What has happened to junior doctors' pay?

Junior doctors recently took further strike action as part of their ongoing disagreement over pay. With discussions to try and end the dispute already underway between the doctors and the new Secretary of State for Health and Social Care, Lucina Rolewicz takes a closer look at how junior doctors’ pay has changed over time.

Chart of the week

Published: 09/07/2024

Junior doctors recently staged their latest round of strikes in England as part of their ongoing dispute over pay, which has now totalled 48 days of industrial action since they first walked out in March 2023. But what do we know about the changes to junior doctors’ earnings over time, including the period during when they have taken strike action?

The government implemented a consolidated pay increase of 6% + £1,250 for 2023/24 as recommended by the pay review body. The BMA have asked for “35% full pay restoration”, based on their claim of pay falling by over 26% in the 13 years to 2021/22. Our calculations differ in that we have used a more reliable measure of inflation and use 2010/11 as the baseline, as the comprehensive time series on NHS earnings only goes back this far.

With this in mind, while inflation has fallen from the levels seen in 2022 and 2023, pay for junior doctors at all levels still lags behind relative to their pay in 2010/11. This includes foundation year doctors, who are medics in their initial stage of postgraduate training after finishing medical school, and those in further training posts following successful completion of the foundation programme – known as doctors in core training or specialty training.

By 2023/24, pay had fallen by 15.4% on average compared to 2010/11, ranging from 12.9% for doctors in core training to as much as 18.7% for second year foundation doctors. However, it is important to note that average earnings across the public sector have also felt the squeeze, falling by 10.1% in 2022/23 relative to 2010/11.

Average earnings can fall during industrial action, with those going on strike forgoing pay. If we assumed pay increased in line with the pay deal, this would suggest a real-terms cut in full-time earnings of between 10.1% and 15.1% (as indicated by the dotted lines in the chart) in the 13 years to 2023/24 – rather than what we have observed to be a decrease of between 12.9% and 18.7%, which is likely to be the result of forgoing pay during strikes.

These recent strikes landed at a crucial time, just days before the UK electorate headed to the polls to cast their votes in the general election. Following Labour’s victory in that election, it was not surprising to find the issue at the top of the in-tray for the new Health and Social Care Secretary, with talks to end the long-running pay dispute already underway. The new Secretary of State has already ruled out meeting the BMA’s demands for a 35% increase. But the data suggest there is room for negotiation to achieve a settlement that goes some way towards addressing the real-terms decline in pay since 2010/11. 

Suggested citation

Rolewicz L (2024) " What has happened to junior doctors' pay?", Chart of the week, Nuffield Trust