BMA writes to Hunt to demand assurances before re-entering junior doctor talksBMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5471 (Published 13 October 2015) Cite this as: BMJ 2015;351:h5471
The BMA has written to the health secretary, Jeremy Hunt, to seek the clear “concrete assurances” that it wants before agreeing to re-enter negotiations on the junior doctor contract.
The BMA was replying to a letter that Hunt sent to Johann Malawana, chair of the BMA Junior Doctors Committee, on 8 October.1 In that letter, Hunt said that the new contract for junior doctors in England would not cut junior doctors’ pay or increase their working hours. Writing in reply, Malawana said that, if the health secretary was able to give assurances on the matters he had raised, then the BMA would be able to re-enter contract negotiations. “If you will offer us clear assurances on our reasonable needs for a safe contract, we would be in a position to enter negotiations on the number of other areas that would achieve our combined stated aim. Our priority as doctors is how we can deliver the best NHS for future generations,” he said.
In August this year the BMA announced that it would not renew talks on a new junior doctor contract.2 After an announcement from the Department of Health for England that it would impose a new contract for junior doctors in August 2016, the BMA said that junior doctors would be balloted over potential industrial action.34
Malawana said that the BMA needed assurances that the threat to impose a new contract on junior doctors would be withdrawn. “Your letter makes no mention of this, so we continue to seek urgent clarification from you as to whether the government still intends to persist with its timetable for the imposition of a new contract.”
Malawana said that he was seeking clarification that the health secretary would guarantee that junior doctors would not have their pay cut. “You have told the press that you ‘don’t want to see any junior doctor have their pay cut.’ Can we clarify that this represents your guarantee that this will not happen?” he said.
He also sought clarification that safeguards to protect junior doctors from working excessive hours would be set within the contract. “We welcome the fact that you have given your ‘absolute guarantee’ that doctors will not be forced to work unsafe hours. We would assume that the teeth in the safeguards will be contractual,” the letter said.
In his letter to the BMA, Hunt said that nights and Sundays would continue to attract unsocial hours payments for junior doctors and that he would be happy to discuss “how far plain time working extends on Saturdays.” In response to this, Malawana said, “It remains our position that work on Saturdays and late evenings cannot be considered as exactly the same as daytime on a weekday.”
Malawana also tackled the government’s plan to introduce “flexible pay premia” to support recruitment into shortage specialties. He said, “Our concern is that those specialties which require a higher level of intensity during unsocial hours will, in fact, see a reduction in remuneration as a result of these proposals. Yet, these are the very specialties which are essential for the delivery of a safe, seven day NHS.”
Malawana also called for assurances that there would be contractual protections for doctors wishing to work less than full time or take leave to have a family or pursue research. “The proposals to change the way junior doctors are paid through the course of their training would see trainees, who currently go through up to 11 levels of training, put into just six pay grades. This means that the critical experience which junior doctors gain through training would not be recognised,” he said.
Commenting on Malawana’s letter, a spokeswoman from the Department of Health said, “We have already given key guarantees including protecting the overall paybill, ensuring the great majority of junior doctors are at least as well paid as they would be now, and reducing the number of hours worked. As the BMA has said today, a negotiated contract is the best way forward, so with independent voices like the Academy of Medical Royal Colleges, we urge the BMA to come back to the table to determine a deal that better supports seven day services.”