Time To Review The Review Body, Say Doctors and Dentists
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- Published: Thursday, 02 February 2023 07:38
- Written by Peter Ingle
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The recent announcement of a 4.5% pay uplift for NHS dental contracts at a time when inflation exceeds 10%, represented a further pay cut for dentists. This is on top of the claimed 40% real-terms cut in pay since 2008/9.
What makes these figures even harder to stomach is that they have been delivered each year by what is described as an independent review body. Set up in 1960 as the Doctors and Dentists Review Body (DDRB), it was intended to take political considerations out of doctors and dentists pay. This year, against the background of other health workers representatives announcing that they would withdraw from working with their review bodies, the imposition of yet another pay cut has pushed doctors and dentists leaders to join forces.
The BDA and BMA complaint is simple. It is that Ministers have interfered in the (DDRB) processes as a matter of course, year after year. They have imposed public sector pay freezes and pay caps, and arbitrarily defined NHS ’affordability’ each year. To add insult to injury the process has been subject to repeated delays, one example being that the government routinely provides late evidence. The pay uplift for 2022/23 in England will be implemented 10 months late in February 2023, close to the end of the NHS financial year.
A Report into the Failings of the Pay Review Process for Doctors and Dentists has now been produced by the BMA in consultation with the BDA. It begins with a reminder of why the DDRB was first set up. “The Royal Commission (that resulted in the DDRB) was clear in setting out how an independent pay review process should function. It stated that the pay review body should ensure that pay was kept in line with ‘cost of living, the movement of earnings in other professions and the quality and quantity of recruitment in all professions.’ They also noted that doctors’ and dentists’ pay should not be used as a regulator of the national economy, that ‘doctors and dentists must have some confidence that their remuneration will be settled on a just basis’, and that the formation of such a body would ‘give the profession a valuable safeguard’ as ‘their remuneration will be determined, in practice, by a group of independent persons of standing and authority not committed to the government’s point of view’.
The report then goes on to list the more recent failings of the DDRB. These include, the imposition of pay freezes over 3 years, capping pay uplifts to 1% for 5 years when inflation exceeded that figure, imposing its own concept of “NHS affordability” as a limiting factor, and sometimes ignoring or reducing the review body pay awards. In addition it was suggested government has appointed members to the review body with “government affiliations,” and ignored the agreed timetable both in terms of submitting its evidence and then publishing the report.
The report states that, “The shared view of the BMA and BDA is that the DDRB process has been modified beyond recognition from its original purpose”
It goes on to demand that the review body is once again allowed to work independently. The changes that will be needed include, an end to government remit letters, appointments to the body being made in consultation with the professions, governments committing to meeting the bodies recommended pay awards, a clear and enforceable timetable for the process, and importantly that, “The reformed DDRB must be empowered to correct for pay losses caused by the current constrained pay review process.”
To underline how much the DDRB has lost its way, the BMA and BDA include highlighted sections of the 1960 Royal Commission report showing some of the areas where the review body has deviated from the original intention.
Commenting on the review process BDA Chair Eddie Crouch said, "Savage cuts to real incomes are the result of a system that’s doled out pay caps and pay freezes to order."
"Every dedicated health professional requires fair and timely pay uplifts. When so many are reconsidering their future in the NHS, to do otherwise is an act of self-harm."
Report-into-the-Failings-of-the-Pay-Review-Process-for-Doctors-and-Dentists.pdf (bda.org)
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