Earlier this month I wrote to Health Minister Jeremy Hunt MP about the concerns myself and many of my constituents have raised about the proposed changes to contracts of our hardworking Junior Doctors.
I have also signed EDM 539 "Junior Doctors" which states the following:
That this House recognises that junior doctors are dedicated professionals who are the backbone of the NHS, providing the best quality care for their patients; believes it is essential to ensure a contract that is safe for patients, junior doctors and the NHS; supports the view of the BMA's Junior Doctors Committee that the best outcome for junior doctors is a contract agreed through genuine and meaningful negotiations and therefore calls on the Secretary of State for Health to drop all preconditions; further believes it is essential that proper hours safeguards are introduced to protect patients and their doctors, together with proper recognition of unsocial hours as a premium time, and an agreement that work on Saturdays and late evenings cannot be considered the same as daytime on a weekday; believes there should be no disadvantage for those working unsocial hours compared to the current system, nor for those working less than full time and taking parental leave; is concerned that the NHS Trust's responsibility to monitor the number of hours worked has been withdrawn and urges its reintroduction; further recognises that junior doctors already work seven days a week for emergency work, and that the barriers to extend that to non-urgent elective work are the lack of complementary services, for example social care packages and pharmacists, not doctors' working patterns; and urges the Secretary of State to accurately reflect this reality in his statements, to work to restore morale within the NHS, and to bring an evidence-based approach to renewed negotiations.
After receiving so many correspondence concerning these poorly thought out proposals I thought it would be best to publish the letter I sent to the minister on the 15th October 2015. I will endeavour to update you on any responses I receive back.
Dear Rt Hon Jeremy Hunt MP,
RE: JUNIOR DOCTOR CONTRACTS
I am writing to express my concern regarding the Government’s proposed changes to Junior Doctors contracts, affecting all 53,000 junior doctors working within the NHS in England from August 2016. My key objection is that this contract will damage patient care as tiredness and exhaustion cause mistakes in clinical care. Your claim that it will improve doctor’s work-life balance and work patterns is wrong in my view. I am especially concerned that this contract will hit women working in the NHS the very hardest.
These contract changes would result in a punitive overall pay cut of 15-40% for the vast majority of Junior Doctors who can have in excess of 11 years’ experience working at the frontline of the NHS. I believe plans to extend ‘standard’ working hours is both unsafe and unfair for doctors and patients and is not borne out in the published evidence base. It has been demonstrated time and again that tiredness and exhaustion results in mistakes in clinical care. This clinical risk is compounded by reducing break time at work for doctors to 20 minutes every 6 hours.
In extending the standard working week to include weekends and late evenings maintaining any kind of work-life balance will be near impossible; and harder still for anyone with childcare commitments.
The net effect being that women and people with families are effectively frozen out of certain medical specialties such as A&E and Paediatrics which tend towards more antisocial hours. At a time when we have a shortage of A&E doctors, which has resulted in an ever increasing agency staff bill and a financial crisis in the NHS, I do not see how these proposals make fiscal sense.
Your plans to significantly reduce break time would mean that in an 11 hour shift a doctor would only have 20 minutes to rest. What effect would this have on the health of pregnant doctors?
I am also concerned that removing annual incremental pay progression and pay protection also puts women at a disadvantage. Doctors who take time out of a training programme and then return to work part time would not be eligible for annual increases in pay despite gaining additional skills and experience. I am concerned that this hurts women taking maternity leave who then return to work part time while raising children.
It is also women who are less able to absorb a pay cut of this magnitude considering the high cost of childcare. Part time childcare on average costs over £100 per week. A FY1 junior Doctor with a starting salary of £22,636 would have a weekly pay of £346 post-tax; childcare therefore takes up 1/3 of their entire weekly income.
I believe your contract proposals act as a serious disincentive to women considering studying medicine. If approved I believe it will lead to an already male dominated profession becoming even more so. Overall, this sends a powerful message to current and future trainees that if you want to have a career, if you want to have children, then the NHS is not for you.
I seriously urge you and the Government to reconsider your current position. It is imperative that you constructively engage with the BMA and continue talks. It is essential that we reach a negotiated settlement. I know that Junior Doctors do not wish to strike but I fear they are being offered little other choice.
Dawn Butler MP
Member of Parliament for Brent Central
Chair of the Women’s PLP