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BMA Cymru Wales to put pay offer to doctors in pay dispute 

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DOCTORS’ union the BMA has secured pay offers for doctors working in secondary care in Wales following pay talks with the Welsh Government. 

Members of BMA Cymru Wales including Junior doctors, SAS doctors and Consultants will now vote on whether to accept the three separate offers. 

Junior doctors have been offered a 7.4% additional uplift taking the total to a 12.4% uplift for the 23/24 financial year and will be back dated to April 2023. 

A revised consultant pay scale is proposed, which provides higher career earnings, significantly better starting pay, and an additional pay rise of up to 10.1% for some consultant doctors.  

For SAS doctors, pay offers for newer contracts include increases of 6.1-9.2%, as well as an additional uplift for associate specialists, senior doctors who are on closed contracts. 

The offers, which also include non-pay elements and reform of pay scales and contract terms,* are the result of weeks of pay negotiations which began in April this year after sustained pressure from BMA Cymru Wales including 10 days of strike action by junior doctors and planned industrial action by senior doctors which were suspended last month to start the talks. 

From Wednesday 12 June to 26 June members will vote on whether to accept the offers.  

Dr Oba Babs Osibodu and Dr Peter Fahey co-chairs of the BMA’s Welsh Junior Doctors Committee said:  “We entered pay negotiations in good faith to reach a deal that will put us on the path to achieving full pay restoration to address the years of erosion to our pay We’re satisfied that this offer delivers on our ambition. This offer puts us well on the path to pay restoration. 

“We are therefore encouraging members to vote to accept this deal. It is a testament to the resolve they have shown in taking part in industrial action to achieve a better future for the profession 

Dr Stephen Kelly, chair of BMA Cymru Wales’ Consultants committee said: “We are pleased to have been able to reach an offer that we believe honours our overwhelming strike mandate and offers significant improvements in pay for consultants across their careers.

“The offer is recognition of the hard work and dedication of senior doctors and signifies a commitment to attracting and retaining doctors in Wales by offering a fairer more competitive value for their service. 

“Whilst ultimately it will be up for members to decide, we believe the offer is a big step in the right direction for the profession and so we are recommending that members accept it. We will continue to work hard to improve your pay and working conditions, and we understand this is just the first step.” 

Dr Ali Nazir, chair of BMA Cymru Wales’ SAS doctor committee said: “We are pleased to be able to bring an offer worthy of the hard work and dedication shown by SAS doctors in Wales. We know voting to take industrial action was a very difficult decision for our members but in voting to strike they were choosing to stand up for themselves and their colleagues. 

“By taking part and getting us here they have played a part in securing a better future for SAS doctors in Wales. We are encouraging members to vote to accept this offer.” 

In August last year the BMA’s committees representing all secondary care doctors in Wales voted to enter a trade dispute with the Welsh Government after being offered another below inflation pay uplift of just 5% for the 23/24 financial year.  

The RCN in wales has responded. Helen Whyley, Executive Director of Royal College of Nursing Wales said: “All NHS workers deserve a proper pay rise, but nursing staff are still waiting at the back of the queue. They feel let down and misled by this government.”

“The repeated firm position from the Welsh government that there was no money in the pot for NHS nursing staff salaries was either untrue or demonstrates that they can’t
manage their finances. Either way it shows a total disregard to principle of equity of approach to NHS negotiations.”

“Actions speak louder than words. This announcement comes only
days after the First Minister opened our annual RCN Congress on home soil in Newport, speaking of his unwavering support for nursing staff. It shows his government support is merely hot air and no real commitment. His government have failed to fulfil the promises
made to nurses in last year’s pay award and now they add insult to that injury by substantially increasing only the doctors’ pay award for 2023/24.”

“Congress saw the RCN launch its general election manifesto, with the leading priority being a substantial pay rise for all nursing staff. The nursing workforce highlighted
inadequate staffing levels, treating patients in corridors, limited or no access to continuing professional development and the increased demands of delivering patient care. All of these pressures lead to severe moral distress, leading to an increase in nursing
staff so overwhelmed with pressure from work that they even considered taking their own lives. This is unacceptable.

“All health care staff deserve to be paid fairly and be recognised for the safety critical work that they do. Our members will be deeply discouraged to hear that their
sacrifices and unrelenting efforts during the RCN Wales pay campaign in Wales has been cast aside by Welsh government.

“We will be urgently raising this with the Cabinet Secretary for Health and Social Care and the First Minister urging them to address fair pay for nursing now.”

Eluned Morgan MS, Cabinet Secretary for Health and Social Care said on Friday (Jun 6): “We have today made a formal pay award offer to each of the three BMA branches of practices – junior doctors, SAS doctors and consultants – for 2023-24, following successful negotiations over the last two months.

