Meeting of the Parliament

Meeting date: Wednesday, June 14, 2023

Official Report 1075KB pdf

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Urgent Question

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Junior Doctors (Pay Offer)

To ask the Scottish Government what its response is to the announcement that Scottish junior doctors have voted overwhelmingly to reject the pay offer made by the Scottish Government and plan to take strike action.

We are disappointed that junior doctors have rejected our cumulative pay uplift of 14.5 per cent over two years and have decided on industrial action, which is in no one’s interest.

We negotiated in good faith, and I addressed concerns from junior doctors. That would have been the biggest investment in junior doctors’ pay for the past 20 years and a step forward in modernising pay bargaining, restoring confidence among junior doctors and ensuring that their contribution to our healthcare system is appropriately recognised.

I have also been very clear with the British Medical Association that the request for a 35 per cent pay increase is unaffordable, with the funding for any increase likely to come from the health budget. However, I continue to engage with BMA Scotland and we will meet tomorrow to discuss how we can move forward.

Last week, I met the Royal College of Emergency Medicine, and its members told me that last winter was the worst winter that they have endured. While patients waited for hours to be seen in accident and emergency units, staff were pushed to the brink, with many working long hours on understaffed wards—and that was on top of punishing previous years.

The responses to Scottish Conservatives’ freedom of information requests show that almost 75,000 national health service staff have been absent in the past five years due to anxiety, stress, depression and other mental health-related illnesses. Morale is at rock bottom in the Scottish health service. Given the precarious nature of our services, can the cabinet secretary guarantee that the current offer, and any further and future offers that he makes, will not take funding away from crucial front-line services?

Presiding Officer, I must confess that I have heard of leading with your chin in a debate, but the Conservative Party has got some brass neck. On the very day when junior doctors in England are on their third round of industrial action because of the failure of the Conservative Government in England, to even engage with them meaningfully is quite a stark contrast. I am sure that Dr Gulhane recognises that we recognise how important this issue is, which is why we have been in detailed negotiations with junior doctors over a considerable period and why the BMA viewed the offer that was made to it as being credible enough to put to its members.

I assure the member that I will not disrespect junior doctors as his colleagues in England have. I will engage with them in a serious and meaningful way, and with a sense of humility, to try to address their concerns and issues instead of arrogantly dismissing them as his colleagues at Westminster are doing. He can be assured that I will continue to engage with them in a way that seeks to address their concerns and to find a resolution to the matter, as I believe that it is in everyone’s interests—across our NHS and wider society—to ensure that junior doctors are treated with respect and get the support and assistance that they require.

What an arrogant answer. [Interruption.] Quite frankly, the cabinet secretary did not even bother to answer the question that was put to him.

As an NHS general practitioner who is currently working, I have to categorically tell you—[Interruption.]—how difficult things are right now. [Interruption.]

Members! Let us hear one another.

Health is devolved in Scotland. Simply put, this is the Scottish Government’s mess to fix. Of course our junior doctors deserve a fair pay offer, but the Scottish National Party Government has consistently neglected other areas of terms and conditions. Poor workforce planning, lack of access to nutritious meals and a culture that does not value front-line staff have all contributed to these strikes.

Can the cabinet secretary guarantee that those issues will be addressed when he next sits down with the junior doctors—which he said will be tomorrow—and can he actually answer my question from the last time?

I think that Mr Gulhane has got himself in a bit of a guddle on this issue. [Interruption.] I will be quite clear: it is not just me, the cabinet secretary for health, who is saying what we are doing with the BMA. Let me quote from a letter that the BMA issued today—[Interruption.]—because it is exceptionally relevant—

Let us hear the cabinet secretary.

—to the point that the member has made. It is a letter to Rishi Sunak on this particular issue—[Interruption.]

Members! Can we please have silence in the chamber when a member is on their feet, putting or responding to a question?

The letter says:

“As you will be aware, and with no additional funding, both the Welsh and Scottish Governments have recognised the real terms cuts to doctors’ pay, yet your government still refuses to acknowledge pay erosion.”

That is a letter from the BMA recognising that we, as a Government, understand and are concerned about the issues that junior doctors have and pointing out the heartless, empty rhetoric that has come from the United Kingdom Government and the member’s colleagues at Westminster. I do not know whether the member is a member of the BMA, but it is very clear that the BMA thinks that the Conservative Party leader—the member’s party leader—is not interested in the interests of junior doctors. [Interruption.]

