Guest post: The government on junior doctors - "We're committed to the values of the NHS"

[MumsnetGuestPosts]

Junior doctors working in the NHS are among the best in the world. They are the leaders of tomorrow and with over 50,000 across the country, the backbone of medical care in our hospitals.

The debate around proposed reforms to their contracts has highlighted their passion and dedication. That's why this week's firm contract offer from the Government and NHS Employers is important.

The Government has been clear that our proposed reforms are about delivering a fairer, safer deal for doctors and patients. This proposal builds on the cast-iron guarantees that the Government has already set out on better basic pay, a shorter working week and improving patient safety.

In order to deliver safe patient care around the clock, seven days a week to patients, we need a culture of safe working hours for NHS staff. The current junior doctors' contract incentivises long hours by rewarding those that work above and beyond the legal limit. Our proposal will change that.

Contrary to suggestions of a return to the long hours of the past, our proposals will reduce hours. The new contract will be based on no junior being required to work more than an average of 48 hours per week, with tougher limits on unsafe hours - including a new maximum working week of 72 hours, down from 91. Employers will be banned from scheduling any shifts over 13 hours too. This will all help to reduce burnout and improve patient safety, so junior doctors can deliver the very best care.

We are proposing an end to the 'week of nights' experienced by many junior doctors, with a new limit of four night shifts in a row and are introducing a new limit of five consecutive long days.

No junior doctor will receive a pay cut compared to their current contract either. Around three quarters of junior doctors moving to the new contract will see an increase in pay, with the remainder getting pay protection. There are a very small minority - around one per cent of junior doctors - who are forced to work excessive hours under the current contract and who will be better protected under the new contract against breaching hours limits. Junior doctors will get better basic pay based on progression through training instead of time served, a shorter working week and improved patient safety.

As the British Medical Association (the union for junior doctors) has now begun balloting its members for strike action, it's important to be clear about how we're making pay fairer.

We will remove the current situation where two doctors working very different hours can be paid the same. We will remove the complex banding payments system and replace it by paying doctors for hours worked. As opposed to misleading statements by the BMA, there will be around an 11% increase to junior doctors' basic pay - with proportionately higher pay for unsocial hours.

To support this offer, junior doctors can now log on to a pay calculator where they can work out projected pay. This can be found at here.

Everyone working in the NHS wants to give patients the same high quality care every day of the week and we know that junior doctors already work at weekends, providing good, safe care to patients.

But the current pay structures result in some hospitals rostering three times more senior cover during the week compared to the weekend. Junior doctors that do work weekends already often don't have the right level of support to deliver the safest care we all want.

Over the next few weeks, junior doctors will be invited to briefing sessions with Medical Directors and HR Directors at their NHS Trusts over the next few weeks to elaborate on the offer I have laid out here.

We're completely committed to the values of the NHS - the same values that encourage aspiring doctors to take up a career in medicine. That is why we have stated that a new contract will be in place from August 2016. The Government is very clear that it will not remove this timetable for putting in place a new contract. I hope this firm offer will allow junior doctors to make decision based on fact. Once again, we invite the BMA to come back to the table and negotiate on the detail of this offer to secure a deal that rewards doctors fairly and has safe care at its heart.

[DoctorTwo]

My guess as to why this piece is here is that the government demanded right to reply. A government that is so out of touch that its leader is surprised that the council in his own constituency is cutting front line services.

For the record, I'm not a doctor, nor am I a nurse. I am an occasional user of the NHS, an ordinary member of the public who supports the junior doctors because I can see where this shower of duplicitous bastards is taking us.

[Becles]

Bullshit, bullshit, bullshit.

This is merely a few steps towards inching the nhs towards privatisation.

When parliament has to function on a 10% year on year cost savings AND every health minister who blocked the NHS 1% payrise yet took 11% themselves can explain this in words other than 'we're worth it', I call fatuous, insultingly thinly disguised, patronising, ruinous, demoralising bullshit.

