The Revised Pay Offer to BMA Cymru

3. Topical Questions – in the Senedd at on 12 June 2024.

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Photo of Mabon ap Gwynfor Mabon ap Gwynfor Plaid Cymru

(Translated)

1. Will the Cabinet Secretary make a statement on the Welsh Government's revised pay offer to BMA Cymru? TQ1107

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 3:18, 12 June 2024

(Translated)

Following robust negotiations with the BMA, I'm pleased to report that the Welsh Government has made substantial offers in terms of salaries to junior doctors, SAS doctors and consultants, with a view to bringing strikes to an end and improving services to patients. The offers ensure that the additional salary is weighed against commitments on reform, which will aim to get improvements in terms of productivity and efficiency and to secure reforms to the contract in the future. I am delighted that the BMA Cymru committees have agreed to recommend this to their members in the vote that will open today, and we will receive the result of that vote on 27 June.

(Translated)

The Deputy Presiding Officer (David Rees) took the Chair.

Photo of Mabon ap Gwynfor Mabon ap Gwynfor Plaid Cymru 3:19, 12 June 2024

(Translated)

I thank the Cabinet Secretary for that answer. I welcome the fact that the Government has reached an agreement with the BMA over pay for junior doctors, consultants and SAS doctors. It's been a long battle for the doctors here, and it's regrettable that they've had to fight against a Labour Government in order to secure better pay and conditions. But there we are, this is not the same Labour Party as the one that was formed to fight for the rights of the workforce a century and a quarter ago. Once again, we've had to wait for this Labour Government to pull a rabbit out of a hat, after having insisted for many months that there was no additional money available. All they did was waste time, delay, put unnecessary stress on the doctors and their colleagues and the health service, and pay out more in the end than what the cost would have been if they had agreed to better terms at the outset.

So, even though you said that there was no money available originally, it's clear that you've found a new sofa to look down the back of. You need to be clear with the public regarding where this money has come from, and you need to explain why it has taken so long to find the money. Is it a cynical move that we have here to create good headlines for the First Minister, or even to influence the general election? Transparency and honesty on this point is vital, because this choice has clear implications regarding the status of pay negotiations in other areas of the workforce.

Time and time again representatives of the workforce, such as those from the RCN, have been told by the Government that there was no additional money to bring in a fair contract for nurses, for example, and the RCN, in this case, took your word in good faith. But this assertion made to other bodies now clearly runs counter to what the Government has managed to do now with the BMA. Let's be clear about this, this is not about pitting one group of the workforce against another. Instead, it's about trying to get to the truth and ensure honesty, transparency and consistency. So what is different about your negotiations with the RCN and other representative bodies compared to the BMA that has meant that there is no extra money avaiable for nurses in Wales? 

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 3:21, 12 June 2024

Thank you very much. I'm sure, if the Member was paying attention, he would have recognised that, actually, some money came in in the form of—[Interruption.]

Photo of David Rees David Rees Labour

That was me, I'm sorry. 

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour

Oh, I see. I shall carry on. You'll recognise that, actually, the money came in in the form of consequentials right at the end of the financial year. What had happened is that money had been put into reserves, and we've taken some money now out of reserves in order to settle the pay. And let's not forget that this is about last year's pay award.

We entered the negotiations before there was any suggestion that there was going to be a general election. We entered because, obviously, we work in close social partnership with the unions, unlike in the rest of the United Kingdom. It demonstrates that, actually, when you sit down and you negotiate—. And I hope that the Conservatives are watching, because in the UK, they have called and said that they will be taking industrial action, the junior doctors. It demonstrates that when you sit down, you listen and you negotiate, you can come to a conclusion.

Of course, we were pleased that we were able to settle with the RCN earlier on in the year. I'm sure you recognise, and I hope you recognise—and I think it is important that there should be a recognition—that, actually, the junior doctors absolutely deserved a pay increase. And it's probably just worth reflecting on the fact that a junior doctor, after five years in medical school, was earning £28,471, which was less than a nurse at band 5 level, that earned £28,834. So, I'm sure that there will be people who are actually really happy that we have come to this offer.

