THE BLOG

Junior Doctors: How Did It Come to This?

24/02/2016 14:03 GMT | Updated 24/02/2017 10:12 GMT

Just after 8am on 11 February I Tweeted that I was glad that Junior Doctors were back at work and hoped that both sides would set about settling their remaining differences and negotiate a new contract that would be safe for patients and fair for staff. A few minutes later I was shocked to hear the news that the Secretary of State was going to impose the new contract, something he had threatened all through negotiations.

I could not understand what had made him reach for the 'nuclear' option when so much progress had been made in a fairly short period after several years of stalemate. His claim that he had a letter agreeing imposition signed by leading Trust chief executives started to unravel within hours as one after the other claimed that, while they thought the offer was fair, they did not agree to imposing the contract.

How did it come to this? The contract negotiations have been so badly handled from the start, with the threat of imposition hanging over the talks like the sword of Damocles. A cynic might almost think it was a deliberate attempt to 'break' the doctors and thus make changing the contracts of all other health workers a simple matter.

The contract that Jeremy Hunt and the UK Government have decided to impose on junior doctors reclassifies antisocial hours in evenings and Saturdays which will reduce the pay of those who work a significant proportion of their hours at these times. This will act as a further disincentive to doctors considering entering the very acute specialities such as A&E or emergency medicine where the NHS is already struggling to recruit young doctors.

Mr Hunt claims these changes are crucial to developing safe healthcare over seven days in the English NHS but junior doctors already work across seven days. The research which the Secretary of State regularly quotes has shown a higher number of deaths, within a month, among those admitted at weekends but it has not been further investigated to find out if the patients could have been saved or were just too ill. Nor has he considered any of the research which might explain the actual cause of the problem before trying to fix it.

The contract also removes the automatic increase in pay for working excessively long hours which has encouraged hospitals to employ sufficient staff rather than overwork their junior doctors. This vital safeguard has served us well and its removal poses a threat to patient safety, the working lives of our health service staff and the sustainability of the service. The Government proposes a designated 'guardian' to whom junior doctors can report concerns about the hours they are being asked to work but this requires a young doctor to be willing to step forward and complain which is not always easy in a hierarchical system and they may fear being labelled as a trouble maker.

In contrast to the ever worsening relationship between the BMA and Jeremy Hunt, Cabinet secretary Shona Robison has been working closely with the medical profession to ensure that our Scottish health service provides first class care in a way that is safe for patients and fair for staff of all grades and professions within the NHS. While the Scottish NHS faces the same challenges as England, with an ageing population and ever increasing demand, we do not have the additional difficulties of fragmentation, privatisation and confrontation.

The Scottish Government is committed to protecting all sectors of the Health Service in Scotland and will not be imposing this contract on our Junior Doctors.

No one wants strikes, certainly not health service staff, but the UK Government must listen to the concerns of the profession. I certainly would not like to see a return to the ridiculous hours I used to work as a Trainee surgeon; it was not safe for patients nor for staff. As they say on the signs above the motorway 'Tiredness Kills' and sadly, on occasions, that has been only too true.

It is hard to see how trust between the medical profession in England and Jeremy Hunt can be regained but it is imperative that he steps back from the imposition of this contract and both sides come back to the negotiating table to achieve a fair deal that is safe for patients and staff.

Dr Philippa Whitford is the SNP MP for Central Ayshire, and the SNP health spokesperson in Westminster