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.

Sorry that was a bit of a ramble

Gender was not part of the equation Grazia when we made this decision. We both started out as physicians doing acute medicine, I specialised further into a specialty that lends itself better to part time working (less impact on patient care) and DH is in a specialty where part time working is virtually non-existent. It was just where our aptitudes lay. If our specialties were reversed DH would have worked part time. The higher earning potential bit refers to the potential for private practice. We both anticipated working for the NHS at the start of our careers, and had never considered going into private practice. But the current government's aims for the NHS is pretty clear and that was why I said if one of us had to give up working, it would have to be me as my specialty isn't one with much potential for private practice, vital as it is for patients.

Doctors work long hours, full time hours on paper are on average 48 hours, many of them unsociable. This doesn't include the early starts or late finishes and the time needed to study and advance in your training. I'm not moaning, just stating facts. We knew from our days as a two-acute-medic couple that raising a family and both of us working full time would be impossible, not least because of the availability and cost of childcare out of the usual Mon-Fri 9-5. Like most other two medic couples, we are nowhere near family that can help either as you get very little choice in the geographical area where you work.

lisa please don't move the htread just becuase I asked for a petition. Much more traffic in Chat for people to debate this.

Oh, I see you've already moved it.

I find it acutely depressing how it always 'makes sense for the family' for the woman to fuck over her career to enable her husband to forge onward unencumbered. That is actually a far greater concern to me, as a woman and mother of daughters, than doctors' contracts.

I think they are completely separate matters whatthe, I also find that depressing but that doesn't mean you can't also be concerned about doctors hours.

It 'made sense for the family' because my career has flexibility to be self employed where as DHs doesn't. If he'd been the architect and me the Consultant then we'd have done it the other way round. In fact I know of a couple where this is the case.
In the current climate of NHS employment we often think it's him that's made the sacrifice not I because the toll the stress and hours has on our family.

But the point is, posters are saying the change in junior doctors contracts are a particular problem for women, because they aren't family friendly. Why is that a particular problem for women? Why can't the fathers share the load, reduce their hours, go flexible, to enable women to continue to build their career? Tinkering about with a contract does not solve a societal issue that goes well beyond the medical profession.

This is partially because the contract changes will have a huge impact of you take time out to have a baby which last time I checked due to the physical nature seemed to be a women only problem. I believe this is somewhat protected by the current contract and will be lost under the changes.

Are you claiming the new contract will remove a junior doctors right to statutory maternity leave? I think that is unlikely - the clue is in the name - 'statutory'. No contract takes precedence over law, so women will still be able to take maternity leave, as they do in other jobs.

I think you have misunderstood me whatthe
The contract will impact everyone of us, some will be worse hit than others. The more unsocial hours you do, the worse off you are. If it makes you feel better our close friends are in the same situation except he will be the one having to quit because his specialty will be worse affected and he is the one currently part time.

I have just stated how this will affect my family personally. The other aspect which is more relevant to patients and public is the removal of safeguards currently in place which prevents doctors working excessive hours. Trusts currently have to monitor our working hours regularly and if found to be in breach in a regular fashion, then the trust is penalised by having to pay the doctors a higher pay supplement for the unsocial hours. Monitoring is currently a joke as diary cards are often lost, or you get told a 5pm during monitoring week that you are not allowed to stay on the ward any more and a different group of doctors who aren't monitored simultaneously have to pick up the slack and add that to their workload. But it is all we have. The new contract does away with this, and there are no financial penalties for trusts so removing their disincentive for overworking doctors. The DoH claim that the European Working Time Directive will form the basis of protection from dangerous working patterns - the same EWTD that Cameron is trying to negotiate an opt out of for the UK.

This issue does go beyond the medical profession. It will impact everyone on agenda for change pay scales as well, as they will have a new contract next year too. The doctors have just been targeted first because if we lose this fight, then other health professionals don't stand a chance when the same conditions are imposed on them. And it impacts on everyone who will need healthcare in this country. In the short term we will have a very poorly staffed NHS at all levels, and when privatisation eventually goes through no NHS at all. No one in my circle of medical friends is working on a fully staffed rota. It's about to get much worse.