“We would like to thank members of the BMA’s negotiating teams and NHS Employers for the constructive nature of the talks, which have enabled us to make these formal offers, which will now be put to the BMA membership for consideration. Each of the three BMA elected representative committees are recommending members accept the offers.

“While strike action has been paused during negotiations, if these offers are accepted, it will end this dispute and industrial action, meaning doctors will return to work in Wales for the benefit of patients and NHS services.

“The negotiations have been robust and while the aim was to end the 2023-24 dispute and prevent further disruptive strike action, these offers also ensure the additional investment in doctors’ pay is balanced against commitments towards operational reforms, which seek to address productivity and efficiency and achieving future contract reform. These pay awards, if accepted, will also help to address inequalities in the senior NHS medical workforce.

“These offers are at the limit of our affordability. We have been open and transparent about our financial constraints with our social partners during negotiations.”

The Welsh Government confirmed that for Junior Doctors, the offer consists of a 12.4% pay uplift, backdated to 1 April 2023. This includes the 5% pay lift for 2023-24, which has already been paid. If agreed, this offer is outside of the Doctor and Dentists Review Body (DDRB) recommendation for 2023-24. This offer is in line with the pay award accepted by junior doctors in Scotland.

It was confirmed that all parties will commit to re-entering contract negotiations as soon as practicable once a new BMA junior doctors committee is elected this year with the ambition of reaching an agreement that, subject to approval by BMA members, would begin implementation in 2025-26. The contract negotiations will build on the contract rejected in 2022, while recognising that significant changes will be required.

The Welsh Government and the BMA Welsh consultant committee have agreed the time is right to reform the current pay structure, which is more than 20 years old. A modern pay structure will better support recruitment and retention, better reward performance, address the gender pay gap, and support progression through the career of consultants in Wales. The new pay structure will be backdated to 1 January 2024. If this offer is agreed, it will be outside the DDRB recommendation for 2023-24.

The BMA rate card will be withdrawn if the offer is accepted with immediate effect at both local and national levels in Wales.

All parties have agreed to an all-Wales job planning policy being developed and implemented during 2024-25 along with an NHS Wales recruitment template for newly-recruited consultants in Wales.

It has also been agreed that scoping work will be undertaken during 2024-25 in preparation for contract reform talks. Any reformed contract will need to be fully modernised against current and future requirements of the NHS Wales for the benefit of patients and the wellbeing of consultants.

In 2021, a new specialty doctor contract was agreed in social partnership and implemented as part of a multi-year pay deal. This offer addresses the unintended imbalances in the pay scale for doctors on the 2021 contract and the 2008 contract to ensure consistency and fairness across the specialty doctor workforce.

This investment will encourage more doctors to take up the new contracts, which offer modernised terms and conditions to ensure that doctors and patients benefit from the reformed contract and working conditions.

In 2021, a new specialist doctor contract was agreed in social partnership and implemented as part of a multi-year pay deal. This offer addresses the unintended imbalances between the specialty doctor and specialist pay scales to ensure a career progression pathway is maintained across the workforce. It will resolve the current issue that exists where the top pay point of the 2008 specialty doctor pay scale is higher than the starting salary for the specialist grade.

The Welsh Government says it has listened to the BMA Welsh SAS committee and while recognising this is a closed grade, recognises the rationale for associate specialists to receiving comparable levels of pay against the consultant pay scale, given the skills and experience of associate specialists working on consultant rotas.

A spokesperson said: “The offer includes uplifting the 2022-23 pay scales by a further 4%, making a total of 9% for 2023-24 backdated to 1 January 2024 for associate specialists.

“The BMA rate card will be withdrawn if the offer is accepted with immediate effect at both local and national levels in Wales.

“Full details of each pay offer will be communicated through BMA Wales to their members.

“We would like to take this opportunity to encourage doctors who have any questions about the offer to speak to their BMA representatives as this is a fair offer to address the pay dispute.

“We look forward to working in social partnership with all NHS and health trade unions to discuss the 2024-25 pay award.”

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Welsh Government under fire over NHS escalation levels

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THE WELSH GOVERNMENT has maintained the escalation statuses of NHS trusts, special health authorities (SHAs), and health boards in Wales amid ongoing financial, operational, and staffing pressures. Eluned Morgan MS, Cabinet Secretary for Health and Social Care, announced the decision today, emphasising that the challenges faced by these bodies are not unique to Wales.

The current statuses indicate varying levels of intervention and monitoring. Notably, Betsi Cadwaladr University Health Board remains at Level 5, denoting special measures, while several other boards are under enhanced monitoring or targeted intervention.

In response, Sam Rowlands MS, Welsh Conservative Shadow Health Minister, criticised the decision, accusing the Labour Welsh Government of failing to make any progress. He highlighted that all health boards remain escalated to at least Level 3 and questioned the Level 1 status of the Welsh Ambulance Services University NHS Trust, given that less than half of red ambulance calls are reached within the target time.

