Junior doctors have been striking a bunch this year. The Department of Health was proposing to change the working conditions 53,000 NHS junior doctors. A lot of NHS staff flat out do not want these contract changes to go through. The latest is that negotiations have ceased, and the Department of Health plans to impose the contracts whether docs like it or not.
This argument has been going on for a good while, but things have come to a head recently. The confusing bit? Both the government and the striking doctors claim to have the patients’ best interests at heart. Cant they both be right?
The government is suggesting a bunch of changes, but the one that is getting people so worried has to do with getting rid of safeguards which punish NHS trusts for over-working their doctors, and the potential impact on patient care.
The way it currently works, once a junior doctor has worked more than 48 hours in a week, NHS trusts have to pay them a whole bunch more. The same also goes for paying junior doctors more when they work outside of “standard” hours. These standard hours are 7am-7pm Monday to Friday. Working evenings and weekends currently gets you mo’ money. Standard.
Handing over extra cash when junior docs work long or unsocial hours encourages them to work in places like A&E which demands a lot of weekend or night time work. It also discourages trusts from making their junior docs work excessive hours.
This would change under the government’s planned new contract. They want to make evenings and Saturdays “standard” time as well, so no extra cash for working at these times. This would mean junior docs working what were previously classed as unsocial hours for up to 30% less of their salary.
Medics remain junior doctors for up to a decade after they graduate, and often well into their 30’s. If these changes go through it will affect a good chunk of their working lives.
For a lot of doctors, it’s not really about the money. Many are worried that overworked doctors will be more likely to make mistakes in caring for their patients.
There’s also talk about stopping junior docs’ pay steadily increasing year on year, and instead anchoring their pay increase to the actual amount of hours they work within that year. Sounds fair enough, but medics are protesting that this unfairly impacts people who take time off to care for their children, so women are likely to get a particularly bad deal out of this. Same goes for people who take time off practising medicine to go research medicine, and, you know, invent new stuff to make us better and all that.
Just like the protesting medics, the Department of Health has been saying it is doing what’s best for the patient. A spokesperson said:
“Clear and independent clinical evidence states that mortality rates are higher at the weekend and we are committed to changing that by putting in place a seven-day NHS. That doesn’t mean making doctors work longer hours, it means working differently to improve patient safety. We are not seeking to save a penny from the pay bill. We have also guaranteed that the great majority of junior doctors will be at least as well paid as they would be now.”
Give that to me decoded? More people tend to die in hospital if they are admitted on a weekend. Scary “weekend effect”. The government reckons it can prevent this by making weekends part of the regular working week.
BUT: Health Secretary Jeremy Hunt has been accused of misrepresenting the key study he used to justify these proposed changes. This study – published in the British Medical Journal – did show an increased death risk in hospitals on weekends, but did not chock this up to poor staffing, which is what Health Sec Hunt is suggesting.
The government is also insisting that most junior docs will not have their pay cut. In fact, they recently offered them an 11% pay rise. Sounds good right? The striking docs aren’t buying it: They argue that after the extra pay for out-of-hours work is cut, they will still be getting a pay cut overall.
In their open letter they tell Jeremy Hunt that: “not one hard-working doctor should be financially worse off.”
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