1/ IMPORTANT🧵: Its been a busy week. A new #workforceplan- (supposedly) #RETENTION central to it, to help #CutWaitingLists.
But something is missing from the plan... a plan for PAY.
I produced that chart 👇 2 months ago, new pay & wait data are just in - pls read to end & RT!
2/ The most common come back when people talk about public sector pay is that "everyone has taken a hit" especially given high inflation, but as @JohnBMurdoch @FT showed very nicely in his charts, NHS workers, especially junior doctors, have fared worst of all 👇
@JohnBMurdoch @FT 3/ Like many people I found the charts extremely compelling. There are many different ways to measure pay loss, but I wondered if I could add consultants to the charts which I did - JBM kindly provided a graph to compare and as you can see they were essentially identical
@JohnBMurdoch @FT 4/ There's a small difference (circled) in "all workers all sectors" (an @ONS dataset) during the initial phase of COVID as I have chosen to average pay each month over the prior 12 month period (to better match the @NHSDigital Earnings Estimates methodology) = fairer comparison
@JohnBMurdoch @FT @ONS @NHSDigital 5/ And as with the now expired charts I previously produced (which like the @FT graphs went to Dec '22 as that was then most recent data set) I added some other comparators, perhaps more appropriate for NHS i.e. professional, technical & scientific.
@JohnBMurdoch @FT @ONS @NHSDigital 6/ The bottom line in those charts is that NHS pay had been *massively eroded* compared to 2009, but the whole economy fared pretty well vs CPI inflation, the most commonly used measure of "headline inflation" which is generally preferred by government & economists
@JohnBMurdoch @FT @ONS @NHSDigital 7/ As commentators have pointed out regarding the plan "the ‘elephant in the room’ is pay"
The @TheBMA said it was “illogical and uneconomical as it would not stop the exodus of doctors from the profession"
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 8/ So returning to the central omission from the "plan" - PAY.... @NHSdigital update their statistics each quarter and the final quarter of the 22/23 pay year has just landed - so lets take a deep dive into NHS pay and update all the charts.....
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 9/ So starting with the main pay chart but now to the end of the 22/23 tax year - once again there are HUGE difference in gross pay decline (versus CPI) to comparators. We are *NOT* "in this together. NHS pay declines are worse than the last release, rest of the economy better
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 10/ Taking each group (to March 23 vs Dec 22 as previous)
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 11/ And now adding the waiting list back in (in MILLIONS waiting), it is completely obvious to see the fatal floor in the workforce plan. Contrary to what you may believe from listening to ministers talk about the waiting list, its - sadly - continuing to rise at an alarming rate
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 12/ So what do those pay cuts actually mean for real terms pay had it kept up with even CPI (and there is a STRONG argument for using RPI which is also very valid, for example as it includes mortgage interest payments). It means NHS staff pay has been BRUTALLY cut
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 13/ Compare that to the "whole economy" and the differences are simply flabbergasting.
NHS = BRUTAL Real-terms Cuts - £5-40k/ each and every year DOWN
Whole economy = NOT so much - £1k/yr down - £2k/yr UP
Please *ANY* politician tell me this is "FAIR" or REASONABLE 👇
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 14/ Or maybe someone from the Bank of England pipe up and tell us inflation is "hurting" us all, and we should show "restraint"
I think the public sector, and the NHS has been "restrained" a little too tightly, dont you?
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 15/ Even if we compare those graphs to the official datasets from just one quarter ago (Mar 23 end vs Dec 22 end) you can see how the NHS is being FURTHER strangled, the rest of the economy showing slow improvement relative to inflation
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 16/ In JUST ONE quarter (i.e. 3 months) consolidated annual pay has been eroded by over £1,000 for consultants, and over £700 for juniors - whereas the rest of the economy are slowly improving (and didnt have our huge losses to recover)
Our NHS pay is dropping faster than ever
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA 17/ So @RishiSunak @SteveBarclay have a good look at promise to cut waiting lists. These waiting lists are not due to covid (though worsened by it), and they were not caused by "strikes". Just like inflation has not been caused by public sector pay.
You CANT do this without us
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA @RishiSunak @SteveBarclay 18/ As we ebb toward a general election
1) People are clearly not happy & I suspect very much at the top of the agenda is the PERILOUS state of public services
2) The next general election will I believe be quite close & largely fought on the NHS
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA @RishiSunak @SteveBarclay 19/ Of course past performance not a guarantee for future performance, & Ive not heard ANY of the major parties explain how they will get out of this mess.
