NHS strikes: What is happening to consultants’ pay?

Published

2 years ago

July 20, 2023

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As consultant doctors walk out for 48 hours, Sky News analysis has found that their real terms annual earnings have fallen by 15% since 2010.

The NHS Confederation has said the consultants’ strike is a “step into the unknown” – and it feels like that in terms of the statistics used by both sides to make their case. The British Medical Association and the government each have their own favourite figures.

Let’s start with the real terms pay cut. The BMA says that, because inflation has risen faster than pay, consultants have seen their real take-home pay fall by 35% over the past 14 years.

But the BMA is using the Retail Price Index (RPI) to calculate this. The problem is that it’s not how we measure inflation – the Office for National Statistics (ONS) recommends using the consumer price index – CPI – instead. That’s the measure you see when we talk about inflation on Sky News.

And if you use the CPI to chart consultants’ earnings, they haven’t fallen by quite that much – it’s a 15% decrease since 2010.

But that’s still a big decrease, especially when you compare it to the public and private sector averages.

It’s also worth noting that 2010 was a relative high point for consultants’ pay.

Billy Palmer, senior fellow in health policy at the Nuffield Trust, told Sky News: “People typically use 2010 as a baseline, but in fact that was a fairly high point in the somewhat cyclical nature of consultants’ pay. If you look back over a longer period, three decades for example, consultants have actually received a pay rise.”

What about the amount of pay itself?

You might think this should be uncontroversial enough but again, both sides prefer different data.

Tom Dolphin, a consultant and a member of the BMA council, spoke to Sky’s Kay Burley on Thursday morning and referred to the starting basic pay of a consultant – £88,364.

But any pay rise would be applied to all doctors so we should probably use the average basic pay instead, which is £97,406. And if you compared basic pay to 2010, it’s clear that doctors are being paid less.

And basic pay has fallen more in England than in Scotland across all levels of experience.

While a consultant in England working for 10 years would receive a basic pay of around £105,996 in the 2022/23 year, a consultant in Scotland would get £108,345.

In comparison to 2010/11 (adjusted for inflation) this means consultants in England see a bigger decrease in basic pay – 14% compared to 12% in Scotland.

That figure, though, is still some way away from the figure the government likes to quote, that the average annual salary last year was £127,228. That includes non-basic pay: things like working beyond contracted hours (£14,566), medical awards such as the clinical excellence award (£6,028) and money received for being on call (£2,882).

The government likes this higher number – it’s nearly four times the average UK annual salary – but it’s also not an unfair statistic to choose.

The government also likes to mention its offer of a 6% increase in pay for NHS staff consultants, which might sound relatively generous.

But again, if you use CPI forecasts for next year, this would increase doctors’ annual earnings by only 1% in the year ending March 2024 – still far short of that actual 15% decrease since 2010.

Comparisons to other countries and professions

Dr Dolphin also mentioned that consultants were being tempted by job offers from countries where the weather is sunnier and the wages are higher.

Some of the comparisons here are a bit trickier because of different definitions and data.

We’ll start in the UK and compare how “specialist medical practitioners”, which would include consultants as defined by the ONS, compared to other categories in the professional occupations category.

And they compare very, very well – a median gross annual income of £68,614 in April 2022. That’s 3% more than headteachers and nearly three-fifths higher than aerospace engineers.

So specialists are top of the league at home. Abroad, though, they’re mid-table.

Consultants in the UK rank moderately in terms of earnings on a global scale.

The OECD puts a UK medical specialist’s earnings at $155,418 (we’re using dollars now for ease of comparison). This is nearly a third higher than a consultant in France but around a quarter lower than in South Korea.

Private pay and extra work

One last issue to think about. We’ve been talking about consultants’ pay from the NHS. But they’re also free to do work privately. Unfortunately, we don’t know how much they earn on average from this. (We couldn’t find any reliable data – if you have some, let us know!)

The BMA has said that any striking doctors “should not schedule any other work, including in private practice, when they are taking part in industrial action”.

However, there’s nothing stopping them legally.

And consultants may have also benefitted from their junior doctor colleagues striking. “It appears that the medical pay bill has increased over strike periods. So some doctors are demanding and receiving large amounts to cover a shift,” Mr Palmer told Sky News.

“But in that context, there doesn’t seem to be as much of a financial friction as there would be in maybe some other services and professions about going on strike for some staff,” he added.

To sum it up: consultants have high salaries compared to the UK average; they may have earned more money during other BMA strikes and they may – if they choose to – work privately during strikes. That gives them more financial resilience than other occupations: a train driver can’t really drive a private train on a strike day.

Coupled with that very real 15% drop in wages, they could be prepared to wait a long time for a better offer.

The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.

UK

Lingering dread over what else about Prince Andrew could still emerge

Published

38 mins ago

October 20, 2025

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Lingering dread over what else about Prince Andrew could still emerge

Just a cursory glance at the headlines, and it’s clear the disgrace and downfall of Prince Andrew is not over.

So what next for the man and the monarchy?

The King might have hoped his involvement showed direct action had been taken.

He certainly does not want any distraction from his upcoming state visit to the Vatican.

But that might be wishful thinking.

Now the Met Police has been dragged in too. Forced to look into reports in the Mail on Sunday that Andrew asked his protection officer to smear his accuser, Virginia Giuffre.

The prince allegedly wanted his officer “to dig up dirt” and told an aide at the palace what he had done.

Let’s be clear: back then, Andrew’s security was funded by the taxpayer.

So are we reaching the endgame, and what does that look like?

Andrew might have given up the use of his title, Duke of York, and other honours too.

But what about his style ‘prince’? Some want that ditched too.

It’s a complicated but not impossible process. Andrew could, of course, just stop using it voluntarily.

