The  (BMA) representing over 59,000 consultants in England has agreed a sell-out pay and productivity deal with the Conservative government aimed at ending a months-long dispute.

Doctors should reject the agreement in December’s vote and resume the industrial action which the union called off in October to enter negotiations without pre-conditions. It says everything about the agreement that the BMA does not describe it as a pay rise, but an average 4.95 percent “investment in pay” for the 2023-24 financial year, adding to the 6 percent already offered by the government.

While the BMA is not formally recommending the deal, with BMA Consultants Committee Chair Dr Vishal Sharma saying it was not “perfect”, to all intents and purposes it is doing so. Sharma said, “We are pleased that after a month of intense talks and more than six months of strike action we never wanted to take, we have now got an offer we can put to members.” He added that the committee “felt there was enough progress to put it to our members to vote on.”

The smaller Hospital Consultants and Specialists Association (HCSA) in , also involved in the talks, has approved the offer and announced a separate vote.

Consultants came out on strike in July alongside already striking junior doctors in pursuit of a pay deal addressing years of real terms salary cuts. The industrial action was the first by senior doctors in a decade and came during a strike wave encompassing several million workers in the public and private sectors.

The doctors demanded a 12 percent pay increase for the year, rejecting the 6 percent imposed by the government—“less than 6% for consultants, once all elements of pay are considered,” the BMA wrote at the time. This followed an increase of just 4.5 percent the previous year, amid double-digit inflation. The BMA said any deal would have to address the fact that consultants’ pay has fallen by 27 percent since 2007/8, or 35 percent once tax and pension changes are considered.

At the start of October, with strikes by senior and junior doctors having a major impact on NHS services and widely supported, the BMA offered to end the action for weeks if the government would enter fresh talks. By this time, the initial demand of 12 percent had been walked back by the union, which instead said it was seeking a “credible offer that we could put to our members.”

The deal on the table is the rotten outcome of this capitulation. The 4.95 percent is not backdated, only applying to the final three months of the financial year—next January, February and March—before being added to yearly salaries in April.

The BMA has sought to sugarcoat its sell-out by pointing out that some consultants will have gained an overall increase of 19.6 percent between the end of the 2022-23 financial year in March 2023 and the beginning of the financial year next April. The union claims that a majority of consultants will “also receive an additional uplift of up to 12.8 per cent, depending on their pay point”.

Even then, the figures cited for only a section of the workforce are miles below the 35 percent collapse in pay that sparked the dispute in the first place.

Moreover, some consultants will receive no pay increase. The Guardian reported, “Consultants have 20 different pay bands. Under the deal, some of them will receive no extra pay at all as a result of the 4.95%, because of what they already earn, while others—mainly the higher paid—will get an uplift of 10.59% or 12.8% for those three months.”

Every single dispute over the last year 18 months was sold out by the trade unions on below-inflation pay deals, including the nurses’ strike ended by the Royal College of Nursing in June.

The Guardian noted, “Neither the unions nor the Department of  and Social Care claimed victory in their respective announcements about the prospective resolution.” The fact is the consultants’ deal continues the post-2008 suppression of their pay. The government has maintained its stance of not backing down an inch over workers’ demands, meaning they have to stump up even less money than agreed in previous sub-inflation deals, including with the NHS nurses and ambulance crews, part of the 1.1 million NHS staff who were in dispute.

Only 3.45 percentage points of the offer are funded by additional money from the Treasury, with the remaining 1.5 points coming from “recycled funding” deriving from the Local Clinical Excellence Awards system—used to top up basic pay—which will be scrapped. Prime Minister Rishi Sunak’s response to the deal confirmed it as a government win, declaring the deal “fair for taxpayers because it will not risk our ongoing work to tackle inflation.”

Within minutes of the deal being announced, BMA members expressed their anger and feelings of betrayal.

One doctor pointed out that the deal “doesn’t address inflation for the last 2 years let alone since 2008” and that “Consultants of less than 10 years [are] almost completely left out.” Another commented, “So much for 35% pay restoration... this ‘deal’ gives consultants 3.45% averaged across 14 years AND removes CEAs [Clinical Excellence Awards]. Can’t believe the BMA consultants committee actually negotiated this?! The DoH [Department of Health] and Treasury are going to be laughing all the way! Time to leave the BMA...”

This was a common theme, with a doctor questioning, “Why did anyone in the BMA agree to this? They’ve spent years taking and taking. Why do we allow the government to continue to degrade conditions?” and a second declaring the deal a “Total betrayal and an awful offer.”

Many highlighted the attempt to “divide and conquer doctors, same as what they do to other staff member groups in the NHS.” In a different doctor’s words, the deal was “A calculated ‘divide and conquer’ tactic designed to pit senior consultants against those newly promoted and cut off the Junior Doctors fight for pay restoration at the knees.” A third asked, “Are we going to leave the juniors high and dry?”

Several newspapers, including the Financial Times, noted that government officials are eager to see the deal “increase pressure on junior doctors to reach an agreement.” The BMA’s junior doctors committee is formally calling for a 35 percent pay deal, but has also used the phrase “a credible offer”. In July, Philip Banfield, chair of the BMA’s ruling council, said the junior doctors committee 35 percent demand was “not set in stone”.

NHS FightBack, initiated by the Socialist Equality Party, calls on doctors to form rank-and-file committees to campaign for a rejection of the deal. This fight must encompass the tens of thousands of junior doctors still in struggle and the hundreds of thousands of nurses working under an imposed contract. Contact NHS FightBack today to discuss the way forward.