Rowlands reiterated the Welsh Conservatives’ call for a comprehensive workforce plan and full allocation of health spending to address these issues.

The Welsh Government today announced no changes to the current escalation statuses of NHS trusts and health boards across Wales, despite significant pressures. Eluned Morgan MS, the Health Secretary, stated that these bodies are still grappling with financial and operational challenges, which are not unique to Wales.

NHS Escalation Statuses:

  • Aneurin Bevan UHB: Level 4 for finance, strategy, and planning; Level 3 for urgent care at Grange University Hospital
  • Betsi Cadwaladr UHB: Level 5, special measures
  • Cardiff and Vale UHB: Level 3, enhanced monitoring
  • Cwm Taf Morgannwg UHB: Level 4 for performance; Level 3 for finance
  • Hywel Dda UHB: Level 4, targeted intervention
  • Powys Teaching HB: Level 3, enhanced monitoring
  • Swansea Bay UHB: Level 4 for performance; Level 3 for finance, maternity, and neonatal services
  • Public Health Wales, Velindre, Welsh Ambulance, Digital Health and Care, Health Education and Improvement Wales: Level 1, routine arrangements

Sam Rowlands MS, Welsh Conservative Shadow Health Minister, lambasted the government for making “zero progress” and criticised the decision to keep the ambulance service at Level 1 despite poor response times for serious calls. He called for a substantial workforce plan and full health spending allocation to improve the situation.

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Health

‘We are not for sale’ – Young people back plan to remove profit from care

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FOUR remarkable young people gave evidence to the Senedd’s health committee about their experiences of Wales’ social care system, supporting plans to stamp out profiteering.

Mark Drakeford asked the witnesses if they agreed with the principle of the health and social care bill, which would remove profit from the care of looked-after children.

Elliott James told the former first minister – who introduced the proposal while leading the Welsh Government – that for every £10 given for a child in care, £3 is taken away in profit.

He said one relatively standard residential placement can cost as much as £5,000 a week, with support workers paid a “shockingly” low amount.

Elliott stressed: “At the moment, companies are profiting off us and we are not for sale.”

Joanne Griffith similarly said: “We are not in the care system for people to profit off us – we don’t choose to go in the system, the system chooses us.

“Why should people be able to gain money … and spend it on whatever they want when in actual fact the money should be going to the young people, so that we can thrive?”

She added: “Put yourselves in our shoes, you probably wouldn’t want to be profited off.”

Rhian Thomas and Rowan Gray wholeheartedly agreed with the principle. But Rowan raised concerns for-profit providers “could end up packing up and going elsewhere”.

Elliott raised concerns about children being placed a long way from home, saying: It’s not just about the profit, it’s about the care of young people as a whole.

“A lot of young people are being let down currently.”

He said: “Moving a child hundreds of miles away isn’t always suitable….

“These placements can’t commit to contact, they can’t commit to free time so that leaves us not being able to see our family, not being able to go and see our friends.”

He warned that placements for children and young people with severe mental health problems are more than likely to break down because carers cannot cope.

Elliott said: “Unfortunately, the system thinks as soon as we enter care, all of our problems have been solved. They haven’t. We are still deeply traumatised young people who need care, love and support.”

While recognising the need for emergency placements, Elliot raised concerns about children moving from one to the next until a suitable placement is found.

He asked: “Why can’t we be placed into a suitable placement the first time around?”

Elliott told the Senedd some young people are “placement hoppers”, going to as many as 10 or 20 different placements in one week.

He said he was given only an hour-and-a-half notice before going into care and nobody was trained to really understand his autism.

“I was always left to suffer by myself because nobody knew how to help me,” he said, warning that symptoms of autism were treated as a behavioural issue.

Rhian stressed the importance of keeping siblings together and support for young people transitioning into care or adulthood.

She told Senedd members: “When you first come into care that’s the hardest part of it all.”

Rowan said it is vital to match the children going into care with the right foster carers.

“My last placement was with some people that were in their 60s,” he said. “When I was younger, I had a lot of energy and I was always wanting to do something.”

He told committee members the foster carers did the best they could but he wanted to build memories and they were sometimes not able to take part in activities he found fun.

Rowan was placed “out in the middle of nowhere” more than 10 miles from home.

“I didn’t have anyone around my own age who I could build friendships with,” he said.

Calling for more accountability, he told the Senedd: “If my local authority had actually done what they said they were going to do, I wouldn’t be sat here.

“I would be currently in Bristol living with my mother. Because there was no accountability … they went back on their word … and I ended up in long-term foster care.”

Joanne raised the importance of stability and continuity of care.

