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

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.”
Health
‘Postcode lottery’ concerns over fertility treatment

COUPLES seeking fertility treatment in Wales face a postcode lottery in terms of access to services, a Senedd Member warned.
James Evans, the Conservatives’ shadow health secretary, said the eligibility criteria for NHS-funded fertility treatments varies across the country.
Mr Evans called for the Welsh Government to standardise the criteria to make sure everyone has equal access to treatment and provide people with greater choice.
He said: “There are notable differences in the fertility treatments offered across different health boards and patients often lack autonomy to choose their preferred treatment centre.”
Mr Evans raised the example of ICSI, a treatment for men with infertility, during health questions in the Senedd on February 12.
He said: “For those people with low sperm counts, that is the only way in which they can actually access fertility treatments but some centres don’t do that.”
Peter Fox cautioned that male infertility issues are often overlooked despite studies showing that male factors contribute to 30% to 50% of cases in Wales.
He added: “When males are diagnosed… they’re often left in the dark with no support offered to them because most of the treatment services are focused toward the women.
“A lot of those men are left feeling frustrated – they feel shame, they feel anger – because they don’t feel like they get the mental support needed to get through that time in their lives.”
Standing in for health secretary Jeremy Miles, who was ill, Sarah Murphy, the mental health minister, said one in six couples will struggle with infertility.
She explained that the Human Fertilisation and Embryology Authority regulates the NHS and private sector, setting out the treatments and procedures available.
Raising commissioning policy on fertility services, Ms Murphy stressed: “I think it’s really important to emphasise, though, that this is a specialist service.

“It is not something that is provided across every health board.”
Ms Murphy pointed to services provided in clinics in Cardiff and Swansea, adding: “I understand completely that there will be people out there where this is not ideal, I do.”
She told the Senedd: “There absolutely shouldn’t be any shame or stigma around this – it’s not as uncommon as maybe people think.”

Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, warned of high levels of homelessness, mental health issues and financial insecurity among unpaid carers.
He said only 6% of unpaid carers were able to access personal needs assessments during 2024 despite a right to one being enshrined in Welsh law a decade ago.
Mr ap Gwynfor raised concerns about a “chronic lack of capacity” to conduct assessments, with councils facing spending pressures of £559m in 2025/26.
Dawn Bowden, the Welsh Government’s social care minister, recognised the picture, saying: “This is something that I hear consistently from unpaid carers … and carers’ organisations.”

Ms Bowden added: “I want to reassure you, Mabon, that we know we are nowhere near where we need to be with this and this is very much a priority piece of work.”
Plaid Cymru’s Sioned Williams said one in three women will have an abortion in their lives as she criticised a lack of services within Wales despite warnings since 2018.
She told the Senedd that nowhere in Wales offers surgical termination beyond 16 weeks nor any type of abortion after 20 weeks.
Ms Williams said: “If a woman needs access to abortion services beyond this up to the legal limit of 24 weeks, they must travel out of Wales for treatment, usually to Liverpool or London.

“Although abortions at later gestations account for only 2% of all abortions, the women who require them are some of society’s most vulnerable.”
Ms Murphy pointed to the ten-year women’s health plan, adding that she has sought to move the issue up the agenda with work on a specialist abortion service under way.
Health
Ultra-processed foods ‘fuelling public health emergency’

