So here we are. Junior doctors across England are to be balloted by the BMA (the doctors union if you like) over potential industrial action in response to the Government’s plans to impose a new contract on junior doctors from August 2016. So how did we get here? Let us be clear. This isn't simply about pay. It is also about patient safety.
Last month the BMA’s UK junior doctors committee rejected the Government’s attempts to force through a new contract over fears for patient and doctor safety, and opted not to re-enter contract negotiations. The decision was made after it became clear that junior doctors would not be able to negotiate over proposals the BMA believes are unsafe for patients, unfair to doctors and undermine the future of the NHS.
The BMA say it has always wanted to reach agreement on a new contract that protects patient safety and doctors’ wellbeing, but rather than work with junior doctors to address their concerns the government has confirmed that it will impose a new contract on doctors in training from August 2016. The Department of Health has it will look to introduce a new contract by August 2016 for new junior doctors and new appointees when they move to new positions but remain as junior doctors. NHS Employers will continue work to prepare a new contract for August 2016. They say they will impose this new contract whilst calling on the BMA to negotiate.
In order to re-enter negotiations, the junior doctor committee is demanding that the Government and NHS Employers withdraw their threat to impose a new contract, and that they provide the following concrete assurances:
- proper recognition of antisocial hours as premium time
- no disadvantage for those working antisocial hours compared to the current system
- no disadvantage for those working less than full time and taking parental leave compared to the current system3
- pay for all work done
- proper hours safeguards protecting patients and their doctors4
Commenting on the decision, the newly elected chair of the BMA’s UK junior doctors committee, Dr Johann Malawana, said:
“Today’s decision is a reflection of the anger felt by the thousands of junior doctors who have told us that the Government’s position is not acceptable.
“The BMA has been clear that it wants to deliver a contract that protects patient safety and is fair to both junior doctors and the health service as a whole. We can only do this if the government is prepared to work collaboratively in a genuine negotiation. Unfortunately, they have chosen to ride roughshod over the concerns of doctors with their threat of imposition.
“Instead of proper negotiations, the Government has insisted that junior doctors accept recommendations made by the DDRB without question. This would not allow the BMA to negotiate over proposals we believe are unsafe for patients, unfair for doctors and undermine the future of the NHS.
“The contract they want to impose will remove vital protections on safe working patterns, devalues evening and weekend work, and make specialties such as emergency medicine and general practice less attractive even though the NHS is already struggling to recruit and retain doctors to these areas of medicine.
“We remain committed to agreeing a contract that protects against junior doctors routinely working long hours, delivers a fair system of pay and does not disadvantage those in flexible working and we will not stand idly by as the Government imposes a contract which undermines that.
“We’ve already seen reports of high numbers of doctors considering leaving the NHS to work abroad6. These figures should serve as a serious wake-up call to the Government that there is a real risk that junior doctors will speak with their feet. To lose a large swathe of doctors in the early stages of their careers would be a disaster for the NHS.
“We have been clear. Junior doctors are not prepared to agree contract changes that would risk patient safety and doctors’ wellbeing. This has been our position all along and in the absence of any attempts by the Government to address our concerns remains our position today.”
The government has picked an unnecessary fight with junior doctors. The call on the BMA to negotiate and yet hold a gun to their heads.