work of junior doctors.

The ongoing junior doctors’ strike continues to shed light on the complexities and challenges faced by these dedicated healthcare professionals.