She told the committee: “It’s really important that we have a placement that we know we can stay in permanently and we’re not going to be moved within 24 hours … or a week.”

Joanne added: “We need a placement that we can call home.”

She called for compulsory training around mental health and disability, so “we know if we have an issue we can go to the foster carers and we’re not going to get stigmatised for it”.

Joanne also called for more unannounced visits to build up a more accurate picture.

The health committee is scrutinising the bill, aiming to report back to the Senedd in October, ahead a vote on the general principles with amending stages to follow.

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Health

Senedd backs call for more dentists in Wales

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THE SENEDD called on the Welsh Government to increase the number of training places for dentists amid warnings about “dental deserts” across the country.

Siân Gwenllian led a cross-party debate on dentistry training, with the Conservatives and Lib Dems joining forces with Plaid Cymru to amplify concerns about poor access to services.

Ms Gwenllian said a shortage of dentists exacerbates Wales’ “three-tier” system, with none of the practices in her Arfon constituency taking on new NHS patients.

She said: “A three-tier system where some are fortunate to access an NHS dentist, others can pay to go privately and the third tier, unfortunately, are those who can’t access NHS dentistry and can’t afford to pay to go privately.

“I don’t have to outline the problems that emerge for those in the third tier. Members are only too familiar with horrific stories about sepsis and do-it-yourself dentistry.”

Ms Gwenllian told the chamber, or Siambr, a common-sense solution would be to increase the number of university training places.

“But, to the contrary, the government sets a cap on the number of places that can be provided in our only school of dentistry in Cardiff – an annual cap of 74 places,” she said. 

The former councillor and journalist criticised a new dental workforce strategy, saying it does not commit to any specific increase in educational or training provision for dentists.

Pointing to a Tory commitment to a 24% increase in undergraduate places in England, she said: “Unfortunately, the party of Aneurin Bevan hasn’t shown the same ambition.

“And it is depressing and it’s a stain on Wales that the ability of a number of our constituents to access dentistry is reliant on their ability to pay.”

The Plaid Cymru politician argued having one school of dentistry in south Wales will never be sufficient to meet the needs of the whole country.

Sam Rowlands, the Conservatives’ shadow health secretary, said provision in north Wales is “simply not good enough” as he raised concerns about “dental deserts”.

He agreed that 74 places a year is not enough to plug the gap as he echoed calls for a “fully funded and fully functioning” dental school in his region.

Carolyn Thomas, who also represents North Wales, said people across the UK are struggling to access NHS dentists, with nine in ten not accepting new patients.

The Labour member recognised Wales-specific challenges on recruitment and retention, but pointed to progress with the dental academy in Bangor.

She told the chamber Labour has a fully costed plan to “rescue” dentistry at a UK level which will lead to much-needed consequential funding for Wales.

Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, raised concerns about a “failure to retain dentists and an even greater failure to train new dentists”.

Mr ap Gwynfor said only eight people from Wales got a place on Cardiff’s dentistry course last year, with only about half of the wider annual cohort choosing to stay in Wales.

Rhys ab Owen criticised a lack of data, saying: “It’s astonishing that we can’t say here and now in the Senedd how many people are waiting to see a dentist under the health service.”

Mr ab Owen raised a constituent’s concerns about their son, who was referred aged 11, having to wait nine years until he is 20 for orthodontic treatment.

The independent, who represents South Wales Central, said: “My constituent’s son has experienced bullying, his confidence has been knocked and his self-esteem damaged.”

Eluned Morgan told the July 3 debate that NHS dentistry has been a key priority since she became Wales’ health minister four years ago.

Providing an update on the recommendations of a 2023 health committee report on dentistry, Baroness Morgan said work on an all-Wales central waiting list is under way.

The health secretary reiterated that the key aim of dental reforms was new patients who have historically struggled to get access to NHS dental care.

Baroness Morgan said 500,000 people who had not received NHS dental care for more than four years have gained access since the reforms restarted in April 2022.

She said: “It’s interesting to note that an incoming Labour Government is also planning to deliver new NHS appointments, but proportionally we’re streets ahead of where the UK Tory Government was in terms of NHS access by new patients.”

Turning to dental training places, she stressed the need to take a “long-term evidence-based view” and be careful not to “over-focus” on dentists.

Baroness Morgan, a former member of the European parliament, said any increase would be difficult due to financial challenges and a lack of spaces at Cardiff’s dental school.

She said a second school would be the best option but warned: “That would mean a great deal of investment and financial pressures don’t allow that at present.”

However, she encouraged a joint proposal from Aberystwyth and Bangor universities.

The motion – which was co-submitted by Ms Gwenllian and Jane Dodds, the Lib Dems leader in Wales – was agreed with 29 for, none against and 15 abstentions.

Seven Labour backbenchers voted in favour.

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