Scotland facing ‘mass exodus’ of junior doctors, medical leaders warn

A “mass exodus” of junior doctors is likely unless the Scottish Government takes immediate action, ministers have been warned.

A survey by the British Medical Association (BMA) of junior doctors in Scotland found more than 40% are “actively researching” leaving the NHS – while almost 80% expect to have to take on a second job this year to help pay their bills.

Dr Chris Smith, chair of the BMA’s Scottish junior doctors committee, said: “Our survey results show us that more than four in 10 doctors are actively researching leaving our NHS – which would leave massive gaps in an already stretched workforce and seriously threaten quality of care.

“The health service is already on its knees – it simply cannot afford to lose any more valuable members of staff, but this is where we are now.

“We risk a mass exodus of junior doctors in Scotland if the Scottish Government does not take immediate action.”

A total of 730 junior doctors in Scotland took part in the survey, with the results published as the organisation prepares to ballot junior doctors on strike action over the Scottish Government’s approach to pay.

Some junior doctors earn “as little as £14 per hour”, Dr Smith said – saying this “disgraceful” pay rate leaves some “struggling to pay their rent or mortgages and heat their homes”.

More than half (56%) of the junior doctors surveyed revealed they had had to work paid overtime or take on additional shifts as a result of their financial situation, and 19.7% said they have struggled to pay their rent or mortgage at some point in the last 12 months.

Almost all (95%) junior doctors said they are worried about the impact the rising cost of living will have on their personal situation, with 51% saying they are “very worried”.

With the strike ballot opening on March 29, Dr Smith said the “extremely worrying” survey findings show junior doctors have “simply had enough”.

He described junior medics as being a large and “crucial” part of the NHS workforce, but said years of below-inflation pay rises, combined with the increasing cost of living, has left them feeling “underappreciated, undervalued and demoralised”.

Dr Smith said: “It is shameful that 80% of those who responded to our survey are reporting they will need to take on a second job in the coming year just to meet their financial needs.

“Many junior doctors already work around the clock and being forced to take on a second job or additional shifts will only further increase the risk of burnout and exhaustion – leading to safety concerns not only for them but for their patients too.

“Junior doctors in Scotland are ready to stand up and be counted and we will open our ballot on strike action later this month.

“Our pay has been eroded over the last 15 years and we are not worth 23.5% less than our counterparts in 2008 – we do not carry out 23.5% less work.

“That’s why doctors deserve pay restoration based on our skills and sacrifices. We shoulder enormous clinical responsibilities; we make complex and consequential decisions in high-pressure environments, and we provide an essential service for the people of Scotland.

“That alone should justify a wage that mitigates against the cost-of-living crisis, covers our examination fees and sufficiently values the job we do.

“Actions speak louder than words – this is the Scottish Government’s chance to make amends, and they can do so by entering into meaningful and direct negotiations with us over pay restoration within the next five years.

“By doing so they can finally begin to resolve the retention crisis our NHS faces, securing staffing for generations to come, while at the same time averting the strike action we are currently compelled to ballot on.”

Scottish Health Secretary Humza Yousaf said he recognises the “importance of junior doctors” to the NHS in Scotland, but he added there is no additional cash for pay for them “without cutting funding to the NHS and other public services”.

He said: “Junior doctors in Scotland have already been awarded a 4.5% pay uplift for 2022-23 recommended by the independent Doctors and Dentist Pay Review Body.

“I am disappointed BMA Scotland is planning to ballot junior doctors on industrial action, which would be in no-one’s interests.

“As I made clear when I met with the chair of BMA Scotland’s junior doctors committee, their demands for an above retail price index pay increase, plus an additional ask of 23.5% – meaning a pay raise of more than 35% – is simply unaffordable.”

He has now asked the Doctors and Dentist Pay Review Body to consider making a “separate and specific recommendation for junior doctor pay in 2023”.

But he stressed: “I have been very open about the real fiscal challenges we face, have explored all options for 2022-23 and there’s no additional money for pay without cutting funding to the NHS and other public services.”