Viewpoint: DH still has time to show common sense and avoid junior doctor strike

Industrial action by junior doctors looks almost inevitable, with results of a landmark ballot due on Thursday. But health secretary Jeremy Hunt could still end the dispute amicably by agreeing to reasonable demands put forward by the profession, says BMA deputy chairman Dr Kailash Chand

Junior doctors could go on the first all-out strike in the history of the NHS next month, after results of a ballot that will almost certainly sanction industrial action are announced on Thursday. The NHS would see one day of emergency care only for 24 hours on 1 December, followed by a full walkout from 8am to 5pm on 8 December and 16 December.

This action is not being taken lightly by junior doctors and the BMA. The industrial action is a last resort in the face of the government’s continued threat to impose a new contract. Doctors believe the proposed contract is unsafe for patients, unfair for doctors and will undermine theJuni future of the NHS.

It will remove vital protections on safe working patterns, devalue evening and weekend work, and could have a real impact on the quality of patient care if we return to the days of exhausted junior doctors working dangerously long hours.

Junior doctor protest

The outpouring of anger and frustration we have seen from thousands of junior doctors across the UK must be a wake-up call for health secretary Jeremy Hunt. If he and his team thought that junior doctors would simply accept their threats to impose a new contract, they have been proven very wrong.

We are already seeing reports of thousands of doctors, including a large number of junior doctors, looking for opportunities to move and work abroad, which at a time when the NHS is facing a recruitment and retention crisis is cause for serious alarm.

The government’s proposals will impact those specialities such as general practice and emergency services that are facing particular workforce shortages, whether it is through reducing the pay of doctors involved greater amounts of evening and weekend work, or reducing pay for those in training. Worse still, by making it easier for hospital trusts to return to the days where junior doctors worked dangerously long hours, they risk compromising patient care as well as junior doctors’ health and wellbeing.

The BMA has been clear that it wants to deliver a safe and fair contract for junior doctors and patients. Instead of genuine negotiations, the government has insisted that junior doctors agree without question. This would not have allowed the BMA to negotiate over proposals we believe are unsafe for patients, unfair for doctors and undermine the future of the NHS.

Seven-day NHS

Mr Hunt has accused junior doctors of misleading the public, yet at the same time he continues to conflate junior doctors’ concerns and the government’s rhetoric on seven-day services. The junior doctor contract is in no way a barrier to seven-day services, with the vast majority of junior doctors routinely providing care to patients 24/7.

There are more than 50,000 junior doctors in England alone. They form the backbone of our NHS, working around the clock, seven days a week, and with a starting salary of less than £23,000, earning less than you might expect. Despite improvements in working hours in recent years, more than four in five junior doctors continue to struggle with long hours. Working 12 days in a row and clocking up 90-plus hours in a week are still common. Almost one in three have considered leaving the profession.

The contract determines obvious things like pay and working hours, but also affects the quality of doctors’ working lives and the quality of their training. It also plays an important role in ensuring medicine remains an attractive profession for the brightest school leavers, especially at a time when students undertaking a medical degree face debts of up to £70,000. Junior doctors work long hours and take high-risk clinical decisions, but in return they need a contract that protects them and the patients they care for, delivers a fair system of pay and ensures they have the opportunity and flexibility to learn as they progress.

NHS under threat

These things are vital to delivering high quality care for patients and to ensure doctors are trained to the best possible standards. Instead of working with the BMA to deliver this, the government want to force though changes that will be bad for patients, bad for junior doctors and, ultimately, bad for the NHS.

In recent weeks the health secretary has acknowledged junior doctors play a vital role in the NHS. This is at odds with his relentless and extremely damaging rhetoric attacking doctors, which has led to the anger on display. We have always stated that without the continued threats of imposition and pre-conditions, the BMA would be happy to enter meaningful negotiations.

But, until the government gives junior doctors the reasonable assurances they are demanding, industrial action cannot be avoided. Junior doctors are among the hardest working and most dedicated of NHS staff. Without them, the NHS would grind to a halt. The BMA wants to deliver a contract that protects patient safety and is fair to both junior doctors and the health service as a whole. This dispute could still be settled amicably, if the government agrees to very reasonable and just demands of junior doctors.

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