Dr Mudasir Firdosi / London: January 5, 2016

Jeremy Hunt, the Heath Secretary for the United Kingdom is trying to change the contract terms & conditions for the 45000 junior doctors working in the National Health Service (NHS).  These changes will apply only in England. Scotland and Wales are not bringing the changes and Northern Ireland is yet to decide.

The dispute dates back to 2012 when the Department of Health (DoH) called for changes and after many years of talks with the British Medical Association (BMA) which represents the junior doctors, the negotiations broke down in October 2014 with the BMA complaining about then ‘heavy handed’ approach of the government and the threat of imposition by the Health Secretary.

All doctors, who have qualified MBBS and are training in various specialities to become consultants come into the category of Junior Doctors. The basic starting salary of a junior doctor is around £22 636 per annum.  As per the current contract, doctors working between 7 am to 7 pm week days are paid basic rates and working beyond these hours including weekends called as ‘unsociable hours’ are paid additional money by a complex system called banding.

The government wants to expand plain time to 7 am to 10 pm Monday to Saturday, meaning that an hour worked at 9 pm on a Saturday would be worth the same as 9 am on a Tuesday. This would mean in practical terms reduction of around 30% in net salary if the new contract comes into force. The guaranteed pay increase linked to the time in the job are also scrapped with proposed changes and replaced with a system of progression through set training stages. This would mean doctors going for breaks from job e.g. for research or pregnancy will lose out in the long term.

The Health Secretary has been trying to sell the idea of contract change to public as providing 7 days NHS service which is misleading as the junior doctors already work 7 days which includes the weekends. There is a concern that if these changes come in, the hospitals will rota doctors for longer hours as the penalty to do so under the current system will be removed. This would mean overworked and tired doctors who are more likely to make mistakes, putting the safety of patients at risk.

With the negotiations failing, the BMA balloted for industrial action and more than 98% doctors voted for strike action. The strikes were planned for December 1st, 8th and 16th.  Just a few days before the strike action, Jeremy Hunt proposed to give a hike of 11% in the basic salary which was rejected by the British Medical Association (BMA) and was termed as a media spin to mislead people.

Even with this 11% pay rise, the doctors’ calculated that they would have net pay loss if the new contract is imposed. The main demands from the BMA to call off the strike and join the negotiations were:

•   Withdraw the threat of imposition

•   Proper hours safeguards protecting patients and their doctors

•   Proper recognition of unsocial hours as premium time

•   No disadvantage for those working unsocial hours compared to the current system

•   No disadvantage for those working less than full time and taking parental leave compared to the current system

•   Pay for all work done

The junior doctors took out protest marches in various cities of England. Ultimately, with severe pressure from many organisations and the Opposition, the Health Secretary agreed to the intermediation by the independent Advisory, Conciliation and Arbitration Service (Acas), between the BMA, NHS Employers and Department of Health (DH). Finally, after 5 days of severe negotiations Jeremy Hunt withdrew the threat of imposing the new contract just a day before the strike was about to go ahead.  The BMA responded within no time and called off the strike in the interest of patients.  The Health Secretary was heavily criticised about delaying his decision which resulted in the cancellation of routine surgeries and appointments.

It is hoped that with the mediation of Acas, the talks will progress and the two parties will come to some agreement so that junior doctors do not lose in the process and ultimately patient safety is not compromised, which is at the heart of the NHS.

There are allegations that the current government is trying to privatise the NHS and pushing the junior doctors to the edge is one way of destabilising this wonderful institution which is free to all, from the entry point.

 

It is often claimed in the media that this is about providing a 24/7 NHS, but this could not be further from the truth.  In reality, it is nothing but a gimmick which will lead to destabilisation of the free NHS and ultimately to privatisation.