Wednesday, 04 August 2021

Junior doctors prepared to strike over pay

KIERAN BURTON and his partner Samantha Jayaweera bought their semi-detached house in Chestnut Place, Watlington, a

KIERAN BURTON and his partner Samantha Jayaweera bought their semi-detached house in Chestnut Place, Watlington, a year ago and are planning to have a family.

But the couple say they would struggle to pay their mortgage, let alone afford to raise children, if their NHS contracts are changed.

They say they would each lose somewhere between 15 and 30 per cent of their salaries.

More importantly for the rest of us, the couple say the changes to junior doctors’ contracts being proposed by the Government could spell disaster for the NHS and put patients’ safety at risk.

Health Secretary Jeremy Hunt has offered an 11 per cent rise in basic pay for doctors but that comes at a price as other elements of their package are being curbed.

For example, the number of hours during the working week that are classed as unsociable — and therefore attract an extra payment — are being cut.

Guaranteed pay increases linked to time in the job are being scrapped and replaced with a system linked to progression through set training stages.

This would affect people who, for example, take time out to have a baby, says the British Medical Association.

Dr Burton, 30, who works in intensive care at the Royal Berkshire Hospital in Reading and is also undertaking a fellowship at Wexham Park Hospital in Slough, says the new contract would mean that cover in hospitals on weekdays would be cut.

“Our primary concern is for patient safety,” he said. “We’re already quite stretched as we work seven days a week.”

Normal working hours are currently classed as between 7am and 7pm Monday to Friday, so anything outside of this is classed as “anti-social”.

Dr Jayaweera, 29, who is training to be an anaesthetist at the Royal Berks, says: “That is being changed to 7am to 10pm Monday to Saturday so 9pm on a Saturday is going to be the same pay as 9am on a Wednesday.”

She said that staying late after a shift had finished was routine, adding: “If we were actually paid for every hour we were truly working we would expect to be paid much more than we are. What we’re asking for is not a pay cut.”

Dr Burton said: “To me it’s simply spreading too little butter over too much bread.

“Jeremy Hunt is redistributing existing resources and creating gaps. This isn’t extra care, it’s redistributing from existing services. If you’re going to have a genuine seven-day NHS you need a seven-day health and social care system.”

Dr Jayaweera said: “This contract is a direct threat to the future of the NHS. Would I want my parents or brother being treated if the contract was imposed on junior doctors? No, I don’t think it’s safe.”

Both have six years of training behind them but face at least another six until they qualify — a junior doctor is classed in medical terms as anyone from their time of qualification until consultant level.

Dr Burton said: “If you go into A&E usually you’ll see a junior doctor. If a patient gets sick in the middle of the night it is a junior doctor that comes along and sees you. The junior doctor is at the heart of safety in the hospital.”

Under the current system if doctors believe their working hours are “consistently dangerous” they can contact the BMA and will be put on a system called “diary card hours monitoring”.

But the new contract excludes financial penalties for hospital trusts for whom a junior doctor works longer hours than they should.

Dr Burton explained: “When it got genuinely dangerous and out of control there would be no mechanism by which we could rein that in.”

Both doctors are contracted to work 48 hours a week, which includes “anti-social” hours.

The basic pre-tax salary of a doctor at their level is £34,000 a year with an additional 40 per cent for unsociable hours worked.

Dr Jayaweera, who is also undertaking a clinical simulation and patient safety fellowship with Health Education Thames Valley, says that at the moment her hours are “pretty good”, even though she might work for an extra hour or so after her shift.

But in general medicine, where both have worked previosuly, the problem of unpaid overtime is more common.

Dr Burton said then he could work anywhere between five and 15 hours a week unpaid in general medicine.

All this affects the couple’s personal lives and their hopes for the future.

Dr Burton said an 11 per cent pay rise would represent a significantly lower percentage of their current overall income due to the supplements they receive for working anti-social hours.

Dr Jayaweera added: “We have heard figures for loss of overall earnings from 15 per cent to 30 per cent.”

Dr Burton said: “We would struggle to make our mortgage payments. I’m not saying we’d have to sell our house but it would be very, very tight at 30 per cent.

“There is a possibility we will face a choice between the careers we have chosen and a family and maybe one of them has to give.

“At the moment we don’t know which it will be but it’s a cause for great concern.” His partner added: “We’d love to have children in the next few years but it is of real concern how we’re going to manage two of us working in the NHS if this contract comes through.”

The couple have to pay for exams and the majority of courses which they say are “essential” to progress, which costs about £2,500 a year each.

They say they want the BMA to be able to have “meaningful” negotiations with the Government rather than have doctors’ terms dictated.

Dr Burton said: “We would be absolutely delighted if Jeremy Hunt said, ‘fine, the threat of imposition is off the table, we will talk’.”

The couple joined last month’s protest march in London.

“There was a great strength of feeling,” said Dr Burton. “I’ve never seen a consensus of this type before. We support action that will force consideration of our patients’ welfare.”

Dr Jayaweera added: “I feel backed into a corner by Jeremy Hunt. With the new contract I would not be able to anaesthetise safely. I would just be so tired — the fatigue from switching your body clock from nights to days cannot be underestimated.”

They couple met Henley MP John Howell to discuss their concerns but accused him of a “complete lack of engagement”.

Dr Burton said: “He made a statement, which was ‘Jeremy has said you won’t have a pay cut so you need to go away, read what he said and rethink’. That was before we put any of our concerns to him.

“He had a Department of Health briefing sheet in front of him and looked down from time to time and made a statement like that.”

He said Mr Howell would not elaborate, adding: “If you can’t get why your MP has an opinion you’re in a very sorry state. He has an opinion that he doesn’t feel he’s required to justify.”

Mr Howell told the Henley Standard: “Their recollection of the meeting is totally at variance with my recollection of the meeting.”

He continued: “I’ve written to the Secretary of State to ask for a calculation of what the situation is in the future. I think we need to see that calculation in full in order to understand the debate.

“When I have that calculation I’ll be in touch with all the doctors that have written to me.”

• If the doctors decide to take industrial action, there would be a one-day strike on December 1 when junior doctors in hospitals would provide “emergency care only” followed by a full walk-out from 8am to 5pm on December 8 and December 16.

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