Junior doctors have condemned a disastrous new contract which comes into effect next summer. The contract will reclassify a junior doctor’s normal week, known as “plain time”, to include Saturday and until 10pm every night of the week. They currently earn a basic rate salary of £23,000 and gain top-up pay for irregular hours.
The government has claimed that the new contract includes a 15 per cent pay rise. Although because of the contract’s reclassification of normal working hours, junior doctors will not receive additional pay for many of the new hours they have to work, which had previously been designated as irregular. The result is that many fear they will be facing a pay cut of up to 40 per cent.
Fiona Hill, a third year medical student, told Nouse: “As a medical student it’s demoralising. I am happy to work hard; I went into the profession because I want to care for people. I am not happy to work 80 hours a week and endanger people’s lives.”
As Hill suggests, the changes are incredibly dangerous for patient safety because of the potential to overwork junior doctors. Fatigue and stress are a deadly cocktail for fatal mistakes. In a 2014 report by Washington-based foundation the Commonwealth Fund, our health service was rated the best in the world; surely we are not going to let go of that great achievement by maltreatment of the very people who are instrumental to that success.
The demoralisation that will result from punishing hours and lower pay also has the potential to discourage the future workforce of the NHS from a career in medicine. In particular, the contract may put junior doctors off choosing to specialise in areas of emergency care, such as A&E, because they often have irregular hours.
Eleven Royal Colleges have written to the Health Secretary, Jeremy Hunt, warning that the proposed contracts represent “a real and present threat to the current stated priorities of the NHS”. When the potential impacts on staff retention are analysed, the assessment of the Royal Colleges is not unreasonable. There are fears that the unfair nature of the contract will cause an exodus of young junior doctors to other countries, such as Australia.
Indeed, recent figures revealed that in just three days last week 1,644 young doctors had already begun the process of applying for the necessary certification. So it appears that these fears are becoming a reality. This follows the loss of 3,400 senior nurses and over 1,000 matrons between 2010 and 2014. It is hardly rational to push out more workers upon whom the future of our NHS depends. Junior doctors should be paid well. They sacrifice five years for an intense course at medical school, and their huge efforts are reimbursed with a burden of debt, longer hours, and a pay cut.
The government’s actions are an insult to the people who keep one of our most precious institutions running day after day. The NHS, since its conception, was designed to be a system of care – let’s extend that care to those who the NHS relies on for its existence.