Thousands of junior doctors in England are on strike this week over pay.
Their union, the British Medical Association (BMA), says it wants the government to increase salaries to make up for years of pay cuts.
So how much has junior doctors’ pay fallen – and how does it compare to other parts of the health service?
How much has junior doctors’ pay fallen?
The BMA says that junior doctors’ pay in England has fallen by 26 per cent since 2008/09, once you account for inflation.
But the independent Institute for Fiscal Studies (IFS) think tank says a more accurate figure would be an 11 to 16 per cent fall since 2010.
The IFS and BMA have reached different figures because they use different measures of inflation to calculate the “real terms” (i.e. inflation adjusted) change over time.
The BMA uses the Retail Prices Index (RPI), while the IFS uses the “Consumer Prices Index including owner occupiers’ housing costs”, known as the CPIH.
The BMA told FactCheck that it has chosen to use RPI because it tracks the costs doctors will experience in the real economy, such as housing costs, and because the government also uses RPI when charging junior doctors interest on student loans.
But Ben Zaranko of the IFS told FactCheck: “RPI is widely acknowledged to be a flawed measure of inflation – the ONS ask people not to use it for this reason. It’s no longer a national statistic and so is not our preferred measure of inflation – using an alternative like CPIH or CPI gives a smaller number than that used by the BMA.”
In 2018, ONS said: “Our position on the RPI is clear: we do not think it is a good measure of inflation and discourage its use. There are other, better measures available and any use of RPI over these far superior alternatives should be closely scrutinised.”
So, using the ONS and IFS’s preferred measure, it looks like junior doctors’ pay in England has fallen by between 11 and 16 per cent on average since 2010.
How do junior doctors’ pay cuts compare to other public sector workers?
NHS consultants have seen slightly larger real-terms pay cuts than many junior doctors over the same period, according to the IFS. (Though they have much higher salaries to begin with.)
The same analysis shows nurses and health visitors, as well as midwives, have seen roughly similar real-terms pay reductions as junior doctors (10.2 per cent and 13 per cent, respectively).
Meanwhile, healthcare managers, senior managers and clinical support staff experienced less dramatic cuts since 2010.
And ambulance staff even received a real-terms pay increase, albeit of just 1.1 per cent.
Outside the health service, salaries for more experienced and senior teachers have fallen by 13 per cent in real terms since 2010, according to separate IFS figures. Teachers in the middle of the salary scale saw cuts of 9 to 10 per cent, while new starters’ salaries fell by 5 per cent.
And according to the National Police Chiefs’ Council, since 2010, the real terms pay the most senior constables has decreased by 17 per cent (this figure uses CPI inflation).
What are junior doctors’ pay demands?
The BMA is asking for a 35 per cent pay rise. FactCheck understands that this figure was decided because 35 per cent is what would be needed to make up for what the BMA claims is a 26.1 per cent loss in earnings since 2009.
You might be thinking: why do you need a 35 per cent rise to make up for a 26 per cent fall? The answer is best explained with an example. Imagine you have £100 in your bank account, and it’s reduced by 26.1 per cent. Now you’ve got £73.90. In order to return to £100, you need another £26.10, which is 35 per cent of £73.90.
Health Secretary Steve Barclay said today: “A huge amount of effort has gone into the contingency planning, the measures in place, given the effects of the strikes, but clearly they have been timed to have an impact on patients and I think that’s very regrettable.
“The Government has shown that it is willing to listen and to engage in meaningful and constructive talks.
“We are ready to have discussions with them but clearly a demand for 35 per cent […] is not fair or reasonable.”