What’s the objection to the new contract?
It applies to all junior doctors – that is, doctors who aren’t consultants and GPs – and would change how they’re paid. The major concern is about ‘unsocial hours’ – weekends and nights. At the moment, junior doctors are paid a basic rate for working between 7am and 7pm Monday to Friday. Weekends and nights have a higher rate. This higher rate is now being cut. What’s more, the definition of ‘unsocial hours’ has changed – it now doesn’t include Saturday daytime or 7-10pm on weekdays.
Why are the doctors striking?
According to the British Medical Association, it is a last resort: doctors fear the government will impose the new contract despite opposition. The BMA say: ‘We hope the government will see the strength of feeling on this issue and come back to meaningful negotiations.’
Will doctors be paid less?
Not necessarily, because the basic rate would also be increased by 11 per cent – a conciliatory offer Jeremy Hunt made back in November. Junior doctors will earn more for normal hours, but less for ‘unsocial hours’. The government claim that ’No junior doctor working within the current limits will receive a pay cut compared to their current contract.’ Striking doctors dispute this.
So is this an argument about estimating pay?
Junior doctors tend to say no. Their worry is that they will have less control over when, and how much, they work, without getting enough rest to do the job properly. Many say they are exhausted and do not have anything more to give. The BMA is not happy about the demands which could be placed on doctors: for instance, ‘fatigue caused by their working patterns frequently changing times’. If the government wants a ‘7-day NHS’, it should hire more doctors, not squeeze more out of the existing ones. That will inevitably make patients less safe, the union claims. There are other administrative changes which – so the doctors argue – will remove important safeguards.
What’s the government’s response?
Hunt said last weekend that his main concern is patient safety: ‘We have had too many studies now telling us that newly born baby mortality rates are 7 per cent higher at weekends, emergency surgery mortality 11 per cent higher, stroke mortality 20 per cent higher, cancer mortality 29 per cent higher.’ Hence the need to make it easier for doctors to work at weekends. He also claims that, rather than increasing pressure at weekends, the new contract will mean there is less pressure on doctors – because hospitals can employ more of them.