BMA report into the failings of the Pay Review Process for Doctors and Dentists

In recent years, the four governments of the UK have interfered with the pay review process to the extent that it can no longer be considered independent.

It is essential that the DDRB is reformed so that faith in the process is restored and that disputes between the profession and governments of the UK can be avoided.

This report sets out the BMA and BDA's key requirements for reform of the pay review process to ensure that it can function truly independently.

BMA report - Pay review process failings (PDF)

Pay review reform

The BMA has longstanding concerns about the effectiveness and independence of the DDRB – concerns which have only been underlined by the Review Body's unwillingness to make formal recommendations on behalf of doctors subject to multiple-year pay deals, and their refusal to recommend steps to address long-term pay erosion that has happened on their watch.

In the context of more than a decade of significant erosion of the value of doctors' pay, which for some has reached an astonishing and unjustifiable 30% real decline in take-home pay since 2008/09, it is no surprise that our members have lost faith in the DDRB and the pay review process.

The DDRB's position – that it is not within their remit to 'undo past decision making' – simply underscores our concerns about the extent to which the Review Body's remit constrains them from making meaningfully independent recommendations on pay.

We have written to the Secretary of State for Health & Social Care calling for reform of the Review Body and its processes. We continue to ask how the DDRB can possibly demonstrate its independence when:

• Their remit foregrounds health department expenditure limits and the government's inflation targets
• Government remit letters set arbitrary parameters - either explicit limits to possible increases in pay or emphasising budgetary constraints - that prevent the DDRB from making independent recommendations
• Government remit letters are used to highlight economic context that should be confined to its own evidence submission
• The final reports can be held by governments indefinitely without being released to the profession
• The membership of the Review Body is selected solely by government
• The Review Body's recommendations are in no way binding on government

The BMA believes that there is an urgent need to reform the DDRB to restore it to its original purpose, autonomy, and authority.

Either it should return to its original remit, operating in accordance with the principles on which it was first established, or the Secretary of State should engage with the BMA to agree a new, fairer process for determining doctors’ pay which doctors once again trust.