Dear MNHQ, I hope you will be asking for a response to the comments on this thread, or was this just a puff piece to fluffy thinking layeedees that missed the mark? If not, you need to strongly review your guest posting guidelines.

[nocoolnamesleft]

I've worked those longer hours. Here's the odd thing, when you've been up for 36 hours straight, your maths goes to pot. If you've had no sleep in the last 72 hours, you can't even walk in a straight line, or string a coherent sentence together. But at least noone was epxecting me to bounce in and out of night shifts like a demented yoyo, whilst commuting all across the region, due to imposed rotations. Too many doctors crash driving home from their shifts. When you are too tired, you are not safe to look after patients. And you sure as hell aren't learning.

[DeoGratias]

It's all about money. It's ridiculous to think it's about helping the poor doctors to work fewer hours.

In fact in my view longer hours mean better doctors as you get more experience and I don't care if male or female working fathers or working mothers don't like that, it's a fact. You work short hours at your peril.

[TweenageAngst]

I am a nurse in the NHS. I will fully support my Junior Doctor colleagues in any strike action the wish to take. They are dedicated, hard working and now demoralised.
You will be coming after us nurses next wont you Ben?. Do you think we are all stupid? It is the goodwill of the professionals who work in the NHS which has kept it going for as long as it has. You are intent on destroying our good will and then selling off a broken system piecemeal to the American companies you are already allowing into our hospitals to try and seduce the staff.
I do hope you enjoy your weekend in the country. I will be going to work.

[TelephoneIgnoringMachine]

Im not quite sure what the point was at all with this man writing on here.

He hasnt responded to any of us.

My thoughts exactly. So I Googled the piece. Look what came up.

www.huffingtonpost.co.uk/ben-gummer/safer-for-patients-fairer_b_8490936.html

www.thenorthernecho.co.uk/features/13944119.We_want_to_make_the_NHS_the_safest_in_the_world/

[PacificDogwod]

Yes, I support the strike too.

[Melty]

Absolutely.
The Junior Doctors, or Specialist Trainees as most of them are, deserve our support.
If Hunt wont concede, it opens the doors for a much worse future. For all of us.

[Tiredemma]

Im not quite sure what the point was at all with this man writing on here.

He hasnt responded to any of us.

Do we support the intended strikes?

[TelephoneIgnoringMachine]

I'm rather upset that no-one came back to address our concerns. Not actually bothered what we think, then.

[Melty]

Hunt knows absolutely nothing about health. (Although I suppose he is just following orders and toeing the party line. Just as his lackeys- thats you Mr Gummer in case you were wondering- are)
I have not met one person, not one, in the NHS, who has said anything positive about him since he was appointed.

He gave a speech at the Florence Nightingale conference last year, and his response was lukewarm to say the least.
He doesnt seem to understand anything in relation to the NHS but as he is well known, (and has published) for his views on dismantling the NHS.
I've seen a post on Facebook that sums it up.

"A health minister who believes in homeopathy is like a transport minister who believes in broomsticks"

[TelephoneIgnoringMachine]

Questionable. But it's apparently legal to force people to starve because they had to choose between a job interview & an appointment at the jobcentre, so it follows.

[Hatethis22]

Is it even legal to financially disadvantage doctors who have taken maternity leave in this way?

[DisgraceToTheYChromosome]

Setting aside the bullshit, I remember meeting the honourable gentleman when he was a child. I was not impressed then, I am not impressed now. Most people grow out of this sort of thing, unless of course they're brought up in the purple and trained to treat the electorate as fools.

[MargoReadbetter]

Isn't it averaged over 14 weeks? Which doesn't help when you're on your fifth consecutive night and have a week of day shifts waiting to start.

[SplitterBug]

Picture this:
Junior doctor mum-of-two is a registrar in a fairly antisocial specialty (e.g. acute medicine, surgery, paediatrics, obstetrics..)
'D'H's ego can't cope with having to do his fair share of housework/childcare and decides to play away with OW.
Junior doctor consults MN Relationships , and eventually decides to tell H to FOTTFSOFATFOSM.

