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BMA Demands Reform of Doctors' Pay Review Body

A shortage of doctors and dentists in the NHS will continue until there is "wholesale reform" of the body in charge of pay recommendations, a report has predicted.

An analysis by the British Medical Association (BMA) accused all four UK governments of interfering with the Review Body for Doctors' and Dentists' Remuneration (the DDRB) "to the extent that it can no longer be considered independent". However, the Department of Health and Social Care (DHSC) insisted it was "misleading" to suggest it interfered with either the operation or independence of pay review bodies.

The BMA's report examined DDRB recommendations and responses by Government over more than a decade and found that real terms income for some doctors and dentists had been eroded by an "astonishing and unjustifiable" 35% since 2008. It claimed that remit letters sent to the pay review body had been used to justify pay freezes and caps in order to constrain the DDRB's recommendations to comply with what the Government considered was affordable.

The Report into the failings of the pay review process for doctors and dentists called for reform to ensure that pay review bodies could make recommendations based on the need to motivate, recruit, and retain staff.

Frustration with the current system led to junior doctors and consultants in England and Wales withdrawing from the pay review process this year, and the BMA will consider making withdrawal permanent at its council meeting this month.

Independence 'A Sham'

Dr Vishal Sharma, chair of the BMA consultants committee, said: "This report exposes the supposed independence of the pay review body as a sham designed to provide government with deniability whilst it directly meddles with pay outcomes. Simply going back to the DDRB to ask for another recommendation on pay will not solve anything. For more than a decade the pay review process has been constantly interfered with by the Government, resulting in year after year of pay cuts for doctors."

A spokesperson for the DHSC said: "The pay review bodies are independent advisory bodies who carefully consider evidence submitted to them from a range of stakeholders, including government, NHS system partners, and trade unions." Factors such as cost of living and inflation, recruitment, retention and morale, and value for the taxpayer, were taken into account each year, the Department said.

"The Government's remit letter for 2023/24 referenced the many factors the Review Body for Doctors' and Dentists' Remuneration must consider as part of their terms of reference – it was not an attempt to constrain recommendations," the spokesperson insisted.

Dr Sharma said: "Ministers cannot continue to argue that the DDRB is independent while doctors' pay falls off a cliff and we have thousands of medical vacancies."

According to the BMA, the Royal Commission report in 1960 that led to today's pay review process stated that the independent bodies should ensure that pay was kept in line with the cost of living and earnings among professionals in commensurate professions.

The BMA report warned that the current pay review system would lead to growing discontent among doctors and dentists. "If the pay review process is to have any hope in restoring the confidence of doctors and remedying the dire staffing shortages that we face across the NHS then it must be urgently reformed in line with its founding principles," according to Dr Sharma.