Government reforms and Junior doctors' work contracts.
My wife and I, we both are teachers. We teach Physics and Economics.
We have three children, two daughters and a son. The eldest daughter is a dentist, the son and the youngest daughter are doctors. All three children went into medicine/dentistry because, they loved the profession and wanted to be doctors. They do their duties happily. They are so bound by their duty schedules that despite being in the same city ie London, as parents we do not get to see them for weeks (last Eid day, 23 Sept. 2015, is an example; when none could come home for even the Eid dinner).
My youngest daughter who is training to be a Consultant Anaesthetist has texted me the following on 27th of September :
27 September 2015
Can you contact your MP friends regarding Jeremy Hunt's proposal to change the junior doctors contract by 2016.
I am completely opposed to this current government's agenda. They are destroying the NHS in the same way they have neglected the teaching profession since the late 1990s.
Mr. Hunt proposes that he will be making savings by cutting doctors' wages by 30%, stopping doctors from being paid for overtime with the abolition of hours monitoring under the European working hours law, introducing unsociable hours 7am to 10pm Mon-Sat (I already work unsociable hours how can I physically do any more), taking away doctors' accommodation, making maternity leave and out of programme experiences unfavourable and making it increasingly difficult to change specialities - all the while telling the British public that not enough doctors work weekends (simply not true), that doctors earn too much (simply not true - I am nearly 30 years old and I am still living in halls like a student) and making false promises (provision of 5000 gps) - not only is this implausible (recruitment to medicine is at an all time low with many quitting, retiring or going overseas) and little money in the system to provide the care needed to for an aging population; but by undercutting the very people in the front line of the NHS, selling parts of the NHS to private companies and paying less skilled workers to take the place of doctors.
I really fear for my profession. I believe Adeeb (my brother who is a doctor) and I will live through the demise of the one last noble institution in this country if we do not fight back.
I need people to know about this travesty. We must contact newspapers/TV channels and electronic media and, inform/challenge the government.
Can you help ?
Medics say that the new contracts could see pay slashed by 15 percent as 'normal hours' would be declassed as 7am to 10pm, Monday to Saturday. Extra pay for unsociable hours would apply outside these times, rather than the 7am to 7pm, Monday to Friday.
The contract changes the Rt. Hon. Secretary of State for Health Jeremy Hunt MP is proposing, will jeopardise patient safety and the NHS.
It is widely believed that reforms to junior doctors' work contract risk leaving them so exhausted that patients will be put at risk.
Also, we do not want see our children leave NHS and take up jobs in the USA or Australia.
Dr. Hasanat Husain MBE
Letter to my MP about the Junior Doctor crisis
Ms. Lyn Brown MP
Shadow Communities Minister,
House of Commons,
London SW1A 0AA.
4th October 2015
Dear Lyn Brown MP,
I am writing to you as your constituent to ask for your help in holding the Government to account over the current Junior Doctor crisis.
By way of an introduction I am a paediatrician. I have been a medical student for 6 years and a doctor for 5 years. I am a “Junior” Doctor. I am 36 years old. I have a degree in Psychology. I had a career in the City before I studied medicine. As a student I was refused a loan from the Government to pay for my tuition fees. I took out loans culminating in £60,000 of unsecured personal debt to fund my studies. My current salary is £31,000. I receive a supplement for regular night, evening and weekend working of approximately £15,000. I have to personally fund compulsory professional exams, insurance, and professional fees.
I have no choice where my next job is (this changes every 6 months). I have no say on when I can take my holidays. I regularly work between 48 and 70 hours a week. I routinely work extra hours if needed to care for my patients. Some of my shifts are so busy I don’t have time to eat, drink or use the toilet. In every job I have worked there are serious staff shortages. My pay has been cut in real terms for years by successive pay freezes. My pension has been cut. Everyday I am being asked to do more with less. Morale is at an all time low. I am working at the limit of what I can endure. This picture is similar for all doctors. Doctors are leaving the NHS.
I have put up with this because I love my job, I believe passionately in the NHS. I recognise what a privilege it is to care for children when they need it most. Everyday I interact with some of the most compassionate and dazzlingly brilliant healthcare professionals who routinely go above and beyond their contractual duties. This is why I am so angry about a Health Secretary that has ridden roughshod over the NHS, its staff and its values; time and time again.
