Posted on November 1st 2015 by Taha Nasser on the The Utopia.
What are the DDRB recommendations in question?
Recommendations 3, 4, 5, 6, 7, 8, 17, 18 increase routine working hours from 7am – 7pm Mon – Fri to 7am – 10pm Mon – Sat. This increases ‘standard rate’ working hours from 60 – 90 hours per week, an increase of 30 hours.
What would be the effects of this?
It would mean that ‘standard rotas’ and standard days can be much longer. Currently, having to pay us more than basic rate for that extra 30 hours a week with a banding system means that there is a financial incentive for rota co-ordinators to not rota us on for even longer hours back to back and to make sure that our rotas aren’t purely shift work.
If we did move to a system that resembles shift work, for which there would now be no financial penalty, it would cause:
- Greater social strains on doctors since it’s likely they would be working evening, weekend and night shifts even more routinely.
- Greater fatigue and potential damage to patients due to mistakes
- Less interaction with our consultants and thus end up less well trained by the time we become consultants
How do we know that we will work hours for less pay?
(Dr Steven Bishop models effects of DDRB proposals on doctors’ pay)
Broadly speaking, the changes to the contract are likely to cause an overall pay cut in the vast majority of specialties. This was modelled by Dr Steven Bishop, an Academic Clinical Fellow in Anaesthesia and a Specialty Registrar from the Cambridge University Hospitals Trust. His model, based upon the pay scenarios proposed by the DDRB showed that the majority of specialties including general medicine, surgery, psychiatry, A&E, Obstetrics & Gynaecology and Anaesthetics suffered sizeable pay reductions throughout their training period, with Anaesthetic trainees being especially badly hit. The exact pay cut varies depending on what the DDRB sets as their basic pay rate for non out of hours work, but at it’s most severe it may lead to a pay cut between 10 and 30% depending on the specialty. The changes in pay structure would also mean that doctors would end up in a higher bracket of pension contributions earlier but since their overall pay would be cut, they would actually get a lower pension return when they retire. The DDRB also recommends a cut down on current annual leave, which is tantamount to an even greater pay cut.
What has been the Department of Health’s Response?
It’s worth analysing Jeremy Hunt & the department of Health’s responses to the realities that I’ve outlined so far.
In September, the BMA walked out of negotiations after the department of health had made 22 of the 23 points on the DDRB proposal ‘non negotiable’ before the negotiations had even concluded. The department of health then released a statement claiming that it was the BMA that was at fault and that the new contract ‘increases basic pay’ and ‘rewards those who work across all clinical specialties’. In reality whilst basic pay may increase marginally, for many overall take home pay will decrease significantly. By only mentioning part of the picture whilst not explaining what the overall effect would be, the department of health has purposefully tried to mislead us and the public on the issue. And as for the second part of the department of health response, that the new contract ‘rewards those who work across all clinical specialties’ – that simply isn’t true. Many general medical and surgical specialties as well as GPs will suffer pay cuts.
This past week Jeremy Hunt was involved in the commons debate where he attempted to claim that no junior doctor would suffer a pay cut. Unless the sample pay schemes that we have been shown are going to be totally revised, this simply cannot be true. As Dr Steven Bishop’s analysis shows, every pay scheme proposed by the department of health creates a pay cut to multiple specialties. Bearing in mind that that this is the same department of health that misrepresented research about deaths on the weekends then used those false conclusions to make an attack on consultants who already work weekends, and then purposefully attempted to mislead the public into believing that we were actually getting a pay rise by only mentioning our basic pay it’s little wonder that we’re forced to conclude that Jeremy Hunt is lying when he says that no doctor will suffer a pay cut, likely in a crude attempt to divide our ranks the week before we are set to vote on a strike. It is therefore absolutely vital that we see through this tactic and continue onwards united behind the BMA.
Two things to do:
1. Make sure that you vote yes and yes to both types of strike in the forthcoming BMA ballot. The wording of these strikes may not be exactly what you want, but they are worded in accordance with legislation that means that the BMA then has the freedom to go forward with a complete strike if needed.
2. Make sure that you find out who your local MP is (Find your MP) and write to them, making it absolutely clear why you are opposed to the contract and if they’re conservative, make it clear that allowing these contracts to go through will cost them your vote.
See Taha Nasser's blog on the The Utopia.
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