BMA Scotland plans to ballot its junior doctor members on strike action, it was announced today.

Following a period of engagement with the Scottish government which failed to reach an agreement to enter meaningful negotiations on full pay restoration for junior doctors, the BMA’s Scottish Junior Doctor Committee (SJDC) voted to ballot members on industrial action in the first quarter of 2023 – subject to approval from the BMA’s UK Council.

SJDC is now in formal dispute with the Scottish government over the approach being taken to junior doctors pay in Scotland following this year’s unacceptable pay award which was substantially below inflation and fails to address more than a decade of real terms pay cuts.

Pay awards for junior doctors in Scotland from 2008/09 to 2021/22 delivered real terms (RPI) pay cuts of 23.5% for foundation year (FY) doctors and 23.9% for specialty registrars (StRs).

With inflation continuing to rise substantially during 22/23, this year’s 4.5% uplift is again being outstripped, ensuring that the position on pay erosion will be worse by the end of the year. 

Dr Chris Smith, chair of the BMA’s Scottish Junior Doctor Committee, said: "Years and years of being under-valued and under-appreciated has led us to this point – I want to be absolutely clear that we did not reach this decision rashly. We do this reluctantly. We have given the Scottish government plenty of opportunities to rethink this year’s pay award which is, frankly, unacceptable under the current circumstances, and commit to entering into meaningful negotiations on restoring junior doctor pay to 2008 levels. They have given us no confidence this will happen, and so we find ourselves forced to push forward with our plan to seek approval to ballot our Scottish junior doctor members on strike action.

"Since 2008, the take home pay of doctors has been cut by almost a quarter – 23.5% to be exact. As demand for NHS services soared, the amount that successive governments were willing to compensate the staff providing them plummeted. Enough is enough.

"We were clear with the Cabinet Secretary for Health and his team that junior doctors had reached a tipping point. We have consistently been told there is nothing that can be done, that there is no money – and yet we see ‘record pay offers’ being made to other NHS colleagues when they lay down the gauntlet.

"No one who enters medical school is driven purely by financial reward; we want what’s best for the public and our patients. But right now, we can see that, without halting the burnout, demoralisation and resulting exodus of talented and compassionate staff, we will not be able to provide that care for much longer.

"As the health service limps through the end of a pandemic that it entered already at breaking point, junior doctors are being asked to do more and more. We are burning out and struggling to afford our rent, our heating bills and – in some cases – our meals, in the process. Some first-year junior doctors in Scotland – FY1s – making life or death decisions and staffing wards across the country, earn a basic salary that equates to approximately £14 an hour. After years at university, some incurring huge debts, that is simply not good enough.

"That is why, in many ways, pay restoration is the quick fix for the government – it will take years to fix staffing issues, because it takes years to train doctors; you cannot fix wellbeing and workplace culture overnight either – but by committing to paying your workers more, what they deserve for doing a job that is so invaluable, you are showing them that you value them. They are appreciated. They are recognised. Right now, the junior doctor workforce does not feel appreciated or valued. They are exhausted, demoralised and carrying the moral injury of constantly having to apologise for the buckling system they are so desperately trying to hold up.

"Reinstating fair reward for the work junior doctors do – which is simply in line with what our counterparts in 2008 earned – will demonstrate the Scottish government genuinely does value us and our contributions beyond the warm words we often hear repeated. The time for platitudes is over – we have been pushed to our limit. Junior doctors will leave the NHS in Scotland for better pay, better conditions, and better work life balance in places like Australia, New Zealand, and Canada if urgent action is not taken by our government. I implore the Scottish government to finally hear our words and act."

Notes to editors

The BMA’s Scottish Junior Doctor Committee will now request permission from the BMA’s UK Council to go ahead with ballot, in line with the BMA’s agreed internal process. Should that application be successful, decisions about the date of the ballot will be confirmed at that point.