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Junior doctor contracts: should they be challenged?

On Saturday, 17 October, 20,000 people marched to protest against the new junior doctor contracts in London for the second time.

The feeling at the protest was one of overwhelming solidarity, as people marched with placards of varying degrees of humour. Purposely misspelled placards reading “junior doctors make mistaks” were a popular choice, while many groups gathered under large banners identifying their hospital, offering 30% off – a figure the BMA published, noting the potential cuts junior doctors could face to their salary. Many placards joked that they were just passing through on the way to the airport, as it’s argued countries such as Australia offer far better contracts for junior doctors.

Similar protests have taken place throughout the United Kingdom, including in Leeds and Belfast as the country expresses outrage against the new junior doctor contracts.

The new contracts, proposed by UK Health Secretary Jeremy Hunt, aim to reduce the number of essential hours that a doctor is allowed to work. The Health Secretary has referred to the contracts as a “good deal”, telling BBC Radio 4’s Today programme that the plans will benefit junior doctors, and increase patient safety.

The British Medical Association, who entered into talks to negotiate new contracts for junior doctors in 2012, paints a very different picture. They have said that the offer made by the Government is unacceptable, and decided to leave negotiations. The BMA insists that “[they] cannot allow a new contract to be imposed which would be bad for doctors, patients and the NHS.”

The junior doctor protest, London, 17th October 2015
The junior doctor protest, London, 17 October 2015. Photographs by Stefanie De Lucia.

In interviews conducted with junior doctors, as well as Oxford University Press authors and editors, we investigate why junior doctors are protesting, and the potential impact the new contracts could have on healthcare in the UK. From a feared decline in patient safety, to a decline in contributions to academic research, there seem to be many potential repercussions of the new junior doctor contracts….

Lydia Spurr, co-author, So you want to be a brain surgeon?

Recent times have been unsettling for us as junior doctors. Although the current pay-structure isn’t perfect, it’s difficult to understand how the proposed changes will not lead to lower take-home pay – in exchange for longer, or more antisocial hours.

Ultimately, we’re not asking for higher pay, or time off: we’re asking to be treated fairly and for our representatives to be able to negotiate with the government. We are under threat imminently from the enforcement of an unfair contract, which threatens to remove safeguards to our working hours. This is a retrogressive step with clear and direct implications for the safety of both patients and doctors. Personally, I’m unable to trust a government who continue to misquote and misinterpret data to support their own agenda, and who continue to attempt to demonise and demoralise junior doctors.

Attending the protest in London on 17th October highlighted without doubt the camaraderie and unity of the very people this contract is going to affect – thousands of junior doctors, but also their families and patients. More recently, the government’s offer of an 11% rise in basic pay is grossly misguided, miscalculated, and mistimed with the opening of strike ballot. As doctors, we have a duty to protect our patients; the current offers seriously threaten to reduce our ability to do this effectively. While strike action may be unpopular with some, it is driven by our genuine desire to protect both ourselves and our patients.

Anonymous, CT1 anaesthetics trainee:

The reason we are all protesting is fundamentally because the nation’s health is seen as second to profit amongst today’s politicians. The current secretary for health has no concept of life working as a junior doctor. We are tired of working dangerous hours, tired of having no choice of when we take annual leave, and we refuse to be penalised for standing up for patient safety. We want to let the public know how exhausted we are as a profession, and that this should not be allowed to continue. According to WHO figures, the NHS is currently the most efficient healthcare system in the world. We have one of the lowest numbers of doctors per capita in Europe, and what Jeremy Hunt is proposing is further stretches in this service. We cannot let this happen.

Eleana Ntatsaki and Vass Vassiliou, Associate Editors, Oxford Medical Case Reports:

Junior doctors are committed to continuing professional development at every opportunity. In their limited spare time, as well as studying for difficult and expensive mandatory professional exams, they read and evaluate research, complete numerous work-related online assessments, and attend additional training courses and medical conferences. They produce high-quality academic manuscripts about interesting and complex cases in order to share this clinical experience and learning with the wider medical community, submitting them for publication to journals like the Oxford Medical Case Reports.

It would be a great loss, not only for the NHS and our patients, but for the whole academic community, nationally and internationally, if junior doctors were to be deprived of the motivation and time to continue contributing to the academic world and forced to bypass their inquisitive and reflective nature and extremely strong sense of vocation or even exit this profession.

Dr Charis Banks, junior doctor:

During my career I have worked 12 days in a row, I have worked 100 hours in 8 days, I have worked 3 hours longer than I was being paid to do – every day, for months. I am not unique, this is what we do – my colleagues and I – and we do it because we care about our patients. We miss time with our own family and friends so that we can look after yours.

So why am I angry? I’m angry because Jeremy Hunt is trying to destroy the NHS without the general public realising. He is trying to impose a new contract on us. He has decided that it is ‘sociable’ to work at 9pm on a Saturday night. He has decided that the current safeguards which are in place to protect us from working 100 hours every week are unnecessary. He has decided that on top of increasing our hours he will cut our pay, by 30%.

I want to tell you we are always here, 24 hours a day, 7 days a week, front-line medical and nursing staff providing acute and emergency healthcare to patients whenever they need it. We will fight and keep fighting to save the NHS and to protect our patients – what other choice do we have?

Featured Image Credit: ‘Stethoscope’ by Parentingupstream. CC0 via Pixabay.

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