Junior doctor realises her current shifts and training rotation will not be feasible as a single parent; starts retraining in a less antisocial specialty and goes part time (still on duty 33 hrs/week).

This is currently affordable, as basic pay in the new specialty includes any increments earned within the old specialty. This will remain affordable under the new contract for this particular doctor, due to the "pay protection" bribe.

Under the new junior contract, someone newly in this position would go back to the ST1 (year 3) level on the payscale - even if they have 8-10 years experience, and even if lots of that knowledge/experience is transferable to the new role.

It could as easily be, for example, a senior surgical registrar who suffers a serious hand injury, can no longer operate, and wishes to retrain in radiology.

These people will probably be lost from the workforce under the new contract, and this will be tragic for the NHS and general public given that we are already on the low side for doctor numbers compared with other developed nations.

It's not just unfair, it's short-sighted, it's madness.

[aireyje]

m.bma.org.uk/support-at-work/ewtd/ewtd-juniors

[aireyje]

This is utter rubbish. The argument used that junior doctors have to work 72 hours in a working week is a direct contravention of the European Working time directive (WTD) This means that no employee should work more than 48 hours in a week unless obviously they have opted out which should be completely voluntary.
I think junior doctors should stop opting out of the WTD, ensure that their NHS trust is monitoring their working hours (which I don't believe in most trusts is being effectively monitored at the moment) and if it is being contravened report them to the HSE for unsafe working practice where they can then be fined up to £5000. If every junior Dr did this the NHS would be forced to recruit 1000s of extra Drs (that from a European WTD perspective should already be in post) and stop the governments rubbish argument that they are imposing these changes from a safety perspective and not a complete money saving scam.
I have to say I do not love your work Jeremy Hunt.

[Devilishpyjamas]

Counting down the days until the next general election. Let's hope there's some NHS/social care/education system left to salvage.....

[shergar]

Hunt and his cronies insisting over and over that subtracting 30% from junior doctors' salaries and then giving an 11% pay rise constitutes an overall pay rise, while making them work more antisocial hours will also improve their quality of life, is risible. It's like something out of Orwell's 1984:

‘You are a slow learner, Winston,’ said O’Brien gently.
‘How can I help it?’ he blubbered. ‘How can I help seeing what is in front of my eyes? Two and two are four.’
‘Sometimes, Winston. Sometimes they are five. Sometimes they are three. Sometimes they are all of them at once. You must try harder. It is not easy to become sane.’

[seabreeze760]

I hope you realise from the above posts that targeting support websites for parents is NOT going to work for the government.

The new contract for junior doctors significantly disadvantages MOTHERS and working doctors - who get pay cuts in wages above that to heir male and their female colleagues with no children just because they want to have time off for maternity leave and possibly work less than full time after this. Given the number of female students in medical school are you completely trying to wipe out the number of mothers wanting to return to work as doctors (i.e. the majority of your work force). I assume if the same pay cut were offered to your wife you would not be feeling the same way.

The government spin on all of this is sickening. To work 24-7 (as we already do) in and for the NHS has to mean that we all fundamentally believe in the NHS and love the work we do. Instead of demoralising us you are thankfully uniting all health care professionals to fight against your plan to break up the NHS. Cutting junior doctors pay (as you are, and don't you dare deny it) will loose us a valuable commodity which in the next 5-10 years will leave us with too few doctors . Loss to the tax payers and a significant loss to the medical profession and its not just the junior doctors planning to leave its consultants and all other NHS professionals too.

Stop the crap. Admit you have run out of money but despite this we work our backsides off to keep the service going and look after the british people and say thank you.

[GuiltyAsAGirlCanBe]

.

[elspethmcgillicuddy]

Thank you mumsnetters for your support. Behind closed doors junior dr social media is going nuts saying how great you all are. Just thought I'd pass on the gratitude :)

[MargoReadbetter]

The very nature of people is changing. Dog eat dog. Strike the other one, let me survive for a bit longer. It's like Stalinism.