The current contract protects your increment when you are on maternity leave, take time out of clinical work to do research, or take time to gain experience in another specialty. The new contract does doesn't. As we have had a pay freeze for the last few years, the increments are the only thing that have kept things on an even keel for many of us, as compulsory GMC, college and indemnity subscription fees all go up the further up the postgrad ladder you are.

That should read the new contract doesn't.

I fully support the junior docs. I also believe this is another brick in the wall of softening up the NHS to privatise.

I'm a non medic in the NHS and am fully aware it will be me next.

whatthe No it won't remove the right for maternity leave - it will as dancing says remove the protection for the increment. Medicine is not a family friendly career choice for either gender to start with so making it even less attractive to women who wish to have a family (or any doctor who does research or change speciality) will have a negative affect on the profession.

limpets if you are still around perhaps ask MNHQ to remove your petition link and move this back to chat?

So sexism rules. The two women whose husband doctors out earn them seem to be totally conditioned to think women earn less than men, go part time and do more dross stuff at home whilst big swiming dick husband gets his career in priority! there is no hope for the advancement of women whilst these attitudes prevail. (writing as someone who earned 10x their husband.... yes many of us do because women and men can indeed be equal and plenty of women enjoy out earning men and having less time to do the housework and pandering to male needs).

Grazia - excuse me but that's bollocks. The decision to become self employed rather than a director wasn't about about salary it was about the fact that my profession allows me to do that and be more flexible, DHs doesn't. By flexible that means I can work from my studio at home, I can be here at night, I can take and off when needed not that I necessarily do less hours just that there is flexibility in how I do them as I'm my own boss.
If you read my post you would see I said I knew of another couple where he was the architect who became self employed and flexible and she became the non flexible consultant. It's not about gender but differences with the demands of our very different professions.
There was a point where I had earning potential higher than DH but I turned that opportunity down because I didn't agree with parts of the job (I had ethical issues with it), DH would have happily supported me if I'd wanted to do it.
I don't care what gender the higher earner is, I am certainly not conditioned to think women earn less than men. In fact in my old firm I earned more that most of my male colleagues as I was more experienced and worked in some lucrative niche sectors.
My point was about the fact that Drs whatever their gender do not have much flexibility within their job, the hours can be unsocialble, inflexible and can seriously impact on family life and family's and partners of either gender often have to make big changes to make that work.

Going back to the original topic Junior Dr contracts - For me the worry with some of the proposed changes with penalise diversity (gender, research, additional training), will make the acute and more unsociable jobs even less attractive than they already are and will exercerbate an existing recruitment crisis. This is bad for us all because it will mean that these already stretched thin specialties will be spread even thinner. This isn't moving towards a real 7 day service or making a safer service for patients, it's breaking 7 day acute/ 5 day elective service and providing conditions for mistakes to be made.

Don't stereotype us Grazia. We chose our specialties based on our talents, not the money. Doctors are a bit funny like that. Like it or not there are some specialties in medicine where private work just isn't viable such as A&E and palliative care. The only reason one of us is part time is so that the children can see a parent once in a while, seeing as even the part time hours are more than a regular full time job. If I can carry on working and we both worked for the NHS, DH and I will both earn the same amount as Consultants.

wonky one of the worst hit specialties will be anaesthetics. Australia and New Zealand must be rubbing their hands in glee as they have always been popular destinations for anaesthetists to do fellowships in. Most come back to the UK despite the better pay and working conditions there but with the new contract cutting their pay and penalising them for taking time out to gain experience, we will only see more of them heading that way. Ditto for A&E.

(yes, sorry it's off topic; it' just time and time again women on mumsnet who could earn a lot end up just by chance and always they say nothing to do with gender end up working part time whilst their husbands' careers continue unaffected by children and as long as this totally by chance, not gender specific but always the woman sacrificing career stuff continues to happen men will continue to hold 80% of positions of power in the UK and be the 90% who are surgeons etc etc. Sadly it is the individual decisions taken between couples which are the biggest reason that women don't advance in the UK rather than overt discrimination at work).

