Who does this contract affect?
This contract affects all junior doctors. A 'junior' doctor applies to any doctor who is not yet a hospital Consultant or a GP. The term 'junior' is misleading as it suggests that these doctors are inexperienced, or have little responsibility. Nothing could be further from the truth. 'Junior' doctors include a vast range - from those newly qualified to those who have had over 10 years of experience working (by which stage, they are in their mid-late 30s, maybe even early 40s).
'Junior' doctors develop high levels of clinical expertise and bear significant levels of responsibility. They are the doctors in A&E who fight to keep your relative alive after a car accident, the obstetrician who delivers your baby by emergency Caesarian Section in the early hours of the morning, or the doctor who stays on at work to comfort the family of his dying patient. 'Junior' doctors are all of our doctors and are the backbone of the NHS. Without them, it would be impossible for the NHS to function.
Why should I oppose this contract?
Because junior doctors are such a major part of the NHS workforce, anything that affects how they work will affect the NHS as a whole. There are 3 main reasons to oppose this contract:
1) Oppose it because it will harm patients:
It may not be obvious, but the way hospitals pay doctors directly impacts on patient safety. This is why.
Currently, a large proportion (up to 50% for some specialties) of a doctor's salary is made up of the higher rates paid for working outside 'social hours'. Social hours mean Monday to Friday 7am to 7pm. The new contract seeks to re-classify social hours as Monday to Saturday 7am to 10pm. This means that the Department of Health would pay doctors much less because the hours that doctors now work would be classed as 'social' and therefore not paid at the higher 'unsocial' rate.
As things stand, hospitals currently face a very stiff financial penalty if doctors are made to work for excessive hours. Therefore, hospitals currently have an incentive to ensure their doctors get adequate rest and to try to employ enough doctors to share the anti-social shifts.
If 'social' hours are reclassified as Monday-Saturday 7-10 pm, hospitals will no longer face financial repercussions if they do not employ enough doctors. The contract also proposes to remove the monitoring of doctors' hours, which means there will be no checks on how much doctors are working. This means doctors will be forced to work excessive hours, with inadequate rest between shifts. This will increase the risk of mistakes, which could cost lives.
The government claims that doctors will not have to work more hours, just 'different' hours. This claim hides a worrying truth though. If the government's new contract is supposed to be ‘cost-neutral,’ it means they are not planning on employing more doctors (as this would cost more money). So, either doctors are going to have to work much longer hours (resulting in exhausted unsafe doctors), or there will be fewer doctors available on weekdays. The weekday service is already at breaking point - most NHS doctors and other healthcare staff regularly stay on long beyond their contracted hours in order to get 'the work done' and ensure patient safety.
So, there you have it - this contract will lead to one of two dangerous scenarios. Either there will either be fewer doctors available to care for people or the public will be cared for doctors that are exhausted and dangerously overworked. This is why the contract is UNSAFE.
2) Oppose it because it harms doctors:
The proposed new contract will force most doctors to work longer and more antisocial hours, with a significant pay cut (up to 30%). This will lead to increasingly exhausted and demoralised doctors, which can lead to tragic consequences for themselves as well as being dangerous for patients.
By removing the current structure of pay increments, this contract discriminates against female doctors having children, doctors who need to work part-time and doctors who do research (e.g. those running cancer treatment trials). This contract also means that a doctor qualified for 6 years will get paid the same as a doctor qualified for 2 years because in the government's words, "they both look after the same patients". This is clearly a completely false argument. A doctor who has been qualified for longer will be more experienced, be looking after more complex patients and doing more difficult procedures and taking on greater responsibility.
At the end of the day, this contract devalues doctors even further, forces them to work longer and harder, all for less pay - would you be willing to accept that for yourself?
3) Oppose it because it will harm the NHS:
The whole of the NHS will suffer under this contract. All workers of the NHS - doctors, nurses, other clinical staff, support staff - are already at breaking point. They are already trying to deliver a 7 day service without adequate infrastructure. If doctors' contracts can be this easily changed, it is likely to pave the way for attacks on the contracts of all healthcare professionals.
Doctors are overworked, demoralised and find it increasingly difficult to deliver the best care in this environment. Attacking doctors further by introducing working conditions that are unsafe for both patients and doctors will drive even more doctors out of the NHS.
As staffing shortages worsen and patient safety deteriorates under the new contract, it will be easier to label hospitals as "failing". This would make it easier to argue for an alternative system, bringing an end to our current system of free healthcare.
