Taking difficult decisions on money for healthcare
Last year Agenda for Change trade unions received a 5.5% pay uplift and have recently, unanimously accepted, a two year pay deal of 4.25% in 2025/26 and 3.75% in 2026/27. This pay agreement will benefit almost 170,000 NHS Agenda for Change staff – including nurses, midwives, paramedics, allied health professionals, and porters. This will see a Band 5 nurse at the top of their grade getting a £1,689 pay uplift in 2025/26.
I was pleased to reach an agreement with consultants in 2024/25 on a 10.5% uplift which equated to a significant investment of £124.9 million in their pay and reward package. This ensured consultant pay remains competitive with other UK nations.
Neil Gray said difficult choices had to be made (Image: PA) As we look to this year's pay settlement, it has been absolutely crucial to ensure that any pay increase is fair, affordable and equitable.
I have carefully considered the recommendation of a 4% increase from the independent Doctors' and Dentists' Remuneration Body (DDRB), which advises on these matters at a UK level.
I feel this represents a fair and equitable offer and we are implementing the recommendations immediately to ensure uplifts and backpay are received in July salaries.
We have had to make difficult decisions to redirect funding from within the health portfolio. Redirecting funding from patient care is never an easy decision, but I have done so to respect the independent DDRB process and set the Scottish Government on a financially sustainable path.
I have been clear I am unable to go beyond the DDRB recommendations. In the coming weeks we look to hold discussions with the BMA to explore non-pay elements which could be included in this year's deal.
With average CPI inflation forecast to run at 2% over the course of the 2025/26 financial year, a 4% increase means they will receive an above inflation increase which will see consultants raises of between £4,286 and £5,695, meaning at the top of their scale, a consultant will earn a basic pay of £148,064. For specialty doctors, this increase would see their wage rise by between £2,468 and £3,845, with those at the top of their grade earning a basic salary of nearly £100,000.
As I travel up and down the country and meet staff working in our hospitals and health centres, I see first-hand the outstanding work staff in our health service are undertaking and I am extremely grateful for their contribution.
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However, I also hear about the demands staff are dealing with and impact this can have on morale and wellbeing. We know that teams are facing pressure right across the NHS – from porters to consultants - and I want staff to know; we hear your concerns and we are determined to take action and ensure we are directing resources to the right places to relieve pressure on the system.
In recent weeks we announced the allocation of £106 million to tackle waiting times. This investment will help clear the longest waits and I hope demonstrate to staff that we are taking measures to clear the backlog of treatment facing teams currently.
The investment is part of the £200 million announced as part of the Programme for Government to build capacity, tackle delayed discharge and improve patient flow through hospitals.
We are determined to do more on recruitment - a new project called the Future Medical Workforce will seek to explore issues of workforce planning. This will allow us to hear directly from doctors in order to make improvements to the medical education pipeline, ensuring we can continue to deliver the medical workforce Scotland needs.
I have continued to invest significantly in training as we want to have the best qualified people working in our NHS. There are a record high number of Medical & Dental Consultants in Scotland, including Directors. Under this government, the number of Consultants has increased by 70% and our NHS workforce has seen 12 consecutive years of growth.
I recognise the challenges that the Health Service faces and I am determined to do more, but I strongly believe that this must be done in a way that treats all staff with fairness and equity.
Neil Gray is the Health Secretary and MSP for Airdrie & Shotts
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