Tag Archives: 7 day nhs

Doctors’ Strikes: Time For One Final Push

An open letter from the NHSpace blog to all those doctors considering what action to take.

Dear doctors,

You’ve come a long way since the ballot on industrial action last year. You’ve forced the government to come back to the table at least twice, and got concessions out of them. You did this by maintaining a united front, and by being honest and measured whilst your opponents were being deceitful and excessive.

That’s why you still hold the cards. Hunt went all-in months ago with his ‘imposition’. He has no greater sanction left, and can only harm you in the court of public opinion. And so Hunt is trying to convince the public to turn against you.

“Hunt’s contract is far more damaging than any strike. He’s stretched the NHS so thin that people are already falling through the cracks.”

But he hasn’t succeeded yet. A new poll shows 57% of the public still support the strikes, and 51% believe Hunt should not have been reappointed. You can still win the public relations battle. Just do the following:

1 – Be team players. If the public think that doctors are divided over the contract and the strikes, they’ll lose faith in you.

2 – Be constructive. If you don’t like the strikes, focus your energy on talking about the issues you want fixed, rather than attacking your colleagues.

3 – Keep the message simple. The government are still pursuing the ‘7-day NHS’ line, which is easy for the public to follow. So remember: Hunt’s contract is far more damaging than any strike. He’s stretched the NHS so thin that people are already falling through the cracks.

4 – Expect to win, and soon. The government may have put on their poker face, but underneath the pressure is showing. If you can keep the public on your side, the government will have to cave in soon.

Regardless of what you think of the strikes, you must work together to win this fight. The very future of the NHS depends on your actions in these coming days and weeks.

Best wishes,

NHAspace

Why Are Doctors Striking Again?

The BMA are planning a further series of walkouts, this time stretching to five consecutive walkouts each month (8am-5pm). But why are doctors still unhappy? NHSpace looks at some if the reasons.

1 – The contract still isn’t fair

There are some serious problems with the contract that Hunt is imposing, including poor treatment of pregnant women and parents who work part-time. The latest version of the contract pretends to fix these, but the fix is time-limited so that future doctors will suffer. Hunt is treating the contract like a broadband contract, offering a good deal initially but a bad one in the long run. Doctors care about their future colleagues and aren’t about to sell them out.

2 – The government is slashing the NHS

Groups such as the NHA have been aware of the STP hospital closure plans for several months. Now that these ‘secret plans’ are finally being reported in the media, you can be certain that every doctor is aware of the latest hatchet job being performed on the NHS. The idea that Hunt could achieve a ‘truly 7 day NHS’ with no additional funds was nonsensical; expecting it to happen in the midst of massive service cuts is utterly ridiculous.

3 – Whistleblowers are still being punished

The Chris Day case highlighted the fact that doctors in training posts has no whistleblowing protection and could lose their careers just for speaking up. The BMA has made some headway by asking Health Education England to acknowledge their duty as a de facto employer, but you can expect doctors to push for a cast iron commitment to whistleblower protection.

4 – The government are privatising the NHS 

The STP hospital closure plans will create huge gaps in England’s healthcare system; gaps which the private health companies will be happy to fill, for a fee. Healthcare is already being rationed (ask anyone applying for routine surgery that requires ‘funding approval’), but the STPs will take us to the point where co-payments and top-up health insurance become the norm. This isn’t what today’s doctors signed up for.

Read more about privatisation: 5 Forms Of NHS Privatisation You Should Know About.

5 – Jeremy Hunt was reinstated

By inviting Jeremy Hunt to continue as Health Secretary, Theresa May has shown a lack of respect for medical professionals. But in all honesty, Hunt is just a figurehead. The gradual sell-off of the NHS and mistreatment of its workforce is a core Conservative policy, both due to the party’s ideology and their ties with corporate party donors, many of whom own shares in private healthcare. Doctors will express their anger at Hunt, but of course the problem goes much deeper.

An All-Out Strike?

On Thursday 11th February, Jeremy Hunt announced that he would be unilaterally imposing a new contract on front-line doctors. In his infamous imposition letter, Hunt claimed he had the support of a whole raft of NHS CEOs. In fact, most of them had never seen the letter and did not agree with the imposition.

The BMA had proposed an alternative contract that was ‘cost-neutral’ (no more expensive than the existing deal) but kept Saturday as a weekend day with appropriate pay. Hunt couldn’t accept this because of his obsession with a ‘7-day NHS’, which we all know already exists. He therefore vetoed all such deals offered by the BMA, preventing any settlement that might scupper his plans to force doctors to work extra weekends for no extra pay. To add insult to injury, Hunt claimed that no doctor would work consecutive weekends, and then published ‘example rotas’ that had doctors working three weekends straight.