Both main parties now want to dbl med students/nurses *BUT* it WONT help IF you cant #RETAIN @wesstreeting @SteveBarclay
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA @RishiSunak @SteveBarclay @wesstreeting 20/ Leading Economists like @MyStephanomics on @bbclaurak have repeatedly debunked the myth that public sector pay rises will significantly drive inflation.
If you want to fix the NHS, you NEED to fix pay (which will help people get economically active)
@JohnBMurdoch @FT @ONS @NHSDigital @TheBMA @RishiSunak @SteveBarclay @wesstreeting @MyStephanomics @bbclaurak 21/ Our NHS is in a dire state. None of this is due to striking NHS workers, or (just) covid, but due to political choices @10DowningStreet
RT if you want this (or the next) government to make the choices to fix this mess now & properly #payrestoration #fixDDRB
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2/ With BMA colleagues we discussed ridiculous tax cliffs in the system which provide a massive discincentive to do extra work (both £100k & £200k tax cliffs) & incentives for some to even DECREASE extra work. Terrible for patients #WaitingLists
Who would want to #TaperTaxHell
3/ But my chart (left) & DHSC example they used to DDRB in 24/25 show only THAT individual, in THAT tax year (and 24/25 was terrible for many).
But it doesnt help an INDIVIDUAL know THEIR position, especially given disatrous pension admin from NHS pension (often years late)
1/ NEW & important - for many of you (the lucky ones) in England & Wales, the new style annual benefit statement - or "Total Reward Statement" has dropped for the 24/25 - but this one is different - very short 🧵
2/ So what's different this time? Crucially this is first set of statements to acknowledge the McCloud remedy for those affected (usually those in NHS pension in March 2012 and between 2015-22).
You will basically get 2 sets of statements "STANDARD" benefits and "ALTERNATIVE"
3/ STANDARD will show ROLLED BACK benefits. Your STANDARD benefits will be in your OLD legacy scheme i.e. 1995 or 2008 for 7 year between 2015-22
ALTERNATIVE will have those 7 years in the 2022 scheme.
EVERYONE (in both set) is in the new 2015 scheme from 2022
1/ NEW & V IMPORTANT update from @nhs_pensions on pension savings statements for 23/24
•@nhs_pensions have self reported to the regulator
•what do YOU need to do for Self Assessment (31/1)
•What compensation might be due
•Next steps
2/ So firstly after @BMA_Pensions wrote to the NHSBSA CEO this is the first time they have openly confirmed in this letter that thay have reported this issue to The Pensions Regulator (our complaint in the quoted tweet below) 👇
1/ V. Important 🧵 if you are CONSULANT in England. This week I used my FREE modeller to identify & correct an error in #AnnualAllowance for 24/25 which I suspect may be a common error. It will save me over £2,600 from my AA liability, buckle up & see if you are affected
Ps RT
2/ As many of you will know Twitter/X is now really difficult to see the information you want to see from the people you follow so please help by RT, but also sending your colleagues on whatsap / FB groups if you think this will help them
3/ In preparation go onto ESR, download Mar '24, May '24 + Nov '24 payslips & 23/24 TRS (+/- 22/23 TRS) - and then I will talk you through IF you are also affected by this "misallocated arrears" error, tell you how to model the impact of this, and how to correct this
1/ THOUGHT FOR THE DAY: Whilst I'm grateful for the changes to LTA/AA, the AA and the dreaded #taper still remain. And here's your regular reminder why its PARTICULARLY unfair, and stupid, in the NHS (from @BMA_Pensions @TheBMA evidence to DDRB).
Short 🧵pls read & share
2/ We are all in CARE now, so should all be paying generally the same employEE contributions.
But we aren't - and its worst - by a garden mile - in the NHS per this chart showing the ratio of conts from the highest earners : lowest earners in the public sector 👇
3/ So unlike in the private sector where there is no difference in cost for higher vs lower owners other than tax relief, we go through this ridiculously unfair step in the NHS - far worse than anywhere in the public sector - that strips away our higher rate relief
1/ very important and NEW: @nhs_pensions have overnight issues guidance on 23/24 tax year where they have failed to send you a pensions savings statement on time (which was their legal duty)
2/ the bottom line is they expect you ESTIMATE your carry forward and PIA and any charge in the normal timescale ie by Jan 31st 2025 …. Which is going to be extremely difficult …..
3/ after you estimate you will have until Jan 26 to correct your estimation based on the real figures