What resident doctors don't want you to know about their pay

Telegraph

09-07-2025

A fresh wave of NHS strikes looms after the Government refused to reopen pay negotiations with resident doctors.
The British Medical Association (BMA) has demanded a 29pc pay rise for the medics, formerly known as 'junior' doctors, to rectify what it claims to be 17 years of real-term cuts.
Yet what is often forgotten is that these doctors enjoy bumper pensions worth close to 75pc of their salaries in retirement – and which are guaranteed to rise with inflation each year.
Doctors enjoy index-linked, taxpayer-funded, 'defined benefit' schemes, many of which pay a proportion of the recipient's final salary from the day they retire.
Under the NHS scheme, staff contribute between 5.2pc and 12.5pc of their salaries while the state contributes a vast 23.7pc each year.
By comparison, private sector workers, who are almost all enrolled in 'defined contribution' pensions where the value of the final pot depends on investment performance, receive a contribution of just 3pc from their employer.
The NHS is paying out nearly £1bn a month in staff pensions, with almost 2,000 staff receiving pensions of over £100,000 annually – a figure that has more than doubled in a year.
These lucrative pension packages complicate the case for a further pay rise. Resident doctors have already been awarded an inflation-beating 5.4pc pay rise this year. It comes after the Labour Government handed the medics a 22pc pay rise over two years in July last year to bring an end to a series of strikes.
Eleven walkouts by resident doctors since 2022 have led to almost 1.5 million appointments being cancelled or rescheduled, according to NHS England. The strikes are likely to have cost the taxpayer at least £1.7bn.
Resident doctor salaries start at £36,616, rising to £42,008 in the second year of training, according to the BMA. The average starting salary for a full-time resident doctor has risen from £29,380 in 2022-23 to around £38,800 today, an increase of nearly £9,500.
The BMA claims that resident doctors' real pay has fallen by 21pc since 2008. But these calculations use the retail prices index (RPI) measure of inflation, rather than the consumer prices index (CPI) favoured by economists. Under the CPI, pay has fallen by a more modest 4.7pc.
Even so, the pay squeeze is driving resident doctors abroad in search of better salaries and lifestyles. The solution, according to some experts, is to rebalance their benefits – decreasing the Government's pension contributions to top up wages instead.
Some 75,421 NHS workers opted out of their pension scheme in the 2023-24 financial year, a 72pc increase from the 43,732 who did so in 2020-21. These were primarily workers under the age of 40, suggesting they value higher wages today over more lucrative retirement packages later.
Maxwell Marlow, of the Adam Smith Institute think tank, said: 'If junior doctors want a pay rise – which I think they deserve, given that they are paid much more in the United States and Australia – the best thing to do would be to do a fiscal transfer from pension to pay packets.
'This would also help alleviate the public sector pensions crisis, which is a total disgrace.'
Britain currently hands £54bn a year to public sector retirees – including doctors – and another £35bn in pension contributions to current state workers.
Rachel Reeves last month announced the NHS would get a record £29bn boost to its annual budget in her Spending Review.
However, recent increases to NHS funding – such as the £22.6bn uplift announced last October – have almost been swallowed up by pay rises.
The Department for Health and Social Care was approached for comment.