Department of Health's Response to MWF Letter on Junior Doctor Contract Changes

19 October 2015
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In September 2015 MWF President Dr Sally Davies drafted a letter to Jeremy Hunt raising concerns about the proposed changed to the Junior Doctor contract. The letter can be read here. Below is the response we have received from the Department of Health:

Dear Dr Davies,
Thank you for your recent correspondence to Jeremy Hunt about the reform of junior doctors, I have been asked to reply.

The Government was elected on a mandate to deliver a seven-day NHS and ensure NHS care is the same quality across the week. Independent research from the British Medical Journal is clear that there are 11,000 excess deaths in our hospitals every year because of the weekend effect. The Government is determined to change this by ensuring that hospitals are staffed properly seven days a week to ensure that patients get the care they need whenever they fall ill. That means reforming the contracts that were put in place for consultants and junior doctors over 13 years ago.

You will have seen concerns that junior doctors will get pay cuts of 30 per cent and be forced to work longer hours. In fact the opposite is true. The Secretary of State has given the British Medical Association (BMA) the following four assurances on the junior doctors contract in advance of the Government formal proposal. As the BMA itself stated recently, the best deal will be reached by negotiation so the Department of Health continues to urge the Junior Doctors Committee to come back to the table. Many independent and clinical voices are doing the same, including the Royal College of Surgeons, the Royal College of Emergency Medicine, the Academy of Medical Royal Colleges and NHS Providers.
First, this is not a cost cutting exercise. The Government is not seeking to save a penny from the junior doctors.
Secondly, the Government wants the new contract to improve patient safety by better supporting a seven-day NHS. For junior doctors, this means some increase in hours that are not payable at premium rate but this is backed up with a significant increase in basic pay. Staff will still be paid for working antisocial hours, junior doctors will get the same pay on average and the Government wants to discuss at what point premium rates will be payable on a Saturday.
Thirdly, the Government believes that its ambition for the NHS to be the safest healthcare system in the world is underpinned by reducing, not increasing, the number of hours junior doctors work each week. Junior doctors already work seven days and are the backbone of medical care in hospitals at weekends and at night. The contract will not impose longer hours. No junior doctor working full time will be expected to work on average more than 48 hours a week and the Government wants to improve training and ensure better clinical supervision from senior consultants as well.
Finally, the Secretary of State has asked that the details of the new contract ensure that the great majority of junior doctors are at least as well paid as they would be now. The Government can give an absolute guarantee that average pay for juniors will not reduce. The Secretary of State has already given the BMA his assurances that there will be pay protection for doctors who change to shortage specialties and to support agreed academic work.

The negotiations on the new contract began on the basis of a shared view between the BMA and the Government that the current contract had served its purpose and needed reform. In fact, the BMA accepted that point as far back as 2008. The Government is clear that as well as being better for patients this is a fairer deal for doctors. It will reduce the number of hours junior doctors can work from 91 to 72 hours in a week, abolish the week of nights that many junior doctors experience under the current contract, bring in a limit on the number of long days that can be worked consecutively and base pay and progression on achievement and experience. I hope this reply is helpful.

Yours sincerely
Paul Larkin
Ministerial Correspondence and Public Enquiries
Department of Health

Medical Women's Federation
Tavistock House North,
Tavistock Square, London,
Tel: 020 7387 7765

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