NHS Part 2 - Pay

Ok, now I'm going to talk about pay....

For some reason, the general public feel nurses are extremely hard done by, and that doctors wipe their asses with bank notes. Today I'm going to look at this with proper numbers.

The image above is of NHS Doctor Pay Banding Rules, which i'll refer to later. All other info used in calculations is either from the Royal College of Nursing, the British Medical Association, or the BBC.

Let's assume I'm a Year 1 Senior House Officer (SHO), and therefore have been working in the NHS for AT LEAST 1 year.

My basic salary will be approximately £25,000 / year. Based on current job bandings, I'm likely to be banded at either 1A or 2B, which is 50% supplementation of basic salary, giving us £37,500 / year in terms of gross earnings. Now, after taxes (income and National Insurance contributions), this gives us annual earnings of £27,265.92. For the purposes of this blog, I am going to round numbers from now on to the nearest whole. This works out at monthly take home pay of £2272, or weekly pay of £524. At a 37.5 hour working week (what nurses and most other medically related professions do), that works out at £14 / hour. Sounds very good, right? Wrong, because you can probably count on one hand the number of hospital doctors in the UK who do that few hours, if any.

Remember I said Band 1A or 2B? These jobs generally sit between 48-50 hours, which works out at £11 / hour (for 48 hours).

Band 2A jobs (there are still jobs at this level - I'm about to do one this August), will take you to the European Working Time Directive (EWTD) legal maximum of 56 hours a week. Assuming you do this for a year, this gives you £45,000 before taxes, and £31,690 after taxes. This makes a monthly take home of £2641, and weekly of £609. This makes an hourly pay rate of under £11 / hour.

Now, let's throw in the fact that while nurses almost always get to arrive and leave on their "official" times, doctors - hospital juniors especially - rarely get to do so, and in fact generally spend at least 1-2 hours / day extra at work because they feel guilty about leaving so much additional work for the on-call colleague, or because it would be inappropriate to do so (ie: patient just had a heart attack, or you're in the middle of an operation). Ignoring extra time on the weekends, that already works out at a minimum increase of 5 hours a week, so the Band 1A / 2B people are suddenly floating at 53 hours / week and a rate of a little under £10 / hour, and the Band 2A people are in breach of the EWTD and doing at least 61 hours / week at a rate of approx. £10 / hour.

This is based on the 2005/6 pay scale for doctors, and the 2003/4 pay scale for nurses. Since 2003/4, nurses pay has gone up each year, so in fact they're earning more than what I have stated at these grades.....Oh, and they get overtime at either 30% of basic salary for unsocial hours, or 60% of basic salary for Sundays and bank holidays.

Not let's get some perspective, shall we?

Grade D (basic qualified - approx. equivalent to PRHO) nurses get around £9-10 /hour.
Grade E (senior nurses - approx. equivalent to SHO) nurses get around £9-11 / hour.
Grade F (ward sisters - approx. equivalent to experienced SHO) nurses get £10-13 / hour.

Band 1A / 2B / 2A = Approx. £11 / hour (not counting extra hours normally done).
Band 1A / 2B / 2A = Approx. £10 / hour (counting minimum extra hours normally done).

So, what does this show? Well, that a new SHO nowadays most probably earns an hourly rate equal to that of a BRAND NEW QUALIFIED NURSE, who has only spent 3 years studying, and has no post-qualification experience, versus the SHO who has spent 5-6 years studying, and has at least 1 year post-qualification experience. Or that the nurse actually earns MORE than the SHO.

And remember, up until August 2004, the EWTD wasn't enforced, and doctors were working waaay in excess of the current legal maximum of 56 hours a week. I regularly did 80-100 hour weeks as a PRHO back then. The 2005/6 basic pay for a PRHO was £20,295 (more than 2003/4). For a year of Band 2A, this works out at £36,531 before taxes, and £26,694 after taxes., giving a monthly rate of £2225, and a weekly rate of £513. Now, this is not too far off SHO salaries, is it? Ah, but let's add in the fact that I was working minimum 80 hour weeks around 90% of the time (the fact that I've rounded down to 80 helps offset the other 10% which weren't too far below that anyway), shall we....?

At 80 hours / week, that gives almost £6.50 / hour!

I'm not saying that very senior SHO's, Registrars, and Consultants don't earn more (and in the cases of the top, a fair bit more), but you need to take into account the number of years they've been working, the skill of the profession and the amount of training required, and the responsibility they're under - By which I mean if something goes pear shaped, they take the rap, not the senior nurse who was also present. Personally, I think they've earned it. And conversely, I think that the more senior nurses on the wards who do a lot (not the management gimps) and actually keep order, deserve more pay than they get, which still works out at £15-19 / hour - not bad considering.

But next time you fancy being ignorant and tarring junior doctors with the same brush as a Consultant without checking your facts, don't be surprised if you get the crap kicked out of you by the people who work their asses off at probably twice the hours a plumber does, at half their hourly rate.....