I hope that you have already heard from many of your political colleagues, your constituents and other doctors on this matter. If not, I have some issues about the new Junior Doctor contract that I would like to highlight:
1. The new contract will reclassify “normal” working time from 0700-2200Monday to Saturday. Doctors will lose the modest overtime premium that we are paid in compensation for the existing antisocial hours we work. This will cut the salaries for some of the most acute specialties in the NHS (those with significant workloads at nights and weekends- ie A&E, Obstetrics, Paediatrics, Intensive Care, Anesthetics, Surgery). This is a disaster given the current staffing shortages and recruitment crises in these specialties.
2. The proposals remove fundamental safeguards against excessive working hours. This is not safe for doctors and certainly not for patients. We are already working desperately hard trying to meet existing demand in the context of pre-existing staffing shortages. 20% of paediatric registrar posts are not filled. We are only human, and when physically, emotionally and mentally exhausted we are more prone to error. This is simply not safe.
3. The new proposals remove pay progression intended to reflect the clinical experience gained from years of NHS service. This will disproportionately penalise women who often work less than full time or take time out to have families. Women make up the majority of the paediatric workforce. This is a socially regressive step and undoes all of the work to achieve parity and flexible working in our profession.
4. The removal of pay progression also penalises doctors who take time out to do important medical research for childhood cancers, congenital heart problems and many other areas. There is now a huge disincentive to take time out of training to complete PhDs or to run clinical trials. This will seriously affect the UK as a world leader in clinical research and to reduce the quality of the care we can offer our patients.
5. The Government has willfully misrepresented data suggesting that patients were more at risk of harm if they were admitted at the weekend. The reasons for in-hospital mortality are extremely complex and cannot be reduced to politically motivated sound bites. The NHS is already working flat out 7 days, with senior cover. This prompted a furious #ImInWorkJeremy Twitter campaign and a government petition calling for Mr Hunt to be removed from office, attracting over 200,000 signatures in just over 36 hours.
6. The Department of Health is saying that we have refused to negotiate. This is not true. Doctors have been in negotiations for over a year. The BMA walked away only when presented with an unacceptable set of preconditions as the basis for our ongoing negotiation (namely the points mentioned above). We were told if we did not accept this, the contract would be imposed anyway. This cannot, and will not, be the starting point for our negotiation.
Junior doctors, some of the hardest working members of society, are furious at the attitude of the Government. The net result has been a grassroots movement against the imposition of the new contract. Reluctantly we (via the British Medical Association) are balloting for a strike, as we feel we have no other option. Over 5000 doctors gathered on Monday to demonstrate our commitment to the vigorous opposition of this contract. A Facebook group now has 48,000 members discussing our strategy going forward. The BMA has a huge mandate for sustained industrial action.
Despite limited coverage from some elements of the mainstream press (most notably the BBC) we are starting to receive some acknowledgement of our concerns. A poll in the Guardian found that an unprecedented 95% of those polled supported a strike. The Royal Colleges have also taken the unprecedented step of issuing statements warning of the damage this contract will do to the NHS in the short and long term. This is undoubtedly the most serious medical professional dispute of a generation.
Much has been written about this Government’s intention to open up the NHS to the Private Sector, a process accelerated with the passing of the 2012 legislation. Despite the rush to privatisation, it is instructive that although all doctors would financially benefit from a private healthcare system (we would dramatically increase our salaries overnight), not one doctor I have ever spoken to wants this.
We have a unique healthcare system that is the envy of the world. Which, despite the cynical and factually incorrect rhetoric, consistently delivers compassionate, cost effective healthcare. The US model, so passionately embraced by this administration, is one of the most inefficient and fails to protect the most vulnerable members of society.
This is not just about our pay. It is about our patients, it is about our NHS that we love so much. It is about recognition of the caring, sacrifice and dedication of NHS staff I see every day I am at work. I cannot stand by as a passive observer whilst the systematic undermining of the NHS and those who work within it continues. Enough is enough.
I implore you to stand with us and fight these changes to our contracts. Ask questions, table motions, speak at our events, engage with your colleagues, meet with me, meet with us. If you need further clarification, facts or references I am happy to provide these. Please look at #JuniorContract #NotSafeNotFair to understand the strength of feeling here. This issue will not go away. Please help us to protect patients, doctors and the NHS now and for generations to come.
Dr Oliver Bates