By Ellie-Louise Style
The BMA and fellow junior doctors have made a lot of criticism of the suggested junior doctor contracts, but does everyone agree with this?
Being a junior doctor can make you feel wrecked by the end of the week and it can be very emotionally draining, not just by working anti-social hours, but the patients are in need of your help, even though it can be scary at times you have to learn to over come this if the NHS is going to survive. It isn’t all doom and gloom working as a junior doctor though, as you get to experience some of the most astonishing moments, for instance witnessing someone being brought back to life.
At a young age aspiring doctors begin their studies to start their medical career, for most it takes between 10-16 years for them to complete their degree. However, they are not just studying at this time. They are also put on placement in hospitals to gain knowledge and experience of working with doctors, nurses, patients and other hospital staff. They work long hours, and take home an average of £43,000 annually, compared to the average earnings of a fully qualified consultant being between £74,000-£100,000, so in many cases junior doctors will be getting half of their pay.
When you start out, as a junior doctor the basic salary will be £25,500 according to these new contracts, and your pay will increase depending on how successful your training is and if you manage to meet the next level.
On a day-to-day basis junior doctors, doctors and nurses are rushed off their feet dealing with demanding situations with patients at the NHS hospitals. They are already exhausted from working many hours dealing with the sick and injured.
Many junior doctors also have a family to support while they study, as it takes many years to become a fully qualified doctor and the studying takes up a long period of their lives. Not only do they battle with working anti-social hours and low pay, but the majority of them try to balance this with their family life as well.
“We are under confident and under qualified for practice…I believe that the huge stress of learning new skills and experiences is enough, and on top of that this responsibility is going to mean more working hours, which is just going to leave people even more emotionally and physically exhausted. “ Stated Anna, a junior doctor from Leeds.
Since 2008 the BMA have been wanting to create a new contract for junior doctors, as they felt that the New Deal arrangements from 2000 and the Hospital Medical and Dental Staff Terms and Conditions of Service from 2002 were “out-dated as well as unfair and that it operates with unintentional consequences.” Which is stated on the junior doctor full contract.
In 2012 it was announced by the Department of Health that the Junior Doctor contracts were going to change. Since then there has been a dramatic clash between the BMA and Government, as there is a worry that these contracts will not benefit junior doctors very much.
The original contracts that were released by the Department of Health suggested that most junior doctors would get: an 11% pay rise, on call availability allowance, flexible pay premia, unsocial hours enhancements, additional rostered hours and an increase to basic pay. The new contract is aimed to reward those who work more unsocial hours, by either giving them a 33% or 50% enhancement of pay, depending what hours they work.
Plus, junior doctors will also receive on-call availability allowance, which will be between 2% to 6% of their basic pay. While the average amount of hours a junior doctor can work will stay at 48 hours a week, and there will be a new maximum limit of 72 hours a week, meaning junior doctors won’t be as over worked, although this is still almost double the hours worked by most office workers.
However, 1% of junior doctors will be badly affected by these new contracts if they come into place, as they will be made to work longer hours, so if these contracts do go ahead things could be getting a lot worse for them, as they will be made to work more hours for less money, as the Department of Health has suggested. Jeremy Hunt, Secretary of Health believes the NHS will benefit from this, and it will improve the services for patients, as more junior doctors will be available to help them.
There are some benefits for the UK if the new junior doctor contracts are put in place, as Michael Broad, the editor of hospitaldr.com said: “The government does not want to have to increase its budget massively, so it is trying to find ways of reducing its costs. One of these ways to reduce its costs in the NHS is to get staff costs down, so it wants junior doctors to work more flexibly for more hours.
“When the doctor is tired and the doctor is not being particularly observant or caring or switched on, and the longer their shifts are the less safeguards there are, and the more likely people will not get treated very well or diagnosed properly, so what I am saying is you have got to have a contract that benefits both sides.” Therefore it is not just about the British economy, as by making junior doctors work more hours it could affect their ability to work.
Since the suggestion of the new contracts the British Medical Association has been supporting the junior doctors fully, and they have been threatening strikes for the doctors until a negotiation has been met between the Department of Health and the junior doctors.
Junior doctor, Anna also said: “I believe that the positives would be that there are more doctors available, as there is already a shortage of most care workers in the NHS. This would obviously be a good thing, however the risks outweigh the benefits to this… These contracts will leave people who are under qualified and under confident in their role of a doctor with a higher responsibility, and this could put patients at risk.”
Since July 2013 when the first negotiations were held, the BMA has supported the junior doctors in their fight for fair pay and reasonable working hours every step of the way. At times the BMA have even pulled out of the negotiations, for instance in August 2015, but re-entered them in September 2015.
In November 2015 28,000 junior doctors voted for industrial action against the Department of Health, which meant 76.2% are against the new junior doctor contracts. The BMA planned three separate strikes that were scheduled for 1st, 8th and 16thof December 2015. Due to negotiations getting underway between the BMA and the Department of Health the strikes were suspended, until they both come up with a reasonable conclusion.
Not only have their been negotiations to try and change the contracts the BMA have also worked with DDRB to hold polls and petitions for junior doctors to sign, so they can get their point across to the government, which got 91,517 signatures out of 100,000, and ended up being debated in parliament. If it were not for the BMA the junior doctors would be fighting a losing battle against the Department of Health.
The BMA have stated that: “Over 99% of the 4,500 doctors in training who responded to a BMA poll told us that the recommendations are not acceptable and so we cannot accept them as the baseline for any new negotiations.”
“The Government has already told us, for example, that it plans to reduce the number of breaks during shifts down to just 20 minutes every six hours. In practice, this could mean that a doctor working an eleven-hour shift will only get a single 20-minute break. We don’t think this would be safe.”
The new Junior Doctor contracts are set to be in place by August 2016, however there is no clear contract right at this moment, as the BMA are still having disagreements with the Department of Health, and there was hope that an agreement would be made by January 2016.
However, this has not been the case, as on the 4th of January 2016 the BMA stated that a conclusion has not been made on the junior doctor contracts with the Department of Health. Due to this 45,000 junior doctors are holding ‘walk out’ strikes on the 12th and 26th of January and then one on the 10th of February as well. This means that the NHS is going to suffer more, as there will be staff shortages, meaning there could be delayed healthcare for patients.