Letter to my MP

Dear Mr Stride,
I am writing to you to express my despair at the proposed changes to the current contract for junior doctors in England. I am afraid that this is an emotional letter rather than one filled with statistics as I am writing this on my first day home alone with my 13 day old baby girl, I hope that fact shows you how important this issue it to me.
My husband is a junior doctor training in anaesthetics and working at the R D and E, he is back at work today in intensive care on a 13 hour shift. He will be a “junior” doctor until he is 37. We both accept that his job comes with long and antisocial hours, it is what he signed up for. He also spends a large amount of his free time revising for compulsory exams, reading journals, teaching, running audits and managing work emails as he does not have time to do these things when he is at work. His job involves inserting needles into people’s spines and injecting them with drugs to stop them breathing so he can put a tube down their throat and keeping them alive through operations. This is a lot of responsibility and these are your constituents that he is taking care of.
To get to where he is today he has completed a first class physics degree, a four year fast track medical degree then worked for two years as a foundation doctor before specialising in anaesthetics and completed two years of core anaesthetics training before starting this, his first specialist year. He still has four years’ worth of training and two very expensive (about £700) exams to complete before he can qualify and apply for a consultant post. We moved to Devon at the beginning of this year from North Wales so he could continue with his training and I had to leave my job. I do not understand why the integrity and dedication of junior doctors is being questioned by the Health Secretary and it seems contrary to Conservative values that someone who has worked so hard and devoted so much time to educating themselves is now being offered a 30% pay cut and worse working conditions.
I feel personally insulted by the reclassification of antisocial hours as this is telling me that my time with him is worthless and it devalues the importance of a family life. As I am sure you are aware, MP’s have just voted to make Commons more “family friendly” to encourage more MP’s, whilst at the same time this change to the contract for doctors does the opposite. My husband already works frankly horrible shift patterns, for example Monday to Thursday 8:00-17:30 followed by Friday- Sunday 8:30-21:30 with only Monday off before he begins again. But we accept this and his pay respects that this is not a sociable working pattern. With the removal of banding, all of his time apart from Sunday will be “social”. Working at 21:00 on a Saturday is not social. At the moment it is just me that suffers, especially when I was working 9-5 full time, but in the future it will be our child too who will not see her father all weekend. A removal of financial penalties to trusts for doctors working these hours will result in more of them, especially when they cannot recruit enough trainees to fill the rota. This will also make it harder for me to return to work and arrange childcare.
I have also unfortunately been a patient recently as things did not go to plan when I had my baby and I was on the receiving end of help around the clock from trainee anaesthetists, obstetricians and neonatal doctors (along with many midwives, auxiliaries and nurses). The registrar obstetrician who took care of my baby was herself heavily pregnant and she told me her ward round makes her sad because she is always making people cry. This new contract that is being imposed will penalise her too and anyone else that wants to raise a family, this means you will lose fantastic people like her with years of training (and therefore investment) if this contract change goes ahead. Clearly the importance of a family life and flexible working is understood by MP’s judging by the vote.
This is about more than just my small family, it will tear the NHS apart. So much rides on the goodwill and compassion of its staff members. I often worry that my husband has been knocked off his bike on the way home when it is 22:40 and I haven’t heard from him, but normally it is because he has stayed late to help, not for more pay, just because it is the right thing to do. Last month in intensive care a family only arrived at handover and he stayed to talk to them and give them some time with their relative before he turned the life support off because he didn’t feel it was right to pass the case on to the start of the next shift and someone that hadn’t treated their relative. Patients deserve to be treated with dignity and respect, but so do the people who are treating them.
When I left the labour ward to go to theatre to have my baby delivered my midwife had to change shifts and collect her son from school, but she went home, dropped him off and came back just to check I was ok.
People don’t work in the health service for the money, it’s because they care, but this does not mean they should not be valued. These changes will affect everyone and I am concerned that this contract is setting up junior doctors to fail by demoralising then overworking and under valuing them. All these people have dedicated their lives to medicine, I have seen first and that it is impossible to become a doctor without doing so.
These changes will impact on your constituents. This part of England has an aging population and needs doctors to care for their increasingly complex needs. Wales and Scotland are not imposing these changes and you will find that posts become harder to fill, especially in the fields (anaesthesia, obstetrics, emergency) that the changes to antisocial hours impact most. This might seem just an issue to those who will be directly affected by the salary cut my husband is facing, but it isn’t, this will affect absolutely everyone if you can’t recruit enough trainees.
I urge you to support junior doctors and reject these changes for the sake of all your constituents.
I apologise for the length and somewhat disorganised nature of this letter, it is hard to concentrate when you have a very small demanding baby to look after at the same time.
Regards,

Katrina Spinney