work on the Junior Doctor Contract
The junior doctors strike in 2016 and the contract disputes that led up to it was one of the biggest issues affecting trainees for a generation.
Throughout the process the Association and the Trainee Committee worked hard to make sure members' views were heard at government level, and the trainee membership was supported through this difficult period.
The timeline below outlines the most significant points in this debate.
Both the Association and the Trainee Committee continue to monitor issues relating to contracts – consultants and SAS doctors as well as trainees - closely and will keep the membership updated on any developments and consult where appropriate.
In September, the announcement of a series of five day strikes by the BMA led to another joint statement to members. While the three organisations recognised the concern among junior doctors they expressed their concern that patient safety could be put at risk.
Again they urged the BMA and the Department of Health to return to the negotiating table.
In the context of the impending strike an updated welfare statement was also issued making sure members were aware of the support that the organisations could offer them.
Following the announcement by the BMA of a referendum on the new contract, a joint Association, RCoA and FICM statement made it clear that individual members had to make up their own minds on the issue and reiterated their support for trainees colleagues during this difficult time.
A further, more detailed, statement by the Association President was published in April 2016 following the publication of details of the contract due to be imposed. The Association used the statement to reiterate the concerns it had including:
- How the new contract would affect women, lone parents, carers and those working less than full time
- Changes to definitions of unsocial hours and pay premia
- The negative impact the contract is likely to have on plans for seven day services with specialties like anaesthetics likely to end up struggling to recruit and retain people
It ended with a call for a return to negotiations.
When later in April 2016 it became clear that industrial action was imminent, a further joint statement was released. This re-emphasised the importance of patient safety and the need for each department of anaesthesia/critical care/pain management to decide on the prioritisation of clinical duties with relevant partner specialties and hospital management on each day of action.
A short statement from the then Association President was posted on the website in February 2016, stating that the decision by the Health Secretary to impose a contract on trainees in England was regrettable.
In November 2015, after the imposition of the contract was announced and strike action was confirmed, we produced a joint statement with the RCoA and FICM. While urging the BMA to return to negotiations, it also offered practical advice to help members through the period.
In September 2015, we released a statement on the proposed trainee contract. The statement specifically focused on the ways the contract would impact on anaesthetic trainees including:
- Anaesthetic trainees being among the hardest hit by the likely 15% pay reduction as they are almost always the resident on call
- Problems around working hours including limited breaks, the removal of systems that monitor hours, and taking away of rest spaces
- The impact of the changes on women and those working less than full time
The statement ended by calling on members to contact local politicians to raise their concerns.
This was closely followed by a joint statement with the Royal College of Anaesthetists (RCoA) and Faculty of Intensive Care Medicine (FICM) expressing concern that negotiations between the BMA and NHS employers had broken down, but also using the opportunity to reinforce the importance of trainees feeling supported and highlighting the ways in which each organisation could help with this.
In 2015, the Trainee Committee then responded to the DDRB report calling it clear and even-handed. The DDRB stressed the importance of trust and confidence-building that doctors needed to have in the new arrangements, the importance of a reasonable work-life balance for both junior doctors and consultants, and the need for contractual safeguards to ensure this.
The Trainee Committee was encouraged by these statements and called on the government to take notice of them.
In July 2015, the Trainee Committee was one of the signatories of a Joint Training Committee Statement on the Imposition of a New Contract for Junior Doctors.
The statement concluded that the proposed imposition of the junior doctors' contract by the Department of Health was 'unacceptable' and that a 'poorly thought out, enforced contract will lead to irreparable harm to morale within the NHS workforce'.
We responded to the Review Body on Doctors and Dentists Remuneration (DDRB) call for evidence about pay-related issues in the consultant and doctors in training contract negotiations, submitting a response at the end of 2014. This was used to highlight potential concerns with the process including:
- Loss of automatic progression
- Reductions in premium time
- Elective weekend services as a contractual obligation
The government announced in December 2012 that it intended to seek a new junior doctors' contract. The following June, the British Medical Association (BMA) released a questionnaire seeking views about the proposed changes which the Trainee Committee encouraged its members to complete.