Junior doctors contracts-please read

[Limpetsmum]

In my mid 30s, mother of three and I'm a junior doctor.
I just wanted to raise awareness of why doctors are upset at the moment.
We already work many hours a week unpaid (out of good will because we care about our patients). The new contract in essence wants us to work even more but for less money. It's not 'cost neutral' - it's using the same pool of money to recruit more doctors and pay larger number of doctors within the same pool of money. This is resulting in up to a 30% pay cut for doctors.
Furthermore, finer detaIls of the contracts penalises part time workers and those taking maternity leave further.
A common misconception is that our union is not open to talks/negotiations. This is because the powers above will only talk if certain details such as the ones above are accepted ie only the smaller fine print is yet to be decided. Therefore our union has walked out of talks as the contract is being thrust upon us.
Doctors up and down the country are furious and concerned about patient safety as we're being forced to work unsafe hours. we are all concerned with what is going to come of the Nhs. If this is a step towards privatisation by alienating doctors we are the ones to gain in the long run financially as health care becomes private but we all believe in the Nhs and want to work in a safe, free and fair Nhs.
In addition, my own personal view is that I'm a mum of three. I want to see my kids and not have my normal week extended to include 7am-10pm mon-sat. I want to spend time with my kids and be there for my family as I'm there for my patients. I also have a life to fund and kids to support. I have a mortgage to pay and financial commitments.
Please understand why we are upset, why we are considering striking and if you support us, write to your local Mps to raise the issue.

This is not an official post in anyway but a plea for greater understanding from the wider public as I'm left feeling disheartened about my future and my family's future. Thank you for reading.

I will write to my MP and would support striking doctors. Thank you for explaining the issue so clearly.

Thanks BBQueen. None of us want to strike. It's not that we can't, it's our ethics and oath which tell us otherwise. There's only so much I'm willing to sacrifice for the job I love.
That's why I think the greater knowledge the public have on the issue is vital. Please write to your Mps and show your support (if you think we deserve it!)

I think it's worth emphasing that the new contract removes the penalties for health trusts that make their staff work too many hours. This will have serious consequences as many trusts are already understaffed, (this problem will become more acute as this contract change makes the current recruitment crisis even worse) and instead of hirjng more staff or using expensive locums they will look to the obvious easy choice of overworking their current staff.
This contract change will clearly be extended to other healthcare professionals. Overworked, overtired demoralised and underappreciated doctors, nurses, midwives etc do not make the best people to make life and death decisions.
The contract changes won't just hurt the doctors, they will hurt the general public and the NHS as a whole.

Limpet - it was my impression that they will not make you work 7-10 but that these will now not incur a payment enhancement . Am I wrong ?

Also concerned here, I'm a nurse and DH is a doctor . Most of the registrars I now know are talking of emigrating !!

Pippioddstocking - I think the worry is they are taking away the penalties for trusts to overwork their staff so no it's not necessarily going to mean longer hours but practically it is. With the financial difficulties most of the Trusts are currently in combined with the understaffing issues will result in trusts overloading their existing staff rather than hiring more staff or using expensive locums. I think it's also worrying as it sets a precident for change for other NHS staff.
I think they purposely started with Drs and push the salary angle as it's harder to garner public sympathy for Drs especially with the misleading media bombardment over huge Dr salaries - I think the general public really don't understand what the differences between a junior Dr / Consultant / GP (salaried v partner) etc are and even some quite bright people seem to believe drs are all on 6 figure salaries.

The plan is to get a 7 day Nhs. For that to happen all Nhs staff will have to work more evenings and weekends. Doctors are the easiest targets to act on first with paycuts/increased hours as we're seen as 'rich'. It'll be nurses, porters, physios, admin staff all next. By getting rid of the European working time directive, there is no protection for hours to be increased further. When on call I work a 90 hour week already (without adding on the unpaid overtime).
In retrospect, we're not the ones to be hit first - I think it was the tube drivers. After all how are people to get to work if there is no tube service. I think this is careful plan to try and create mr hunts vision of a 7 day Nhs. But truth be told, the country can't afford elective procedures over the weekend. His expectations are too high for the money in the pot. Therefore, cut peoples pay, make them walk out and welcome private healthcare in replacement.

The cynic in me doesn't think Hunt really wants a 7 day service but is purposely setting up another part of the service to fail so it can be shown as completely broken and not fit for purpose, so it can be 'saved' by the private sector.

Marking my spot, have to go out now. I'm a physio & completely support the junior Dr stance

Maplesglobe - I'm not a big mumsnetter so not show how to make this chat. But feel free to copy and paste.
For all those supporting junior doctors - please write to your Mps, please spread the word to Non medics/NHS staff. We make up a large component of the workforce in the NHS but I don't think the general public listen to us as they seem to think we don't work hard and earn a lot. This is going to affect us all in the long run - we're just the first to be hit!

I've reported it to HQ and asked if it can be changed from politics to chat.

worked it out, should be on chat now. I had cross posted on a few threads, but if chat is where most people go, then hopefully I'll capture more of the public there.

maplesglobe - its not had any views or comments yet on chat. DO you think you could make a quick comment to get the ball rolling...?

