Currently junior doctors’ core hours are 7 am to 7 pm Mondays to Fridays. It is doubtful that any reasonable person who understands the importance of our citizens having a healthy family life would disagree with that.
Hours worked outside the core hours are paid at a higher rate. Many junior doctors are already required to do out of hours work under the existing contract, and it is only fair that they should be paid a higher rate when they do so. Some junior doctors also work outside core hours by choice, partly because of the higher hourly rates on offer but maybe for other reasons too. That choice is the basis of our democratic capitalist system.
The government are now proposing to change those core hours to 7am to 10 pm Mondays to Saturdays and to force all junior doctors to work during these hours for no extra pay whether they like it or not.
The reason, they say, is that the Government is trying to achieve a 7 day a week NHS because of the alleged higher death rates recorded for patients admitted at weekends. That is where their arguments break down. Independent thinking soon concludes that this cannot be the real reason.
Junior doctors already provide the bulk of medical care during weekends and nights under the current system. If there is a higher death rate at weekends then the reason is not the lack of junior doctors, but is more likely to be the lack of consultants, who tend not to work as much at nights and weekends, or for other reasons unconnected with staffing. Making junior doctors work at weekends against their will is not likely to improve the situation and could even make it worse.
It is true that some hospital trusts are reluctant to rota junior doctors over the weekend because it costs more for the same number of medical procedures. The cost per procedure would therefore be increased as a result.
The obvious solution would have been to require hospital trusts to have the same rota 7 days a week – unless there was a good and demonstrable medical reason not to, rather than just trying to save money at the expense of patient care.
The Trust managers, who are incidentally paid a lot more than the junior doctors, would then have had to manage their resources to spread the available junior doctors over 7 days rather than 5 – if that is indeed what was required. At least that way any changes would be based on sound medical evidence rather than political spin.
In order to escalate the dispute the Government say that they will impose their contract whether the junior doctors like it or not. Unable to manage the NHS in the traditional way they are now trying a totalitarian state system instead. Again, independent thinking concludes that even this threat is nonsense as only 40% of junior doctors are now employed directly under government control. The other 60% are employed by NHS Foundation Trusts who are free to negotiate their own contracts with junior doctors. That is unless the Government intend to use Soviet style totalitarianism on NHS Foundation Trusts too.
The government says that their proposals are “cash neutral”. That means that they are asking the junior doctors to work longer hours including weekends and nights against their will and for no extra pay. Is there any trade union or employees’ representative organisation that would agree to that?
If Transport for London can reach agreement with one of the most militant unions, the RMT, to achieve a 24 hour tube network, then the present government’s failure to reach agreement with the junior doctors over a similar exercise brings into question the competence of that government. The words “piss up” and “brewery” come to mind – or is there a hidden agenda behind the government’s apparent incompetence?
Do you think that the junior doctors should continue their fight with the government in order to protect patients and the future wellbeing of the NHS?
Yes – definitely.