I assure the member—I am sure that he and his colleagues will want to hear this—that I will do everything that I can to address their concerns. I will negotiate with junior doctors in a meaningful and genuine way. What I will not do is dismiss them as though I am not interested in their concerns, as his colleagues and his party leader at Westminster have done. He can be assured that we will do the right thing by junior doctors, unlike his colleagues at Westminster.

As the cabinet secretary has referenced, the BMA today wrote to Rishi Sunak, asking to meet him urgently to find a resolution to the on-going dispute in England.

How is this relevant?

Can the cabinet secretary outline what engagement the Scottish Government has had with the BMA to address these concerns while the UK Government continues to fail to listen to junior doctors?

I am going to meet with the BMA again tomorrow to discuss these matters. I have had extensive engagement with the BMA. We have very positive relationships in terms of engaging around this issue, and I want very much to keep it on that footing.

I heard somebody from a sedentary position questioning the issue of the letter from the BMA, asking why it is relevant. It is relevant because it references the Scottish and Welsh Governments’ efforts to resolve the issue, unlike their counterparts at Westminster. Maybe there is some backbone on the Tory benches—[Interruption.]—to stand up for junior doctors in Scotland instead of, as ever—[Interruption.]

Members!

—pandering to the Tories’ Westminster masters when it comes to dealing with these issues.

I welcome the cabinet secretary’s comments so far, but I gently point out to him that pay erosion began in 2008 and covers the same period for which the Scottish National Party has been in government.

Half of junior doctors are actively considering leaving to work elsewhere. What additional action can the cabinet secretary take to avoid a strike and to avoid losing junior doctors from the national health service completely? Are there any contingency arrangements should his discussions fail?

I will deal with the last point first. Contingency arrangements are being put in place and we are engaging with health boards on that. We have been doing that for a number of weeks, to prepare for any potential industrial action, as the member will realise.

On the issue of pay erosion starting in 2008, I gently remind Jackie Baillie that junior doctors pay settlements are agreed through the DDRB—doctors and dentists review body—process, which applies across the United Kingdom. Therefore, Labour Governments in Wales and at the UK level have applied that process during that period, as we have done—we have always been committed to it. We agreed with the BMA’s Scottish junior doctors committee’s desire to move to a new pay negotiation process, and we committed to establishing such a process. We were prepared to take forward work to ensure that the process was in place by September of this year. I stand by that and will continue to offer it to the junior doctors as we move forward.

Junior doctors have been committed to the DDRB process, as have Jackie Baillie’s colleagues in Wales, and there is also a commitment to it in England. It is a well-established approach. Therefore, to try to apportion more blame to the SNP than to anyone else is simply wrong, and it would be misleading to do so. We have always honoured the recommendations from that process. Junior doctors now wish to take a different approach and, so far, the Scottish Government is the only Government in the UK that has committed to doing that. I stand by the commitment that I have given to the BMA, and we will continue to work with it in the coming weeks on how we can make further progress on the issue.

I find it very poor that SNP back benchers were jeering and moaning when Dr Gulhane declared his interest as a practising GP. Our primary healthcare workers are all too familiar with that level of contempt from the SNP back benches.

The cabinet secretary’s predecessor set great store by the fact that Scotland did not have healthcare strikes, yet, come July, that could be proved wrong and those words could come back to haunt him. It will mean that every ward is a little less safe and every wait in hospital or for treatment is perhaps a little longer. What does the cabinet secretary have to say to those patients who are waiting in pain?

I presume that the member is keen for us to try to avoid industrial action. In the disputes that we have had with health unions, we have always engaged with them in a constructive way to seek a resolution to these matters. To date, that approach has allowed Scotland to be the only part of the UK that has been able to avoid industrial action in our NHS. I would have thought that, at the very least, the member would have welcomed that partnership approach in working with trade unions to address the issues of concern that their members have.

We have taken that approach into our engagement with the Scottish junior doctors committee of the BMA, and I continue to be committed to that approach. We will re-engage tomorrow and look to see what further progress we can make. I do not believe that industrial action is in anyone’s interest. Ultimately, it will be for junior doctors to decide whether to take industrial action, but I will do everything that I can to avoid that. I will engage with them in a meaningful way through the negotiation process to try to achieve that. If we can achieve it, we will be able to move on and address the issues of concern that junior doctors have.

That concludes the urgent question.

On a point of order, Presiding Officer. In response to the cabinet secretary, I point out that I am, indeed, a member of the BMA.

Thank you, Mr Gulhane.