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The first day of the strike was due to begin yesterday [at 8am on Tuesday] which would have left many hospitals in England offering only the very limited range of services usually seen on Christmas Day. Jeremy Hunt the heath secretary agreed to go to arbitration with junior doctor representatives at ACAS and to remove the threat of an imposed contract [ something that doctor’s leaders had said was akin to having a gun held to their heads.  His actions sparked great anger amongst junior doctors 98% of whom voted for strike action in protest.

The arbitration agency reported “Following five days of productive talks under the auspices of ACAS, the BMA,  NHS Employers and the Department of Health have reached an agreement. ACAS is pleased that the talks have been held in a constructive manner and cooperative spirit between the parties, that will allow an improvement in industrial relations.”

There are two main sticking points;

1. Hunt has been seeking to extend “plain time”, the hours in which a trainee doctor receives standard pay, from 7am-7pm Monday to Friday to 7am-10pm every day except Sunday, though he later offered to make it 7pm on a Saturday. This is in order to create the seven day NHS – normal working for throughout the week that David Cameron wants.

2. To remove  the obligation to work to the European Working Time Directive

The Directive was designed to protect the health and safety of workers by restricting the number of hours an individual can work and by imposing minimum rest requirements for all workers. Limiting working hours can help reduce the likelihood of doctors getting tired and therefore improve the quality of service they can deliver to patients.An individual doctor has the right to opt out of the working time regulations, it maintains that it is the right of all doctors to work within the regulations should they so choose.  No doctor should be coerced or pressurised into opting out.

For Junior doctors it means:

  • working hours have been reduced from an average of 56 per week to 48, calculated over a period of 26 weeks.  Doctors are entitled to choose to work additional hours if they wish.
  • a period of 11 hours continuous rest a day (or compensatory rest to be taken at another time if this is not achieved).
  • a day off each week , or two days off in every fortnight (or compensatory rest)
  • a 20 minute rest break every 6 hours (or compensatory rest)

I am old enough to have been a junior doctor before the European Working Time Directive. It used to be common place to have badly designed rotas and to have to cover doctors who were off sick or on leave [I am sure to save the costs of a locum] and have to be on call 72 hrs in one stretch, without and rest breaks.

Junior doctors have been criticised, and the Government have been quick to portray the BMA as putting well paid doctors wishes before those of sick patients.  This is a dispute very much in the eyes of the public and each side have a lot to lose if they do not have the support of the public. I think it is important to counter myths about pay and stress that safe working is also in the best interest of patients