Junior doctors have made the difficult decision to take part in further strikes – this time once a month for a week each time (Monday to Friday) during normal working hours. So what is this dispute all about?
Who are these Junior Doctors?
Junior doctors are any doctors who are not consultants or fully trained General Practitioners (GPs). They range from new doctors straight out of medical school (usually in their mid-twenties) to senior registrars (often in their mid-to-late-thirties). Like all of us, they have homes and bills to pay for and usually families to provide for.
But isn’t the government giving them a pay rise? Why are they complaining?
No. Jeremy Hunt, the Health Secretary, has talked about increasing the basic pay for juniors by 11%. But he actually proposes to cut their unsociable hours supplement – which can contribute up to 50% of their pay. So in real terms the doctors would receive a pay cut, which would hit those who work unsociable hours the hardest. These are specialties like A&E, Acute Medicine and Intensive Care where we already struggle to recruit enough doctors due to the negative effects on family life.
What about weekend cover?
Jeremy Hunt has spent a long time misusing data regarding “the weekend effect” in hospitals – the marginally increased mortality for patients admitted to hospital at the weekend is multifactorial and the causation is very unclear. And his proposed contract changes would not actually provide any additional weekend cover. They would, however, remove safeguards on the maximum number of hours junior doctors could work, and the type of shifts they could do. These safeguards were put in place to try to avoid doctors making mistakes when they are over-tired, and putting their own lives, and those of their patients, at risk. Junior doctors would also be paid less for working weekends as Jeremy Hunt proposes that Saturday from7am until 10pm should be classed as “normal working hours” and should not attract any unsociable hours supplement. The equality impact assessment on the imposed contract shows that the new contract discriminates against women and single parents – but the government still think it is acceptable to impose the contract.
But surely the doctors should be negotiating, not striking?
Absolutely – and they have been negotiating. But now Jeremy Hunt has announced that he will not take part in any further negotiations and the contract has been imposed, despite junior doctors formally rejecting it.
It can’t be all that bad though? Won’t they just accept it in the end?
No. Many doctors will choose to leave the profession – such is the strength of feeling about this contract. They may leave to practice medicine in other countries (the proposed contract changes do not affect Scotland, for example), they may take up other jobs, or work in the private sector where they can choose what hours they work. Other doctors may decide to switch specialty so that the adverse pay and conditions will have less of an effect. For those that do decide to stay, the working conditions will be even worse as there will be even more vacant posts than there are already. Specialties with the most unsocial hours will suffer the most – like Emergency Medicine, Anaesthetics, Acute Medicine and Intensive Care Medicine. These are the specialties that we depend on the most when we are unwell.
If these proposed contract changes are forced through this will further undermine and weaken our NHS – which should be free and available to all. We must protect our NHS – please stand by our junior doctors.
Dr Serena Carr (Tolhurst-Cleaver)
Consultant in Intensive Care Medicine