Dr Kailash Chand OBE, one of the senior most GPs in the country and the Deputy Chairman of the British Medical Association, comments on the junior doctors’ strike tomorrow
A 24-hour hour strike by junior doctors is due to start at 8am tomorrow, when striking junior doctors will only provide emergency care. Around 60,000 operations and outpatients appointments which were due to take place on Tuesday have now been cancelled.
The BMA regrets the inevitable disruption that this will cause but it is the Government’s adamant insistence on imposing a contract that is unsafe for patients in the future, and unfair for doctors now and in the future, that has brought us to this point.
This will be on the first “all out” strike in the history of the NHS. This action is not being taken lightly by junior doctors and the BMA. The industrial action is a last resort in the face of Government’s continued threat to impose a new contract.
Doctors believe the proposed contract is unsafe for patients, unfair for doctors and will undermine the future of the NHS. It will remove vital protections on safe working patterns, devalue evening and weekend work, and could have a real impact on the quality of patient care if we return to the days of exhausted junior doctors working dangerously long hours. Jeremy Hunt needs to take responsibility for the fact that this is the first time in 40 years that junior doctors have voted to take such significant industrial action.
The outpouring of anger and frustration we have seen from thousands of junior doctors across the UK must be a wake-up call for Jeremy Hunt. If he and his team thought that junior doctors would simply accept their threats to impose a new contract, they have been proven very wrong.
We are already seeing reports of thousands of doctors, including a large number of junior doctors, looking for opportunities to move and work abroad, which at a time when the NHS is facing a recruitment and retention crisis is cause for serious alarm. The government’s proposals will impact those specialities such as general practice and emergency services that are facing particular workforce shortages, whether it is through reducing the pay to those doctors involved in the greater amount of evening and weekend work, or reducing pay for those in training. Worse still, by making it easier for hospital trusts to return to the days where junior doctors worked dangerously long hours, they risk compromising patient care as well as junior doctors’ health and wellbeing.
The British Medical Association has been clear that it wants to deliver a safe and fair contract for junior doctors and patients. Instead of genuine negotiations, the government has insisted that junior doctors agree without question. This would not have allowed the BMA to negotiate over proposals we believe are unsafe for patients, unfair for doctors and undermine the future of the NHS.
Health Secretary Jeremy Hunt has accused junior doctors of misleading the public, yet at the same time he continues to conflate junior doctors’ concerns and the government’s rhetoric on seven-day services. The junior doctor contract is in no way a barrier to seven-day services, with the vast majority of junior doctors routinely providing care to patients 24/7.
There are more than 50,000 junior doctors in England alone. They form the backbone of our NHS, working around the clock, seven days a week, and with a starting salary of less than £23,000, earning less than you might expect. Despite improvements in working hours in recent years, more than four in five junior doctors continue to struggle with long hours. Working 12 days in a row and clocking up 90-plus hours in a week are still common. Almost one in three have considered leaving the profession.
The contract determines obvious things like pay and working hours, but also affects the quality of doctors’ working lives and the quality of their training. It also plays an important role in ensuring medicine remains an attractive profession for the brightest school leavers, especially at a time when students undertaking a medical degree face debts of up to £70,000. Junior doctors work long hours and take high-risk clinical decisions, but in return they need a contract that protects them and the patients they care for, delivers a fair system of pay and ensures they have the opportunity and flexibility to learn as they progress.
These things are vital to delivering high quality care for patients and to ensure doctors are trained to the best possible standards. Instead of working with the BMA to deliver this, the government want to force though changes that will be bad for patients, bad for junior doctors and, ultimately, bad for the NHS.
In recent weeks the Health Secretary has acknowledged junior doctors play a vital role in the NHS. This is at odds with his relentless and extremely damaging rhetoric attacking doctors, which has led to the anger on display. We have always stated that without the continued threats of imposition and pre-conditions, the BMA would be happy to enter meaningful negotiations.
Government officials and the BMA are due to resume talks to avert a strike this morning. The BMA very much want to avert strike action, but the key sticking point is the threat of imposition of the new contract while talks are ongoing.Until, the government gives junior doctors the reasonable assurances they are demanding, industrial action cannot be avoided. Junior doctors are among the hardest working and most dedicated of National Health Service staff. Without them, the NHS would grind to a halt. The BMA wants to deliver a contract that protects patient safety and is fair to both junior doctors and the health service as a whole. This dispute could still be settled amicably, if the government agrees to very reasonable and just demands of junior doctors.