Junior doctors have condemned a new contract imposed on them, which some say will cut their pay by up to 40%, force them to work more antisocial shifts and put many off going into the specialities with the greatest shortages – General Practice and A&E, which will be affected most. Junior doctor’s leaders have walked out on talks and have threatened to strike.
The contract will reclassify junior doctors’ normal working hours as being about 48 hrs from 7am to 7pm between Monday and Friday, to 48 hrs hours from 7am to 10pm between Monday and Saturday. They will lose out by no longer earning higher rates as evenings and Saturdays will be paid at the standard rate.
Basic pay for a newly qualified doctor is only about £23,000 . With the unsociable hours benefit it usually increases to about £28,000 – £30,000.
The government is doing this because it wants to create a 7 day NHS without significantly increasing spending. This pledge came about because studies have shown that you have a 16% higher risk of dying if admitted at the weekend rather than a Wednesday. This is mainly because admissions at the weekend tend to be emergencies rather than routine planned admissions and of course these people are more seriously ill. However even when accounting for this there was still a small significant increase in mortality, although much smaller. Headlines have of course not explained this and Jeremy Hunt himself either does not understand the statistics or is being disingenuous by saying that there are 3,000 people dying every year because of this excess mortality; it is incorrect to simply extrapolate the data.
The BMJ looked at the data and concluded that there would be some lives saved if the same standard of care was given to patients at the weekend as during the week but it was conceivable that if staff were simply ‘stretched out over 7 days’ , without increasing numbers, this would worsen cover and mortality rates during the week.
The BMA’s view is that it is ready to cooperate with the Government on ensuring good cover and more consultant input on the weekends and during the night but it does not support David Cameron’s plan to increase the amount of non urgent work done at weekends. David Cameron wants GP surgeries to be open seven days a week and hospital appointments and operations to be performed ‘so people do not have to take time off work’.
A seven day NHS will be very hard to achieve without extra funds, This government has pledged an extra 8 billion to the NHS this year but wants the NHS to make efficiency savings of £20 billion [out of an total NHS budget of about £100 billion]. Hence, a cynic would say, the creation of the new,imposed junior doctor contract is simply a way to get more for less.