Junior doctors in Scotland are set to be balloted on industrial action to demand full pay restoration following more than a decade of real-terms pay cuts.

Talks between BMA Scotland and the Scottish Government have failed to reach agreement to enter meaningful negotiations.

The BMA Scottish junior doctors committee warned that some members were working for basic pay of £14 per hour – while making life-and-death decisions about patients – and that some were struggling to pay for rent, heating and even food.

SJDC has voted to ballot members on industrial action in the first quarter of 2023, subject to the approval of BMA UK council. The BMA has already announced that junior doctors in England will be balloted on industrial action, with the ballot due to open on 9 January.

SJDC is now in formal dispute with the Scottish Government on the approach being taken to junior doctors’ pay in Scotland following this year’s below-inflation pay award, which the union says fails to take into account continued pay erosion. Pay awards for junior doctors in Scotland from 2008/09 to 2021/22 delivered real-terms (RPI) pay cuts of 23.5 per cent for foundation-year doctors and 23.9 per cent for specialty registrars.

With inflation continuing to rise substantially during 2022/23, this year’s 4.5 per cent uplift is again being outstripped, ensuring that the position on pay erosion will be worse by the end of the year, the BMA said.

SJDC chair Chris Smith (pictured above) said years of being under-valued and underappreciated has led 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.’

He said the take-home pay of doctors had been cut by almost a quarter since 2008 – and demand for NHS services had soared in that period.

‘Enough is enough. We were clear with the cabinet secretary for health and social care 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.

‘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.’

He said some junior doctors were effectively earning £14 per hour and were hard hit by the cost-of-living crisis. ‘After years at university, some incurring huge debts, that is simply not good enough,’ Dr Smith added.

‘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.’

Dr Smith said the time for platitudes was 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.’

Cabinet secretary for health and social care Humza Yousaf said: ‘I’m disappointed BMA Scotland is balloting junior doctors on industrial action. JDC made it clear it would be entering into a trade dispute with the Government if we did not guarantee an above-inflation rise in the next financial year and meet their demands for an additional ask of a 23.5 per cent rise for pay restoration. This is simply unaffordable in the current climate.  

'I’ve been very open about the real fiscal challenges we face. We’ve explored all options this year and there’s no additional money for pay without cutting NHS and other public services. I’ve offered to meet with the BMA again and wrote to them yesterday. Additionally, I will be writing to the doctors' and dentist review bodies to see if they wish to make a separate and specific recommendation for junior doctor pay in 2023.'