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
‘We are on our own’: Unpaid carers forced to ‘beg’ for support
UNPAID carers are being left to “pick up the pieces” of a broken system due to a lack of respite, unsafe hospital discharges and carer’s assessments that result in “nothing at all”.
The warning came as the Senedd’s health scrutiny committee began taking evidence for an inquiry on access to support for more than 310,000 unpaid carers across Wales.
Chris Kemp-Philp, from Newport, who has been a carer for 33 years, gave up her career to become a full-time carer after her husband medically retired from the civil service in 1990.
Ms Kemp-Philp, whose husband died in April, told today’s (December 4) meeting: “I thought he’d been really badly treated… The last four months of his life were dreadful for both of us.”
She was only offered an updated carer’s needs assessment – a right under the 2014 Social Services and Wellbeing (Wales) Act – the day after her husband died.
Ms Kemp-Philp did not realise she had become a carer at first. “But, of course, having lost two incomes and to survive on a half civil service pension wasn’t great,” she said.
She told the committee how the couple “shielded” during the pandemic, saying: “For the past five years, basically, apart from going to a hospital or… a medical facility – I didn’t leave the house because if I’d have gone out, I could have brought something home.
“So, we spent five years literally avoiding people. The experience was unpleasant, I had two great-grandchildren born in that time and I only saw them on video.”
Ms Kemp-Philp said her husband was “pingponged” back and forth after unsafe discharges from hospitals in Gwent. He was put in a car by two nurses then she had to get him out on her own at the other end, with clinicians effectively telling her: it’s your problem now.
“Every time he was sent home, nobody came to help at all,” she said, explaining how she struggled to cope and her husband’s death brought a tragic sense of relief.
Judith Russell, who moved back to Wales to care for her mother 23 years ago, told Senedd Members the responsibility grew greater over the years.

Ms Russell, whose mother died last Saturday on the eve of her 102nd birthday, told the committee: “It’s been my privilege to care for her but I wish other people—I wish there had been more actual care for her. That’s it.”
Ms Russell also cares for her husband who has Alzheimer’s disease, acts as guardian for her disabled sister and cooks every week for her sister-in-law.
“It’s quite a responsibility,” she said. “My life is taken up with caring. I didn’t actually know I was a carer, I cared for my mother because she was my mother – I looked after her, of course I did – and it wasn’t until about three years ago that I identified as a carer.”
Ms Russell warned: “All through this last 23 years, I’ve had to fight and struggle to find things out… there’s very, very little help out there.”
She said she was given a carer’s assessment earlier this year but “there was nothing they could offer me, quite frankly – nothing at all”.
Ms Russell told Senedd Members: “We had a diagnosis [but] there’s no offer of help, there are no directions to find help, somebody to point you – you should be doing this, this is available, that’s available – nothing, you’re on your own completely.”
She joined the Bridgend carers’ group which opened a door to other people grappling with the same weight of responsibility and helped navigate the system. Ms Kemp-Philp added that joining a similar peer support group saved her life.
Ann Soley, who is originally from France and has been living in Wales for eight years, described how life was turned upside down when her British husband had a stroke.

She said: “We are stressed, we are lost. A lot of carers have lost their friends, that is just unbelievable for me because I realised society is not there – there is no compassion.”
Kaye Williams, who works at Bridgend carers’ centre and is herself a carer, warned the witnesses’ experiences are commonplace across the country.
Sue Rendell, from Caernarfon, has cared for her husband who has vascular parkinsonism for nearly 14 years and was waiting for a doctor to call as she gave evidence remotely.
She told the committee: “You go in in the morning to see if he’s still breathing to be honest. We’re at the later stages of his disease and it’s physically demanding, it’s mentally demanding and it’s administratively difficult as well… it’s just very wearing.”
Ms Rendell, who was shattered after a late night caring, said she has tried to get respite but has been told there’s nothing available in Gwynedd nor Anglesey for her loved one’s needs.
She told the committee unpaid carers in Wales are “expected to pick up the pieces” but “nothing much happens” after an assessment. “Fine words butter no parsnips,” she said.
Ms Russell added: “As carers, we save the government millions… and I asked for some help this week actually. I’m 258th on the list for a hip replacement… and I asked the doctor: as a carer, couldn’t I possibly go up the list a little bit? ‘No, we’re not allowed to do that.’
“It’s the only thing I’ve ever asked for.”
Education
‘Sink or swim’: Young carer sat exam hours after 3am hospital ordeal
A TEENAGE carer sat a GCSE exam only hours after getting home from a hospital at 3am following a family emergency, a Senedd committee has heard.
The warning came as witnesses highlighted a “sink-or-swim” reality where children as young as three are taking on caring roles while feeling invisible to schools and social services.
Elektra Thomas, 15, who cares for her autistic, non-verbal brother and her epileptic sister, was part of a remarkable and articulate trio of teenagers who gave evidence to a new health committee inquiry on access to support for unpaid carers today (December 4).
The teenager helps her brother Blake get ready for school in the morning and helps him communicate by acting as his voice, which she has done since about three years old.
Ms Thomas told Senedd Members her sister has two children, “so I’m either handling her having a seizure, running around with her medication… or I’m looking after her kids”.
She said: “I’ve been having school assessments at the same time she’s had a seizure. I’ve been in ambulances waiting for her to get into a hospital while also studying.”
Ms Thomas explained how she is unable to focus on her schoolwork if her brother has had an overwhelming day. “I can’t focus on myself and I don’t have time for myself,” she said.
The teenager, who is from Carmarthenshire, described how she was once in hospital until 3am then sat a test – which went towards her GCSE grades – that same day.
Ms Thomas warned young carers do not have time to manage their own mental health, saying: “I didn’t have time for myself, I had time for my brother and sister and that was it.”
She said: “As a young carer who wasn’t noticed for a decade, it was pure manic: I had no coping skills, I had no support – and this has been going on since I was about three or four.”
Ffiôn-Hâf Scott, 18, from Wrexham, who is working while studying in sixth form, has similarly been a carer since she was four years old.
“I used to care for my mum and my sister,” she told the committee. “My sister used to be in a psychiatric ward, she was there for seven years.
“And I care for my mum because she’s diabetic, classed as disabled, has a long list of mental health issues, she has in the past suffered a stroke and had cancer.
“I don’t know how she’s still standing.”