Let me be absolutely clear that this is not an unconditional offer, that we have ensured that there will be operational reforms to address issues like productivity and efficiency. And, of course, we have had a commitment to achieving future contract reform. The key thing here is to remember that this isn't all about the doctors—it's actually about the patients. We're interested in getting the very best deal for the patients, and that is what I hope we've got as a result of this offer.

Photo of Altaf Hussain Altaf Hussain Conservative 3:24, 12 June 2024

It's great news you've come to the agreement with the BMA. Cabinet Secretary, I note your response to Mabon, but the fact that you were able to find funding for this enhanced pay offer now begs the question as to why was this not possible earlier. The people of Wales, our constituents, are facing the most inhumane waits for treatment, and while the Welsh Government was considering its options, those people have been forced to live in pain and discomfort. Welsh Labour has been at the helm of the Welsh NHS for a quarter of a century. Rather than blaming everyone else, will you now admit your failings on health and care? Cabinet Secretary, will you now agree to spend the full Barnett uplift received for health on health, and put an end to inhumane two-year waits in Wales?

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 3:25, 12 June 2024

Thanks very much. I'm afraid, Altaf, I'll have to repeat what I said to Mabon, which is that it was your Conservative Government that didn't give us the money until the last few weeks of the financial year. We can't plan on that basis, and so we had to put that money into reserve. We've taken that money now out of reserve in order to fulfil our commitment in order to put this money on the table. Let me remind you, Altaf, that it's your Conservative Government that is facing industrial action in England in the days before a general election. If you think that is a good idea, good luck to you. But I think it is important, also, that there is an understanding that that negotiation was a really tough one. It hasn't been easy. I'd like to thank the negotiators on both sides for the strenuous efforts that they have made, and I think that what we're getting is not just—. They're not getting just an increase in pay; we are getting a huge amount in return as well for the patients in Wales, and that commitment to contract reform is absolutely important. You will know, as a former consultant yourself, that the BMA rate card is pretty expensive. And one of the things that they've agreed with us is that they will withdraw the BMA rate cards as a result of this negotiation. That is good for the taxpayers of Wales, it is good for the patients of Wales, and more operations will be done as a result of that.

Photo of Gareth Davies Gareth Davies Conservative 3:27, 12 June 2024

I wanted to focus on some of the periphery issues around this as well in terms of recruitment and retention of medical professionals. Because often, when I'm approached in the constituency and nationally—I've taken a lot of responsibility for health services—it's actually the periphery issues around this sometimes, in terms of IT systems and migration, and attracting staff into Wales from other parts of the UK. Often, a barrier to that is sometimes the difference in some IT systems and periphery issues that put staff off in terms of being attracted into Wales. So, are there any discussions going on between the Welsh Government and external stakeholders and partners to ensure we do have some fluidity within the system so people can indeed feel attracted to Wales and not be put off by periphery issues that can sometimes be a barrier to recruitment and retention within the medical profession across the NHS and other sectors as well?

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 3:28, 12 June 2024

Thanks very much, Gareth. You're quite right. Doctors want to work in a modernised system, and that is certainly something that I'm very keen to do. We've got to remember that there is one pot of money here, so if I'm giving it to the doctors, it's very difficult for me to modernise and to do the digital upgrades that I would like to do as well. So, there is a payoff here. Every time we give money to one section, there's another section that is going to have to do without. That is the difficulty in terms of the situation we're in, where we have a restricted budget. Obviously, that's what we're keen to do. I'm really keen to do digital transformation. That's how we're going to get some of the productivity gains that we're very anxious to get. But the fact is that we have agreed with, for example, the BMA Welsh consultants committee, that now is the time to reform the current pay structure, which is more than 20 years old. The good thing about that, and you asked about retention, is that a modern pay structure is going to be better in terms of support and recruitment, but also to address the gender pay gap, which has been evident. So, we're hoping that this will address that. And, another issue in relation to what happens in the future is that we're going to be looking at a contract that can be used across the whole of Wales, and I think that might be quite interesting in terms of consultants being able to move from health board to health board. So, there is some real progress being done, I think, in relation to this. Thank you.