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Health Pay Review Bodies

Volume 474: debated on Monday 21 April 2008

I am responding on behalf of my right hon. Friend the Prime Minister to the thirty-seventh report of the review body on doctors’ and dentists’ remuneration (DDRB) (Cm 7327) and the twenty-third report of the NHS pay review body (NHSPRB) (Cm 7337) which were laid before Parliament on 7 April 2008l. Copies of the reports are available in the Vote Office and the Library. I am grateful to the chairs and members of the review bodies for their hard work.

The DDRB has recommended that the national salary scales for all salaried doctors and dentists, and the top and bottom of the salary range for salaried general medical practitioners, should be increased by 2.2 per cent. for 2008-09. For general dental practitioners (GDPs), the DDRB has recommended a 3.4 per cent. increase in the gross earnings base. The DDRB intend this to result in an increase in GDPs’ net income of 2.2 per cent.

With regard to independent contractor general medical practitioners (GMPs), DDRB have recognised in their report that there are significant, unwarranted variations in GMP income caused solely by the operation of the minimum practice income guarantee (MPIG) regardless of the workload and patient care provided by individual GMPs and their practices. They note the evidence presented to them that GMP income varied from £54.72 per patient (where there was no MPIG) to £120 per patient (where there was MPIG). In making their recommendations, including the 2.7 per cent. uplift to a GMP’s global sum, the DDRB acknowledged, and therefore clearly intended, that the practical implication of their recommendations was that most practices would not receive any increase in their global sum. This is predicated on any increase in global sum being offset against the correction factor in MPIG. The Department estimates that implementing these recommendations means the 6 to 7 per cent. of GMS practices without any MPIG would receive an increase in their global sum payments of 2.7 per cent. in 2008-09. A further 2 per cent. of practices will receive some extra increase in payments as their current correction factor will be less than their increase in global sum.

In addition to any DDRB recommendations, we have guaranteed to the profession that once the costs of implementing the recommendations of the DDRB have been agreed with the British Medical Association, the Government will ensure up to 1.5 per cent. of new investment is available across all practices for providing more services or improving the quality of care and provision to existing patients.

The DDRB’s pay recommendations have been accepted in full by the Government, without staging. However, in taking forward the DDRB’s recommendations on GMP pay there remain issues that will require further consultation with the BMA before they can be implemented and that will delay payments to GMPs.

The NHSPRB has recommended an increase in the ‘Agenda for Change’ pay rates of 2.75 per cent. from 1 April 2008. The NHSPRB has also recommended that the high cost area supplements and existing national recruitment and retention premia should be increased by 2.75 per cent.

On 7 April 2008, I announced that the Department has agreed with NHS employers, UNISON and the Royal College of Nursing a proposed three-year pay package for all NHS ‘Agenda for Change’ staff which incorporates the acceptance of the NHS pay review body recommendations for 2008-09 in full. The proposed three-year package is now subject to consultation by members of all the trade unions covered by ‘Agenda for Change’. It includes:

acceptance in full of the 2008-09 NHS Pay Review Body’s (NHSPRB) recommendations for a 2.75 per cent. pay rise for staff on ‘Agenda for Change’ from 1 April 2008;

2.4 per cent headline award in 2009-10; 2.25 per cent. headline award in 2010-11; and

additional changes to the pay structure in years 2 and 3 that would give extra financial support for the lowest paid workers, allow quicker progression up the pay ladder and increase the earning potential for hundreds of thousands of staff.

If trade union members reject the proposed three-year deal, we will need to review the NHSPRB’s recommendations and consider whether to accept, stage or abate them in the context of a one year settlement.

I apologise that we were unable to announce these decisions to Parliament in the normal way before making them more widely available. Unfortunately, it was not possible to do this before the Easter recess as pay negotiations had not concluded. I also felt that it would cause an unnecessary delay in the consultation process and thus the payment of the award to staff if we had waited until Parliament returned on 21 April before making these important announcements.

1 Cm 7337 was laid on 7 April in its pre-publication form as the printed version was not available. This version has now been withdrawn and replaced with the printed version.