Ms Scott said: “The main challenge right now is looking after myself and learning that you actually have to keep yourself afloat… to keep looking after someone else.
“I think for a very long time I ran on nothing because of my caring role or I didn’t think about the things I needed to do for me, so respite and things like that.”
The Welsh Youth Parliament member warned a lack of support for young carers has been normalised, saying she has had to explain herself 70 different times while aged 12.
Ms Scott said: “I remember going to my teacher and saying – we had a piece of coursework – look I can’t do this right now… you’re going to have to fail me…
“Their response was just ‘well, you have too much on your plate and you need to take things off your plate’ and I was like: it’s very bold of you to stand where you’re stood and say that to me because it’s not a choice to take on the things that we do take on.”
She recalled receiving a phone call about her mum collapsing moments before a maths test and expressed concerns about the prospect of mobiles being banned in schools.
Albie Sutton, 16, a young carer from north Wales, looks after his disabled mother by doing things such as cleaning the house, budgeting and cooking for the family every day.

Mr Sutton said: “It’s a real struggle for her to move around the house, to even do stuff like getting dressed or moving to the toilet by herself… so I’ve got to help her.”
The teenager estimated his caring role takes up about 25 hours a week and makes it difficult for him to pursue some of his hobbies such as competing in powerlifting.
“My mind feels like a hive of bees,” he said. “There’s so many things going in and out… I get home at the end of the day and I’m like ‘oh my God, I’ve got to do this, I’ve got to do that’.”
Warning of the mental stress, he added: “It’s also really difficult for me to socialise… I feel very isolated in my caring role, especially at home. I’m always housebound, I never get the opportunity even just to go out in my local town.”
Mr Sutton told Senedd Members it plays on his mind that his younger brother may have to take on responsibility. “It’s got me debating whether I can go to university,” he said.
He called for a Wales-wide campaign to raise awareness among educators and employers of the issues young carers face and how to recognise the signs.
Ms Thomas agreed: “I’ve had multiple teachers look at me and go ‘what’s a young carer, sorry?’. I’ve had pharmacists go ‘are you sure you’re a young carer?’ and it baffles me.”
Health
Fresh alarm over life expectancy in Wales as CMO warns of ‘prevention revolution’
WALES is living sicker for longer, the Chief Medical Officer has warned, as new figures show a worrying drop in the number of years people can expect to live in good health – with women hit hardest.
The findings, published today in Dr Joanne Absolom’s first annual report since taking over from Sir Frank Atherton, have prompted immediate calls for the next Welsh Government to overhaul its approach to public health after the 2026 Senedd election.
Dr Absolom says Wales must now move decisively away from a system that largely treats illness towards one that prevents people becoming ill in the first place. Her report warns that healthy life expectancy is falling across the country and highlights widening inequalities between communities.
Responding to the findings, Darren Hughes, Director of the Welsh NHS Confederation, said the message could not be clearer.
“NHS leaders in Wales welcome the report’s call for a prevention-first approach,” he said. “We have to move from simply treating illness to actively promoting wellbeing, and that means a proper cross-government strategy that tackles inequality and gives people the support to take control of their own health.”
He added that every pound spent on proven public health programmes delivers an average return of £14 – evidence, he said, that prevention “makes moral and financial sense” at a time when NHS budgets are under extreme pressure.
“It is deeply concerning to see healthy life expectancy falling, particularly for women,” he said. “Investment in prevention is vital if we are to make our health and care services sustainable.”
While health boards, councils and community groups are already working on preventative programmes, the Welsh NHS Confederation says Wales needs far greater ambition – and the NHS must be given the tools and flexibility to scale up what works.
The Chief Medical Officer’s report also raises serious concerns about NHS workforce shortages and urges significant investment in digital technology to improve productivity and patient outcomes.
Mr Hughes said all political parties should “take heed” as they prepare their manifestos for next year’s Senedd election.
“Those seeking to form the next Welsh Government have a clear blueprint here. We cannot keep doing the same things and expect different results. Prevention, workforce and digital transformation have to be top priorities.”
The Welsh NHS Confederation — which represents all seven health boards, the three NHS trusts, HEIW and Digital Health and Care Wales — has already outlined its detailed priorities in its own election document, Building the health and wellbeing of the nation.
With the Senedd election just over a year away, today’s report adds fresh, authoritative evidence that Wales needs a radical shift in how it approaches health if it is to secure a healthier future for all.
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