I don't get why as a doctor you wouldn't have to work extended hours. Nurses don't have the choice

Of course we work extended hours. I currently can work 90 hours a week. We do night, weekends etc. these are our 'oncalls' and part of our wage is made up of 'on calls'. What the govt are wanting to do is increase our normal working day so mon-sat 7am-10pm is a normal working day. On top of that they want to take away two protective factors to stop us working 24/7. Currently there's the European working time directive (EWTD) which limits the hours we can work. Secondly if hospitals don't abide by this our hours are monitored and we're paid a supplement accordingly - the more hours we work the more that supplement is.
Jeremy is pushing forward our new contracts and in the background mr Cameron is trying to abolish the EWTD. Therefore the end aim will be to have us working as much of the 7-10pm mon-sat as possible with the reduced pay. We'll go back to working over 100 hour weeks BUT our job is even more pressurised now. - growing population, increasing demands, innovative techniques. The beds are full in hospital and full of really sick people. 30 years ago you'd be in hospital for 3 weeks following a Caesarian. Now you're discharged after 2 days. Imagine the turnaround of patients and intensity. It's not safe. We can't function doing that many hours, we'll make mistakes and the public will be affected as a result.
Then, all other health professionals will be affected. If doctors are willing to work x many hours for reduced wage; nurses, porters, secretaries will be too. And it's unlikely the govt will keep their wage the same either.

I'm a nurse and this horrifies me. I already think the strain on junior doctors is massive. 12 day stretches of 10 hour days (our juniors rarely leave before 7!), on calls covering multiple wards...I agree with wonkylegs, the cynic in me thinks this is designed to be the downfall on the NHS. There simply isn't the staff to facilitate 7 day working.

Exactly! There's not enough money in the pot for 24/7 NHS services. The NHS is open for acute services over the weekend so if you have a road accident, a heart attack, a massive bleed, We're there ready to serve the public. But jeremy wants non urgent care provided 7 days a week. For that to happen means more staff needed. Which costs money. He's hitting doctors by reducing our pay AND asking us to work more. As I say, we're the easy target as public perceive us as bring 'rich' and using the title 'junior doctor' misrepresents us. I've been qualified over 10 years. In less than a year I'll be a consultant.
It's doctors first, then everyone else in the Nhs next. After all no point having doctors providing the care if there arent any nurses, secretaries, porters.

Jeremy's view on what constitutes seven-day service is flawed. I would love a seven-day NHS. I'd love not to keep babies in hospital because I can't safely stop their antibiotics; I'd love to arrange a scan for as soon as I recognise it's needed, rather than the next available slot. But I can't because even though I (NICU doc) am working, other allied services aren't.

For me it's not so much about money - as with a lot of doctors, I couldn't quote you my exact salary (though I've looked it up and how it will change). It's enough to pay the mortgage, bills and childcare. We can holiday if we're careful and we eat good food. For me, it's about safe working patterns and appropriate remuneration for those. A recognition that it is horrible to miss your baby's wake up and bedtime. That we incur extra costs for out-of-hours childcare and emergency childcare (because when the shit hits the fan at 5:25pm, no-one goes home, regardless of what time nursery closes). That sometimes we might like to go for dinner with our husband, our friends. Or, just stay in and watch a movie.

I fear that all specialties are going to have rotas resembling A&E, with start- and finish- times around the clock, no regard for families or outside commitments. I volunteer in a regular slot on a Saturday morning. I already miss this three weeks out of eight, due to my normal on call pattern. If my trust could employ me then, for the same price as a Wednesday, I'd probably have to stop. It isn't fair for people to rely on me when I can only be there 25% of the time.

The 12-day stretch is already a dangerous time. Seven long days (8am-9pm if you're lucky) and five short days (8-5:30) is great for really knowing your patients inside-out, but not if the doc looking after them doesn't know her arse from her elbow by the end of it. To remove safeguards preventing worse patterns than this is a real risk to safety. I don't want to work when I'm too tired to reason. I definitely don't want to drive home afterwards.

I don't mind losing the annual increment when I'm on mat leave - I don't feel the need to increase pay in this instance as I've not been at work and, therefore, haven't gained experience (notionally what the annual increment is for). But to take it away when researching, or doing overseas work to gain experience...seems counterintuitive. I already do a lot in my spare time to improve my practice, to teach the (other) juniors...all unpaid of course. There's never a day where there are enough doctors to send one off the unit to work on an audit, to write a presentation, etc.

Heck that was a bit long. Sorry!

Doctors already do 13 hour paid shifts (plus the unpaid overtime at the end meaning there is sometimes only 9 hours between start and finish) but the percentage of work outside normal working hours gets a supplement. Just like other allied professionals get.
Working the same 13 hour shifts but without the banding supplement will mean a huge drop in pay for the majority of junior doctors. Why would they want to stay in the UK, or those in six form want to apply for medicine when they can get more working on so many other careers, that require less than 5 years at university. But they will keep applying, as they want to help.

Doctors know their pay would be better in a private Health are system, along with actually being paid for overtime, and the chance of actually getting to stop to eat food on a night shift. But no doctor wants a private healthcare system, as they want the NHS for all. If they were money grabbing they would be pushing for privatisation long ago.

Canada/New Zealand/Australia is set up so much better for doctors to get paid what they work. Why would they not want to leave the country?

The NHS is 7 days a week for any emergency, just not 7 days a week for routine outpatients clinics and elective knee replacement surgery, which is more than acceptable to only occur 9-5 mon-fri

I would certainly be lobbying against this if I were a doctor. Many many London lawyers have a much worse deal and hours actually than doctors not that that matters, just saying.

When you have children, yes it's difficult to have those sort of jobs. I can't have that sort of job, or many others using my skills, unless I have round the clock childcare such as a live in nanny. DH goes away for days, short notice, holidays cancelled etc etc. He's in industry, so not healthcare. However it impacts upon the sort of job I can do. Unfortunately I think it will impact more on women, particularly when they have children. It has implications for women's career paths.