Government officials and doctors’ leaders are holding secret talks with the aim of ending strikes by hospital consultants before the start of the NHS’s winter crisis.
In a remarkable move, the deal under discussion would give consultants in England a hefty further pay rise for this year in return for calling off their stoppages. That is despite Rishi Sunak’s previous insistence that he would not revisit the 6% award he described as final.
Under the deal, if agreed, the NHS’s 34,600 consultants would receive an extra 6% increase for 2023-24 on top of the 6% they have already had.
The extra 6% would be in the form of a one-off award rather than a permanent increase in their pay. Similar offers helped to persuade nurses, ambulance workers and other NHS staff to call off their strikes in the spring.
The Department of Health and Social Care (DHSC) and the British Medical Association (BMA) are keen to resolve the dispute, in which consultants have staged nine days of strike action since July.
The DHSC hopes an agreement with the consultants would help to isolate their much more militant junior doctor colleagues, who have threatened to keep on striking until the next general election, expected at the end of 2024, in pursuit of a 35% pay rise.
An unprecedented wave of strikes by doctors, nurses and other NHS personnel since December has already forced services to cancel 1.2m outpatient appointments and operations.
NHS leaders say the strikes, especially those involving doctors, have so far cost the service about £1.5bn, mainly the result of paying consultants to cover shifts by striking junior doctors.
The BMA’s consultants committee is talking to the DHSC amid growing unease among consultants that their strikes are damaging the NHS and disrupting patients’ care, including cancer operations and planned caesarean sections.
Many consultants believe that holding further stoppages during the winter would add to the huge strain the service always comes under during the cold months and leave hospitals worryingly understaffed.
Hopes are rising that the DHSC will be able back the 6% one-off award in order to break the impasse between it and the BMA because much of the extra money consultants would receive as a result would go straight back to the Treasury, leaving them with about £250 a month after tax.
Sunak and the health secretary, Steve Barclay, would have to explain, however, how giving consultants a 12% uplift squared with their previous statements that 6% was final.
The BMA said it had previously made clear that it would not accept a pay increase that was not added to salaries because “all this does is defer any real-terms pay cut into the next year”.
The talks have also centred on consultants being paid more generously for doing weekend and overnight shifts, to help overcome the NHS’s lack of doctors and reduce its reliance on locum medics; changes to the clinical excellence awards consultants receive; and more time for non-clinical duties. The BMA has also asked the government to commit to restoring the independence of the Review Body on Doctors’ and Dentists’ Remuneration, which advises ministers on pay.
There is “very cautious optimism” among NHS England and hospital bosses, who are desperate for strikes by consultants and junior doctors to end, that the consultants’ dispute can be resolved.
Last week the BMA said it would not call any new strikes by consultants for four weeks to create a breathing space in which meaningful talks could occur. It also offered to let the independent Advisory, Conciliation and Arbitration Service (Acas) oversee any negotiations.
It also used a letter to the prime minister on 19 September to clarify that consultants, despite having experienced “pay erosion” of 35% since 2008, would accept a settlement of about 12% for this year, the first time it had clarified the size of the rise consultants are seeking as long as ministers committed to reform of the pay review body.
A BMA spokesperson said: “We do not recognise this proposal [for a 6% one-off award], nor any description of detailed talks on pay. We do, as the BMA, of course remain in frequent contact with government officials from different departments to discuss various issues.
“The consultants committee leadership wrote to the prime minister almost two weeks ago inviting the government to formal pay talks, and we are awaiting a response.
“With no new strike dates currently announced for consultants in England we’ve been clear that the government has until 3 November to meet with us officially, and agree an offer we can put forward to our consultant members, in order to prevent further.”
A DHSC spokesperson said: “We’re giving doctors a fair and reasonable pay rise, as recommended by the independent pay review body, with [junior] doctors in training receiving an average increase of around 8.8% – which is above what most in the public and private sectors are receiving – and consultants receiving a 6% pay rise.
“We have received a letter from the BMA proposing talks and will respond in due course.”