SENEDD Members warned of a public health emergency due to the dominance of ultra-processed food in people’s diets.
Labour’s Jenny Rathbone led a debate on a cross-party motion which was co-submitted by the Conservatives and Plaid Cymru.
She told the Senedd: “The food industry spends billions promoting our disastrous diets and we have to use the power of community to fight back.”
Ms Rathbone warned: “There’s no time to lose. The ever-escalating diabetes epidemic is already devouring 17% of the NHS budget.
“The levels of malnutrition among hospital patients are prolonging patient stays, and the main driver of early death and chronic illness is not smoking but our obesogenic diets.”
The Conservatives’ Peter Fox introduced an ultimately unsuccessful bill on sustainable production and food security in 2021.
“We don’t need data to show that things are getting worse,” said Mr Fox, a farmer and former council leader. “It’s clearly evident all around us.
“We see growing levels of obesity across our population and, worryingly, a significant rise in childhood obesity leading to serious health-related issues, such as childhood diabetes.”
During the February 12 debate, Plaid Cŷmru’s Llyr Gruffydd warned that too many people in Wales struggle to access fresh, healthy and affordable food.
He urged ministers to make greater use of public procurement to improve food in schools, hospitals and care homes while supporting Welsh producers.
Labour’s Lee Waters broadly agreed, telling the Senedd that only about 6% of fruit and veg used by the Welsh public sector is grown in Wales.
He said: “What’s stopping us from supporting Welsh farmers and buying local? Well, we don’t grow enough veg for a start, so there’s an opportunity for farmers to embrace horticulture to create new sources of income.”
But the former minister stressed the need to influence the private sector, with the value of all public food procurement equivalent to the annual turnover of one big supermarket.
Warning of a public health emergency, Alun Davies, a fellow Labour backbencher, urged the Welsh Government to put food centre stage.
He said: “I think it’s no exaggeration to say that obesity is an absolute national emergency and it’s not a national emergency that is an act of God; it’s an act of capitalism.”
Huw Irranca-Davies said the Welsh Government’s community food strategy would be published as soon as possible as he pointed to spending on local food partnerships.
The Deputy First Minister, who is responsible for food policy, described the food sector as a real success story employing 228,000 people or 17% of Wales’s workforce.
Ms Rathbone argued the community food strategy will be insufficient, warning a lack of follow through and rigorous execution has left Wales a very pale imitation of Scotland.
She said: “France and Italy would never have allowed their children to be sold the second-class food that is being served in our schools today.
“And I want to see the commitment to actually ban ultra-processed food from all public procurement – that is what we need to work towards.
“We can’t achieve it overnight but we need to set a date and do it.”
Health
Nursing applications rise but concerns remain over long-term decline

RCN Wales calls for urgent action as Cardiff University faces cuts
THE NuMBER of applicants for nursing courses in Wales has risen by 14% this year, but the Royal College of Nursing (RCN) warns that the longer-term decline remains a major concern.
Figures from the Universities and Colleges Admissions Service (UCAS) show applications for 2025 nursing courses have increased from 3,050 to 3,480. However, since 2021, applications have fallen by 15%, down from 4,090.
Helen Whyley, Executive Director of RCN Wales, welcomed the rise but warned that it does not reverse years of declining interest in the profession.
“This increase in applications is a positive step, but we remain deeply concerned about the long-term decline in nursing applicants in Wales,” she said. “The health care system is already under immense pressure, and without sustained investment in nursing education, we risk deepening the workforce crisis.”
Cardiff University nursing cuts ‘alarming’
Ms Whyley also criticised Cardiff University’s proposed closure of its School of Nursing, warning that it would have serious consequences for Wales’ health services.
“RCN Wales is alarmed by Cardiff University’s current proposals,” she said. “Any reduction in nursing education provision would have significant implications for the future workforce and the ability to meet health care needs across Wales. We urge Cardiff University and policymakers to prioritise investment in nursing education and ensure that opportunities for aspiring nurses are expanded rather than reduced.”
Need for more nursing education places
Despite steady commissioning figures for nurse education places in Wales, RCN Wales argues that numbers must be increased to match growing demand.
Ms Whyley added: “RCN Wales will continue to advocate for sustained investment in nursing education, ensuring that Wales has a well-supported, well-educated nursing workforce now and in the future. The RCN urges the Welsh government, universities, and health leaders to work together to secure the long-term sustainability of nursing education and protect the future of the profession.”
With thousands of nursing vacancies still unfilled across Wales, the RCN is calling for urgent action to ensure the next generation of nurses can be trained and supported in their careers.
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