On 29 July 2024, the AFPRB (Armed Forces Pay Review Body) announced its recommendation that armed forces doctors would be in receipt of a 6% uplift to basic pay. 

While this recommendation is above inflation, it does not go far enough in addressing the long-standing pay erosion experienced by MODOs (Medical officers and Dental officers) . The AFPRB has again ignored the evidence submitted by the BMA and BDA (British Dental Association) which clearly outlines the rationale for a meaningful pay uplift, which is necessary for recruitment and retention. Morale in the military is low, particularly among the medical cadre.

Uniformed doctors have watched their NHS colleagues, many of whom work alongside them, take repeated industrial action in their fight for fair pay and receive deals which take significant steps towards tackling pay erosion. The same cannot be said for armed forces doctors, whose pay value is now significantly below that of NHS consultants in England and NHS junior doctors in Scotland and England. Despite the above 6% uplift for uniformed dentists the pay award does not recognise the divergence behind peers in the salaried sector over the previous 4 years. 

Continuous attitude surveys and additional targeted surveys now demonstrate greater and increasing discontent amongst DOs (Dental officers) as their salaries diverge from those of mainstream salaried pay comparators. This means that these highly skilled and specialist doctors and dentists, who have dedicated their life to service, are looking beyond the armed forces at their alternative career prospects. Better pay and a less complicated work-life balance makes opting to leave the military for civilian life increasingly appealing.

The MOD’s continuous attitudes survey has demonstrated that 92.5% of uniformed dentist respondents are concerned about pay erosion. 84% noted that pay had not kept up with incomes available outside of the defence sector. 73.1% indicated that the 2023/24 pay award was unacceptable but, unlike those in civilian employment, are unable to negotiate any higher award. Instead, these valued colleagues will simply vote with their feet.

The BMA and BDA had called for:

• an above inflation, measured by RPI, pay award for the 2024/25 pay round for DMS (Defence Medical Services) doctors and dentists.
• a supplementary 2023/24 MODO Award recommendation reflects the reality of in-year negotiated outcomes in competing sectors, specifically: 

• • The AFPRB to make retrospective awards for DMS consultants of 7.4% for 2023/24 backdated to 1 March 2023 to ensure that pay does not fall below NHS consultants in England in the event of an accepted revised pay offer.
  • The AFPRB to make a retrospective award for DMS junior doctors of 7.4% for 2023/24 backdated to 1 April 2023 to ensure that their pay does not fall below that of NHS junior doctors in Scotland following an accepted pay offer.
  • The AFPRB to make a retrospective award for DMS GPs of 7.4% for 2023/24 backdated to 1 April 2023 to ensure that their pay does not fall below that of NHS consultants in England following an accepted pay offer.
  • The AFPRB to make a retrospective award for DMS dentists of 12% for 2023/24 backdated to 1 April 2023 to ensure that their pay does not fall below that of NHS dentists in England.

Despite our submission of written evidence, engagement in the oral evidence session and supplementary written evidence, it is disappointing to see that the AFPRB has not addressed our pay recommendations which would address the historically below-inflation pay awards MODOs have received.

We are very conscious that NHS doctors across the UK are negotiating and receiving improved pay offers. We have called on the MOD, the Minister for Defence People and Veterans and the AFPRB to work with us to introduce new pay structures which would address pay erosion and make the MOD a competitive employer. We appreciate the AFPRB’s expectation to see more substantial pay proposals for MODOs from the MOD, in light of the NHS comparator. We are disappointed that the MOD did not engage with us prior to this year’s evidence round to complete this work but would welcome the opportunity to work with the MOD to produce new pay scales which deliver fair pay for MODOs.

Furthermore, we have called for reform to the AFPRB and an end to the ‘all in one company’ approach which fundamentally limits the review body. We have asked for MODO pay to be considered separately to the rest of the armed forces, as was done prior to 2015. Restoring this practice would enable the AFPRB to respond more dynamically to what is happening outside the MOD with the wider medical workforce. We have also requested that the terms of reference (TORs), which dictate the scope and remit of the AFPRB when considering MODO pay, mirror that of the new DDRB TORs as agreed between the NHS consultants in England and Government to end their pay dispute.