The Health Secretary has been warned by doctors’ unions that he must address the “workforce crisis” at a meeting during which there was no movement on pay demands.
Steve Barclay was given a “very clear message” that it would not be enough to focus on next year’s pay settlement without a shift on current wages, medical leaders said.
Unions say pay has dropped by more than a quarter in real terms in the past decade and that the system around wages “is broken”.
Representatives from the British Medical Association (BMA), hospital doctors’ union the HCSA, and the British Dental Association (BDA) all met Mr Barclay on Thursday at what was described by both sides as a “constructive” meeting.
It came a day after the BMA said an initial meeting due on Wednesday to discuss concerns over pay was postponed so Mr Barclay could give media interviews.
Following Thursday’s talks at the Department of Health offices in London, Professor Philip Banfield, from the BMA, said it had gone “as we expected” with no details discussed around pay.
He told reporters: “We went into the meeting to discuss the pay review body and we came out of the meeting having laid out our stall and making it very clear the state of the NHS and that, really, the pay dispute with the junior doctors has to include some form of addressing full pay restoration.”
Prof Banfield said the “workforce crisis” in the NHS has been made worse by a drop in pay for junior doctors, adding: “Unless he (Mr Barclay) stops the haemorrhage of staff from the NHS, the NHS is in real trouble.”
He told how doctors feel they have been “driven” to the point of considering strike action because “no-one is listening to us”, but added that there is still time to reach a resolution before industrial action.
Around 45,000 members of the BMA began being balloted on Monday on the prospect of strike action, with the ballot running until February 20 and the result due sometime after that.
The BMA has told the Government that if there is a yes vote, junior doctors will begin their action with a 72-hour “full walkout” in March.
Junior doctor members of the HCSA are currently voting in a strike ballot which closes on January 20, and could result in walkouts in February.
Prof Banfield said: “We’ve got about six weeks, haven’t we, to sit down and try and resolve the situation. None of our doctors want to strike, they would prefer that this was resolved before we got into that situation.”
Asked for his message to members of the public worried about the prospect of a walkout by doctors, he said: “What they should be more worried about is the state of the health service at the moment.
“Doctors feel that we’ve been driven to this position because no-one is listening to us about how unsafe the health service is becoming because of under-funding, under-doctoring and under-provision of beds.”
Dr Paul Donaldson, general secretary of the HCSA, described the tone of the meeting as “polite” and “civil”.
But he added: “There was no commitment to any extra money. Any money seems to be thought to be found from what they call efficiency savings, which of course is always a concerning question.”
Prof Banfield said junior doctors are “really struggling financially” as they qualify “with £100,000 of debt”, and that the system around pay “is broken”.
He said part of the BMA union – consultants and junior doctors in England – had not submitted evidence to next year’s pay review process and would be discussing, at its next council meeting, whether to withdraw completely.
He said: “That’s because the system is broken. The envelope within which the independent pay review bodies work has been set by Government, so there isn’t really anything independent.”
If a strike goes ahead, Prof Banfield said there will be a “full walkout” by junior doctors, but that others such as consultants could step in to provide care.
He said: “The junior doctors are having a full walkout, but what that means is that other members of the medical profession will be providing that emergency care. And what you will see is, in some ways, an enhanced service because people will be treated by consultants and other specialists.”
The HCSA said pay has “dropped in real terms by more than 26% in a decade and only a plan to reverse that decline will move us towards a settlement”.
Dr Donaldson said the “dire need for reform of the pay review system, action on pay and the pensions taxes hitting our consultants and specialists” had been stressed to Mr Barclay.
The Department of Health and Social Care (DHSC) said Mr Barclay recognised during the talks the “significant pressures that staff are working under” in the NHS and that he “appreciates competing workforce and cost-of-living pressures, which he is keen to discuss in the context of the evidence for the pay review body”.
Mr Barclay “welcomed the constructive discussion and shared interest in making the health service better, with opportunities identified to look at reform measures to improve outcomes for patients and help staff, for example, improving IT and freeing up clinicians’ time to focus on patients, not admin”, DHSC added.
The Health Secretary hoped to “continue talking” and would “take away the points raised as part of discussions happening across government”, the department said.
The meeting came as new figures for England showed ambulance response times and A&E waits are the worst on record, though the number of people on the NHS waiting list has fallen slightly.
Meanwhile, ambulance representatives from the GMB union will meet on Monday to consider next steps, including the possibility of up to six further days of strike action, the PA news agency understands.
Labour leader Sir Keir Starmer accused the Government of damaging the NHS.
Speaking in Belfast, he said: “The most important thing is that these strikes are ended. They will only be ended if the Government gets in the room and negotiates and so instead of grandstanding, they need to govern.”