Some want him to give up his home, too. For a non-working royal, the stately Royal Lodge, with its plum position on the Windsor Estate, is an uncomfortable optic.

Andrew’s wider family is worried. The Sunday Times has reported that the Prince of Wales wants him cut off completely.

With the reputation of the monarchy at risk, William does not want to appear weak. He’s putting loyalty to “the firm” firmly above his familial relationships.

Prince Andrew has always strongly denied the allegations, and restated on Friday: “I vigorously deny the accusations against me”. Sky News has approached him for comment on the fresh allegations set out in the Mail on Sunday.

But with Virginia Giuffre’s tragic death and posthumous memoir due out on Tuesday, Buckingham Palace will be braced for more scandal.

When Andrew gave up his titles, there was certainly a sense of relief.

There is now a sense of dread over what else could emerge.

UK

Why Andrew hasn’t given up being a prince – amid call for him to ‘live in exile’

Published

38 mins ago

October 20, 2025

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Why Andrew hasn't given up being a prince - amid call for him to 'live in exile'

Sky News’ royal commentator has explained why Prince Andrew has not given up being called a prince – while another expert has said “the decent thing” for him to do would be “go into exile” overseas.

Andrew announced on Friday that he would stop using his Duke of York title and relinquish all other honours, including his role as a Royal Knight Companion of the Most Noble Order of the Garter.

However, he will continue to be known as a prince.

Royal commentator Alastair Bruce said that while Andrew’s other honours and titles were conferred to him later in life, he became a prince when he was born to Elizabeth II while she was queen.

He told presenter Kamali Melbourne: “I think […] that style was quite special to the late Queen,” he said. “And perhaps the King, for the moment, thinks that can be left alone.

“It’s a matter really for the King, for the royal household, perhaps with the guidance and advice of government, which I’m sure they are taking.”

Since Andrew’s announcement, there has been speculation over whether any further measures will be taken – and one author has now called for him to “go into exile”.

Andrew Lownie, author of The Rise And Fall Of The House Of York, said: “The only way the story will go away is if he leaves Royal Lodge, goes into exile abroad with his ex-wife, and is basically stripped of all his honours, including Prince Andrew.”

Royal Lodge is the Windsor mansion Andrew lives in with his ex-wife, Sarah Ferguson, who has also lost her Duchess of York title.

Mr Lownie continued: “He makes out he’s an honourable man and he’s putting country and family first. Well, if he is, then the optics look terrible for the monarchy. A non-working royal in a 30-room Crown Estate property with a peppercorn rent.

“He should do the decent thing and go. And frankly, he should go into exile.”

Mr Lownie added if the Royal Family “genuinely want to cut links, they have to put pressure on him to voluntarily get out”.

Andrew’s decision to stop using his titles was announced amid renewed scrutiny of his relationship with paedophile Jeffrey Epstein, and fresh stories linked to the late Virginia Giuffre.

Ms Giuffre, who was trafficked by Epstein, alleged she was sexually assaulted by Andrew on three occasions – which he has always vigorously denied.

The former duke paid to settle a civil sexual assault case with Ms Giuffre in 2022, despite insisting he had never met her.

UK

Families whose loved ones took their lives after buying poison online write to PM

Published

38 mins ago

October 20, 2025

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Families whose loved ones took their lives after buying poison online write to PM

Bereaved families whose loved ones took their own lives after buying the same poison online have written to the prime minister demanding urgent action.

Warning: This article contains references to suicide

The group claims there have been “multiple missed opportunities” to shut down online forums that promote suicide and dangerous substances.

They warn that over 100 people have died after purchasing a particular poison in the last 10 years.

Among those who have written to Downing Street is Pete Aitken, whose daughter Hannah was 22 when she took her own life after buying the poison from a website.

Hannah was autistic and had ADHD. She was treated in six different mental health hospitals over a four-year period.

Mr Aitken recently spoke to Sky News around the second anniversary of Hannah’s death.

He said: “Autistic people seem to be most vulnerable to this kind of sort of poison and, you know, wanting to take their lives.”

Sky News is not naming the poison, but Hannah was able to buy a kilogram of it online. Just one gram is potentially fatal.

“There’s this disparity between the concentration required for its legitimate use and that required for ending your life. And it seems quite clear you could make a distinction,” Mr Aitken said.

Analysis from the Molly Rose Foundation and the group Families and Survivors to Prevent Online Suicide Harms says at least 133 people have died because of the poison. It also says coroners have written warnings about the substance on 65 separate occasions.

The report accuses the Home Office of failing to strengthen the regulation of the poison and says not enough is being done to close dangerous suicide forums online.

Lawyers representing the group want a public inquiry into the deaths.

In a joint letter to the prime minister, the families said: “We write as families whose loved ones were let down by a state that was too slow to respond to the threat.

“This series of failings requires a statutory response, not just to understand why our loved ones died but also to prevent more lives being lost in a similar way.”

The group’s lawyer, Merry Varney, from Leigh Day, said: “The government is rightly committed to preventing deaths through suicide, yet despite repeated warnings of the risks posed by an easily accessible substance, fatal in small quantities and essentially advertised on online forums, no meaningful steps have been taken.”

A government spokesperson said: “Suicide devastates families and we are unequivocal about the responsibilities online services have to keep people safe on their platforms.

“Under the Online Safety Act, services must take action to prevent users from accessing illegal suicide and self-harm content and ensure children are protected from harmful content that promotes it.

“If they fail to do so, they can expect to face robust enforcement, including substantial fines.”

They added that the position is “closely monitored and reportable under the Poisons Act, meaning retailers must alert authorities if they suspect it is being bought to cause harm”.

“We will continue to keep dangerous substances under review to ensure the right safeguards are in place,” they said.

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.