This contract affects all junior doctors. A 'junior' doctor applies to any doctor who is not yet a hospital Consultant or a GP. The term 'junior' is misleading as it suggests that these doctors are inexperienced, or have little responsibility. Nothing could be further from the truth. 'Junior' doctors include a vast range - from those newly qualified to those who have had over 10 years of experience working (by which stage, they are in their mid-late 30s, maybe even early 40s).
'Junior' doctors develop high levels of clinical expertise and bear significant levels of responsibility. They are the doctors in A&E who fight to keep your relative alive after a car accident, the obstetrician who delivers your baby by emergency Caesarian Section in the early hours of the morning, or the doctor who stays on at work to comfort the family of his dying patient. 'Junior' doctors are all of our doctors and are the backbone of the NHS. Without them, it would be impossible for the NHS to function.
Why should I oppose this contract?
Because junior doctors are such a major part of the NHS workforce, anything that affects how they work will affect the NHS as a whole. There are 3 main reasons to oppose this contract:
1) Oppose it because it will harm patients:
It may not be obvious, but the way hospitals pay doctors directly impacts on patient safety. This is why.
Currently, a large proportion (up to 50% for some specialties) of a doctor's salary is made up of the higher rates paid for working outside 'social hours'. Social hours mean Monday to Friday 7am to 7pm. The new contract seeks to re-classify social hours as Monday to Saturday 7am to 10pm. This means that the Department of Health would pay doctors much less because the hours that doctors now work would be classed as 'social' and therefore not paid at the higher 'unsocial' rate.
As things stand, hospitals currently face a very stiff financial penalty if doctors are made to work for excessive hours. Therefore, hospitals currently have an incentive to ensure their doctors get adequate rest and to try to employ enough doctors to share the anti-social shifts.
If 'social' hours are reclassified as Monday-Saturday 7-10 pm, hospitals will no longer face financial repercussions if they do not employ enough doctors. The contract also proposes to remove the monitoring of doctors' hours, which means there will be no checks on how much doctors are working. This means doctors will be forced to work excessive hours, with inadequate rest between shifts. This will increase the risk of mistakes, which could cost lives.
The government claims that doctors will not have to work more hours, just 'different' hours. This claim hides a worrying truth though. If the government's new contract is supposed to be ‘cost-neutral,’ it means they are not planning on employing more doctors (as this would cost more money). So, either doctors are going to have to work much longer hours (resulting in exhausted unsafe doctors), or there will be fewer doctors available on weekdays. The weekday service is already at breaking point - most NHS doctors and other healthcare staff regularly stay on long beyond their contracted hours in order to get 'the work done' and ensure patient safety.
So, there you have it - this contract will lead to one of two dangerous scenarios. Either there will either be fewer doctors available to care for people or the public will be cared for doctors that are exhausted and dangerously overworked. This is why the contract is UNSAFE.
2) Oppose it because it harms doctors:
The proposed new contract will force most doctors to work longer and more antisocial hours, with a significant pay cut (up to 30%). This will lead to increasingly exhausted and demoralised doctors, which can lead to tragic consequences for themselves as well as being dangerous for patients.
By removing the current structure of pay increments, this contract discriminates against female doctors having children, doctors who need to work part-time and doctors who do research (e.g. those running cancer treatment trials). This contract also means that a doctor qualified for 6 years will get paid the same as a doctor qualified for 2 years because in the government's words, "they both look after the same patients". This is clearly a completely false argument. A doctor who has been qualified for longer will be more experienced, be looking after more complex patients and doing more difficult procedures and taking on greater responsibility.
At the end of the day, this contract devalues doctors even further, forces them to work longer and harder, all for less pay - would you be willing to accept that for yourself?
3) Oppose it because it will harm the NHS:
The whole of the NHS will suffer under this contract. All workers of the NHS - doctors, nurses, other clinical staff, support staff - are already at breaking point. They are already trying to deliver a 7 day service without adequate infrastructure. If doctors' contracts can be this easily changed, it is likely to pave the way for attacks on the contracts of all healthcare professionals.
Doctors are overworked, demoralised and find it increasingly difficult to deliver the best care in this environment. Attacking doctors further by introducing working conditions that are unsafe for both patients and doctors will drive even more doctors out of the NHS.
As staffing shortages worsen and patient safety deteriorates under the new contract, it will be easier to label hospitals as "failing". This would make it easier to argue for an alternative system, bringing an end to our current system of free healthcare.