Junior doctors’ leaders have vowed to focus on seeking a settlement with the government over their pay in a bid to avoid further strike action. But Vivek Trivedi, co-chair of the BMA’s Junior Doctors Committee, told The BMJ that the government was not approaching negotiations in the way that would usually be expected and that it was blocking any path to a deal.
“What they’ve asked us to do is to move our opening position, which is completely nonsensical,” Trivedi said. “Anyone who has ever negotiated with anyone knows that one side puts their case forward and then the other side puts their case forward, and then after a period of negotiation you come to a mutually agreeable solution. But we haven’t yet had the other side. The government has yet to put anything on the table at all, so it is completely unreasonable for them to expect us to move right now.”
Junior doctors are asking for a 35.3% pay rise, which they have demanded to reverse an estimated 26% real terms cut in pay since 2008-09.
Speaking to The BMJ on Monday 17 April, after the four days of strike action by junior doctors in England that ended at 7 am on Saturday 15 April,1 Trivedi hinted that the Junior Doctors Committee would be willing to discuss settlements that differed from its initial demands, as is standard practice in any negotiation process.
He told The BMJ, “I don’t think anyone would have ever expected a final deal agreeable to both sides to be presented on the very first day. That just doesn’t happen. But we were hoping to have honest conversations to get to that point.”
In response to an urgent question in parliament on 17 April the secretary of health and social care for England, Steve Barclay, made a statement on what steps he was taking to prevent further strike action in the NHS.2
He said, “I recognise that there are significant pressures on junior doctors both from the period of the pandemic and from dealing with the backlogs that has caused. And I do want to see a deal that increases junior doctors’ pay and a deal that fixes many of the non-pay frustrations that they articulate. But the junior doctors committee co-chairs have still not indicated that they will move substantially from their 35% pay demand, which is not affordable, and indeed, not supported on the bench opposite.”
But the Junior Doctors Committee rejected Barclay’s description of its position. In a joint statement Trivedi and his co-chair Robert Laurenson said, “While we have said we are happy to talk any time, anywhere, Mr Barclay continues to demand that we drop our opening position of calling for a reversal of the pay erosion experienced by junior doctors before he will even enter discussions. This does not sound like someone who understands the pay pressures junior doctors are under, nor someone who wants to sit down with us.
“So once again we urge them to drop their barriers to talks and meet with us in good faith, whether that is through the conciliation service Acas or directly, so that we can solve this dispute for the good of junior doctors, patients, and the NHS.”
Trivedi told The BMJ that unless the government was willing to shift from its current stance the committee would be left with little choice but to escalate the current dispute.
But he added, “We want him to come to the table without any further strikes being called. Right now, what our members, what the public and patients, and I think what everyone wants is for us to try to get round the table. So that is where we’re going to be putting all of our efforts, and we hope that Mr Barclay reciprocates and does come in good faith.”
Will Acas step in?
During the industrial action last week the BMA and the NHS Confederation called on the government to agree to the Advisory, Conciliation and Arbitration Service (Acas) facilitating or initiating talks on junior doctors’ pay.3
But as at 17 April the health department continued to maintain that it would enter talks—with or without the help of Acas—only if this demand was lowered and strike action was paused.
When asked by The BMJ whether the department would agree to talk to Acas to try to resolve the dispute, a government spokesperson said, “The health and social care secretary has been clear his door is open and he remains willing to engage constructively but that a demand of 35%, which would involve some junior doctors receiving a £20 000 pay rise, is unreasonable in the current economic context.
“But our position remains that the Junior Doctors Committee needs to significantly reduce its demands and pause strike action for formal talks to begin—and that will not change.”
No coordination with nurses . . . yet
Meanwhile, members of the Royal College of Nursing in England have rejected the government’s pay offer and will go on strike between 30 April and 2 May.
Amid reports that healthcare unions may seek to coordinate strike action in the future, Trivedi said that junior doctors would not be coordinating with nurses in two weeks’ time, because such a timeframe would not give junior doctors enough time to give the required notification period to employers. But he did not rule out coordinating action in the future.
He said, “We fully support our nursing colleagues, and the 5% pay offer that was recommended to them by the government is obviously a real terms pay cut this year, so it goes completely against their fight for fair pay and similarly our fight to restore pay against those subinflationary pay rises. Junior doctors won’t be going on strike for those two days. In terms of coordinating action in the future after that, it’s not something that we have ruled in or out so would be open to consider.”