Ben Gummer: Why we’re changing the contracts of junior doctors for the better

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JUNIOR doctors in the NHS are among the best in the world. They are the leaders of tomorrow and the backbone of medical care in hospitals across Yorkshire.

Indeed, the current debate around proposed reforms to their contracts has highlighted their passion and dedication. That’s why it saddens me to see them take to the streets of Leeds to protest, based on misleading information from their trade union, the British Medical Association.

We have been clear that this is about delivering a fairer, safer deal for doctors and patients.

But the BMA has wilfully misled junior doctors on pay and working hours, causing unnecessary anger and upset.

Last week, the BMA announced that they will be balloting members on industrial action from November 5 – potentially putting patients at risk.

However, Jeremy Hunt, the Health Secretary, has given cast iron guarantees that our intention to modernise the contract will improve patient safety and is not a cost-cutting exercise.

The great majority of junior doctors will be at least as well paid as they are now and average earnings will remain the same.

The BMA has caused further uncertainty by publishing an inaccurate pay calculator, misleading doctors on proposals that have yet to be negotiated.

To the BMA’s credit, it recognised the confusion the calculator caused among junior doctors and as a result took it down.

I want to be clear about how we’re making pay fairer: we will remove the current situation where two doctors working very different hours can be paid the same.

We will remove the complex banding payments system and replace it by paying doctors for hours worked.

There will be an increase to basic pay, with proportionately higher pay for unsocial hours and additional payments for those working in hard-to-fill specialties such as emergency medicine and general practice.

Doctors, nurses and everyone working in the NHS want to give patients the same high quality care every day of the week and we know that junior doctors already work at weekends, providing good, safe care to patients.

But the current pay structures result in some hospitals rostering three times more senior cover during the week compared to the weekend.

Junior doctors who do work weekends already often do not have the right level of support to deliver the safest care we all want.

Our ambition is to be the safest healthcare system in the world. In order to deliver safe patient care around the clock, seven days a week, we need a culture of safe working hours for NHS staff.

The current junior doctors’ contract incentivises long hours by offering financial incentives for working beyond the legal limit.

Our proposals will reduce hours, not increase hours, as the BMA has led doctors to believe.

The new contract will be based on no junior being required to work more than an average of 48 hours per week, with tougher limits on unsafe hours including a new maximum working week of 72 hours, down from 91.

This will help to reduce burnout and improve patient safety, so junior doctors can deliver the very best care.

We are also proposing an end to the ‘week of nights’, experienced by many junior doctors, with a new limit of four night shifts in a row and are introducing a new limit of five consecutive long days.

We also want Health Education England, NHS Employers and the Royal Colleges to continue working with the BMA on how training opportunities for junior doctors can be improved.

This may not be a contractual issue but we do need to look at how we can better support junior doctors’ work-life balance, including annual leave arrangements and recognising that they often have family responsibilities and choose to work part time.

Far from being left with no option but taking industrial action, the Department of Health and many Royal Colleges have continually urged the BMA to come back to the table since they first walked away last year.

We believe in the NHS and its values, and are committed to delivering a contract that is safer for patients and fairer for doctors.

Ben Gummer MP is Minister for Care Quality at the Department of Health.