Junior Doctors deserve better from the government

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.

Ian Duncan-Smith says he wants to make those on benefits 'better people'!

By any account, the government's austerity strategy is utilitarian. It justifies its approach by the presumed potential ends. It's objective is to cut the deficit, but it has also adopted another objective which is specifically targeted. It seeks to drive people off benefits and 'back to work'. The two together are toxic to the poorest in society. Those least able to cope are the most affected by the cuts in benefits and the loss of services. It is the coupling of these two strategic aims that make their policies ethically questionable. For, by combining the two, slashing the value of benefits to make budget savings while also changing the benefits system, the highest burden falls on a specific group, those dependent on benefits. For the greater good of the majority, a minority group, those on benefits, are being sacrificed; sacrificed on the altar of austerity. And they are being sacrificed in part so that others may be spared. Utilitarian ethics considers the ba...

Ethical considerations of a National DNA database.

Plans for a national DNA database will be revealed by the Prime Minister this week. This is the same proposal the Tories and Liberal Democrats opposed when presented by the Blair government because they argued it posed a threat to civil liberties. This time it is expected to offer an 'opt-out' clause for those who do not wish their data to be stored; exactly how this would operate isn't yet clear. But does it matter and does it really pose a threat to civil liberties? When it comes to biology and ethics we tend to have a distorted view of DNA and genetics. This is for two reasons. The first is that it is thought that our genome somehow represents the individual as a code that then gets translated. This is biologically speaking wrong. DNA is a template and part of the machinery for making proteins. It isn't a code in anything like the sense of being a 'blueprint' or 'book of life'. Although these metaphors are used often they are just that, metapho...

Work Capability Assessments cause suffering for the mentally ill

People suffering from mental health problems are often the most vulnerable when seeking help. Mental health can have a major impact on work, housing, relationships and finances. The Work Capability Assessments (WCA) thus present a particular challenge to those suffering mental illness. The mentally ill also are often the least able to present their case. Staff involved in assessments lack sufficient expertise or training to understand mental health issues and how they affect capability. Because of concerns that Work Capability Assessments will have a particularly detrimental effect on the mentally ill, an e-petition on the government web site calls on the Department of Work and Pensions to exclude people with complex mental health problems such as paranoid schizophrenia and personality disorders. Problems with the WCA have been highlighted in general by the fact that up to 78% of 'fit to work' decisions are being overturned on appeal. I...

The Thin End

Search This Blog