Hunt pledges that no junior doctor working within legal hours will face pay cutBMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5814 (Published 29 October 2015) Cite this as: BMJ 2015;351:h5814
The UK government has made a stronger commitment to ensuring that junior doctors’ pay will not suffer under the proposed new contract, during a parliamentary debate on 28 October. It pledged that no junior doctors working within legal limits on hours would see a cut to their pay.
The commitment was made during a debate in the House of Commons on the increasingly hostile dispute between the government and the BMA over a new contract for junior doctors, which is due to be the subject of a two week BMA ballot on industrial action by junior doctors in England, starting on 5 November.
Proposing the motion on 28 October, Labour’s shadow health secretary, Heidi Alexander, MP for Lewisham East, said, “I’m worried a new government imposed employment contract will be unsafe for patients and unfair for doctors.”
Alexander said that she wanted the government to return to negotiations with the BMA but that for that to happen “what the BMA needs to see and what junior doctors need to know is that the health secretary is genuinely willing to compromise, and his performance over the last few months suggests otherwise.”
The BMA was not helping its cause by refusing to negotiate on the contract, argued Simon Hoare, Conservative MP for North Dorset. “Is it not better to talk first, then, if the BMA does not like it, by all means ballot?” he asked. “It is certainly doing it in the wrong way.”
England’s health secretary, Jeremy Hunt, responded during the debate to try to give reassurances over his intentions for the new contract, and while Hunt was speaking the Department of Health released a letter from the health secretary to Johann Malawana, chair of the BMA’s Junior Doctors Committee, putting Hunt’s position in writing.1
In the debate Hunt said, “We did not, and do not, seek to impose a new contract; rather, we invited the BMA to negotiate a new contract so that we could end up with a solution that was right for doctors and right for patients.
“However, because we had recently won an election in which a seven day NHS was a manifesto commitment, we said that, having tried to negotiate this unsuccessfully for two and a half years, we would ask trusts to introduce new contracts if we were unable to succeed in negotiations.
“For junior doctors, we proposed to reduce the high overtime and weekend rates, which prevent hospitals from rostering enough staff at weekends, and increase basic pay to compensate.
“We have made a commitment that the pay bill as a whole would not be reduced, and today I can confirm that not a single junior doctor working within the legal limits for hours will have their pay cut, because this is about patient care, not saving money.”
Despite several invitations to return to the negotiating table, the BMA had refused, Hunt added, saying, “Rather than negotiating, it chose to wind up its own members and create a huge amount of unnecessary anger.”
Norman Lamb, the Liberal Democrat MP for North Norfolk and a former health minister under the last coalition government, asked the health secretary for clarification on what he meant by “the legal maximum.” Lamb asked, “Is he talking about working up to 48 hours or up to 56 hours? He has given no guarantee that those doctors who may still work 60 to 70 hours in a week will not end up losing their pay. It is very important that the government are clear on that,” he said.
The Labour shadow health minister Andrew Gwynne, MP for Denton and Reddish, said, “No one with a GCSE in maths can believe that no doctor will be worse off as a result of the new contract.” He added, “How is it, if the pay envelope isn’t increasing, how is it, if the pay isn’t being reduced, how is it that these sums add up? They just do not, and I suggest you go back to night school and learn some basic arithmetic.”
After the session Malawana said, “It is encouraging that the health secretary has finally made a significant shift and recognised some of the concerns raised by junior doctors.
“However, it has taken the threat of industrial action and the sight of thousands of junior doctors taking to the streets to reach this point.
“The BMA has been quite clear that the government must withdraw the threat of imposition of new contracts on junior doctors [and] the extensive preconditions to negotiations the Department of Health keep insisting on and provide junior doctors with the assurances they are demanding before re-entering negotiations.
“Today’s letter from the health secretary could be a step in the right direction. We look forward to seeing more of the detail that the health secretary has committed to providing in the coming few days.”
Speaking to the BBC the next day, Hunt admitted that some junior doctors would see a pay cut.
“There’s a very small minority of doctors who will be working more than an average of 56 hours, and at the moment they get paid what’s called colloquially in the NHS ‘danger money,’” he said.
“We think that’s wrong. Actually, we shouldn’t be allowing that to happen. It’s not safe for patients, and, frankly, I’m not sure it’s safe for doctors either. But what we are saying is that for the vast majority of doctors who are working within the legal limit there will be no pay cut. We’ll make sure that happens.”
Responding to Hunt’s admission that not all junior doctors would be protected, Malawana said, “Just hours after promising that no junior doctor would have a pay cut, Jeremy Hunt has now admitted that those working the longest hours would in fact see their pay fall.
“Jeremy Hunt has repeatedly shifted his position, and this is another example of the health secretary claiming one thing but the reality being quite different.
“It makes it impossible for junior doctors to trust the government when they have been caught out trying to gloss over the facts.”
Cite this as: BMJ 2015;351:h5814
thebmj.com Feature: Problems with the junior doctors’ contract: how did we get here? (BMJ 2015;351:h5183, doi:10.1136/bmj.h5183); Medicine and the Media: Junior doctors—it’s not about the money (BMJ 2015;351:h5591, doi:10.1136/bmj.h5591); Editorial: Problems with the new junior doctor contract (BMJ 2015;351:h5077, doi:10.1136/bmj.h5077)