The proposed changes to junior doctors’ contracts resulted in a dispute between the government and the BMA (British Medical Association) that, at one point, threatened to turn very nasty indeed. However, on 3rd August 2016 the legal contract was imposed and in the middle of October, it was rolled out across the country.
The main point of contention was the proposition for changing the definition of the working week from 9am-7pm Monday to Friday to 9am-10pm Monday to Saturday. The biggest impact of this would be a direct pay cut; many employees already worked past the standard working week due to staff shortages and increased workloads. So, many doctors who already work Saturdays out of necessity would no longer receive the extra overtime pay they were previously entitled to for working outside of regular hours. Working extra hours out of the regular working week had become the de facto standard of employment, and with these changes many doctors face a 30% cut in pay.
To counter this pay cut, the government offered junior doctors a 13.5% pay increase across all of their working hours. However, according to the BMA, junior doctors would still be worse off than under the previous system. The government responded by saying only 1% of doctors who work a lot of overtime hours would lose out.
A junior doctor is contracted to work for 40 hours a week, but in reality, they work closer to 60, with many working 12 hour night shifts, followed by an 8am start the next day.
The government’s basis for the change in legislation was based on their manifesto promise to make the NHS a ‘7-day healthcare system’. They viewed it necessary to change legal employment contracts to reflect a 7-day system. However, this approach has been criticised by the BMA, who point out that the research the government has based its reasoning on has been heavily discredited by academics
Junior doctors protested heavily against the new changes and called strikes; to justify this, they said that they were sacrificing short-term care due to the missed hours to ensure the long-term safety of their patients. The junior doctors argued that the new contract would create an unsafe work environment and expose them to fatigue on a daily basis, which in turn would damage patient care because a fatigued doctor would be nowhere near as capable as a fresh one.
The government has promised that patient safety is at the heart of the new contract and that it is in the best interests of all doctors to agree to the new contract, rather than continuing to protest. The BMA, however, hasn’t given up striking against the new contract and so the story may not yet be over.