Today, the BMA (British Medical Association) announced that junior doctors will be striking on three dates across January and February. Negotiations with the Department of Health ended this evening; the government having failed to resolve what BMA sources term “absolute areas of disagreement”.
The first strike for 40 years will take place from 8am 12th January to 8am 13th January, with only emergency care provided. Under this model, junior doctors will only provide cover that they did on Christmas Day, with consultants having to step in to cover any unfilled positions. A second emergency care strike will occur from 8am 26th January to 8am 28th January, and for the first time in history, a full withdrawal of labour will take place between 8am and 5pm on 10 February.
The BMA emphasise that they cannot agree to changes which will have a negative impact on patient care and junior doctors’ working conditions. Johann Malawana, leader of the BMA’s junior doctor’s committee (JDC), said this afternoon that he was “sorry we have not been able to find a way forward and get the government to see the genuine concerns that junior doctors have and our continuing desire to have a safe and fair contract”.
Although Jeremy Hunt said it was “extremely disappointing” that doctors are striking, he also said they were unable to solve problems concerning weekend pay and has asked Acas to reconvene negotiations.
On 30th November last year, the BMA called off strikes after Hunt agreed to re-enter negotiations with the BMA at the 11th hour.
In an update to junior doctors this weekend, Malawana emphasised that they would not agree to a contract harmful to the NHS: “We hope that the government is able to come back with a greater understanding of how important junior doctors feel about the future of the NHS they work in.”
One fourth-year student doctor said: “Doctors do not want to strike, they want to do their jobs and look after patients. They have been forced into this position by the current secretary of health Jeremy Hunt who is threatening to impose a contract which is unfair and unsafe without negotiation. It leaves doctors with no other option and this is unequivocally demonstrated by a 98% approval for industrial action when BMA members were balloted”.
Although the contract will only affect England at the moment, trainee doctors are worried there will be a ripple effect on other parts of the UK. One student doctor studying in Edinburgh voiced concerns: “Scotland isn't devolved enough to resist the movement of the English NHS. If this is indeed a move towards privatisation - which I suspect it is - then if England goes, so does Scotland. So effectively it does impact Scottish healthcare just as much down the line”.
Should Hunt’s proposed contract be successful, junior doctors will be paid less for working the same amount of hours. Under the current contract, doctors are paid a basic rate for any hours worked between 7am-7pm Monday-Friday, with an additional supplement to recognise the unsocial nature of any hours worked outside of this framework. Planned contract changes will add in 27 extra hours of “standard time”, extending these hours to 10pm every weekday evening and to incorporate Saturday 7am-7pm.
Additionally, junior doctors currently receive an annual pay progression to recognise the increasing responsibility and competence they gain year-on-year. However, this is to be replaced with just a handful of increments. This has led to a myriad of concerns including claims that this will have a detrimental impact to those who wish to take time out to undertake research, or for those wishing to take maternity leave.
Whilst the government say that only the doctors working outside of legal limits would see their pay actively cut and 75% receiving a pay rise, a student doctor stated: “This is simply government spin. In order to prevent doctors suffering a pay cut, there has been the introduction of ‘pay protection’, based on the salary earnt in October 2015. This is only to last until 2019 and would not apply to newly qualified doctors. If salaries weren’t being cut there would be no need for this payment, and it is simply an attempt to get current doctors to sell their future colleagues down the river.”
The second main issue with the contract is the removal of safeguards that prevent doctors working for dangerously long periods of time. The current contract financially penalises any hospital trust for over-working their junior doctors. However, these penalties would be removed. This has led to fears that despite the legal number of hours that can be worked weekly being reduced from 91 to 72, the lack of penalties would result in this frequently being broken.
Under the agreement made on 30th November, if the government did not alter the contract in line with the JDC’s concerns, it was clear industrial action would be re-instated. During these talks, the government has failed to address these problems - leaving doctors with no other available course of action.
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