The BMA has now asserted that, by failing to provide “appropriate funding for the required level of workforce needed to deliver safe services and adequate training”, the government has broken the original ‘heads of terms‘ agreed during the initial negotiations in 2013. There will be no more talks based on ‘cost neutrality’ – that horse has now bolted, and the BMA will settle for nothing less than a fully-funded workforce. As Dr Johann Malawana of the BMA puts it, “We also know – and the public understand this – that if the Government wants junior doctors to take the brunt of delivering more services across seven days, they need to put their money where their mouth is.”

So will we be seeing an all-out strike in the coming weeks and months? The BMA have made it clear that they do not take such action lightly, and have done all they can to avoid harming patient care. But with the Conservative government working to impose an unacceptable contract that is based upon flawed ideology rather than evidence-based medicine, full strike action may be the only option left.

Analysis: BMA Suspends Strike Action

Junior doctor Alex Ashman updates us on junior doctors’ contracts.

This afternoon, the British Medical Association (BMA) announced that they were suspending the 48 hour strike, which was due next week. Hospital management across the country are sure to have cheered at that news. But why would the BMA want to avoid industrial action? What are they asking for? And what are the government doing?

Why Did The BMA Suspend The Strike?

The threat of industrial action before Christmas was enough to force Health Secretary Jeremy Hunt into talks at the eleventh hour. Hunt had previously refused to negotiate, so this ceasefire was a small victory for the BMA.

Last week’s strike action was triggered by a lack of progress, and the need for the BMA to retain the mandate provided by the 97% of members who voted for action. The strike revealed a great deal of public support for junior doctors, and was said to have ‘landed a hit’ on Hunt.

Conciliatory talks at ACAS have now resumed, with Hunt sidelined. The BMA are obviously keen to aid the talks by suspending strike action, whilst keeping the ace in their hand – the 10th February walkout – as an incentive for the government to make a deal. Avoiding excessive strike action keeps the public on the doctors’ side, and thus keeps pressure up on the government.

Why Are The BMA Still Threatening Action?

There are several aspects of the new contract that the BMA find unfair, including:

  • Removal of safeguards that prevent unpaid overtime.
  • Classification of late evenings and Saturdays as ‘normal hours’.
  • Removal of pay for unsocial hours.
  • Removal of annual pay rises.
  • Removal of pay protection for academics and pregnant women.

Last week, the BMA stated that they still disagreed with the government on around 20 out of the 44  points being discussed.

What Are The Government Doing?

Outside of the talks, the government continue to bully junior doctors. Jeremy Hunt and David Cameron openly blame junior doctors for an imagined lack of 7-day NHS cover. Despite Hunt being criticised for misrepresenting stroke mortality figures, Cameron still repeated his misleading figures on national radio. Both the Health Secretary and the PM have gone on the record threatening the ‘nuclear option’ of forcing the contract upon junior doctors. Whispers in Whitehall are that the government are certain they will win the dispute through sheer brute force. Perhaps they have forgotten that, as with any nuclear option, they are courting mutually assured destruction.

 

7 Reasons Why The Junior Doctor Contract Is Unfair

Junior doctor Alex Ashman explains why you shouldn’t listen to the Daily Mail.

Doctors aren’t in it for the money. Remember that they chose this career over many other options. If money was a big deal, they’d have skipped medical school and gone to work for Deloitte. Instead, they chose to work weekends and nights, getting shouted at and getting covered in other peoples’ bodily fluids. So please let’s do away with the Daily Mail conspiracy theory that doctors are scheming to bring down the NHS, like a bunch of crackpot Bond villains. They are in fact real people with children to feed and mortgages to pay.

Here are the real reasons why junior doctors are fighting against the new contract:

It Removes All The Safeguards

The new contract does away with ‘banding’, whereby hospitals have to pay junior doctors a higher rate if they are forced to work unsafe 80-hour weeks. Banding was a great innovation and successfully brought in a 48 hour week as required by the European Working Time Directive. Under the new contract, doctors will be left with no protection from dangerous long hours, thus putting patients at risk.

It Extends Normal Working Hours

The new contract extends so-called ‘normal’ hours to include late evenings and Saturdays, treating 9pm on a Saturday evening as being the same as 9am on a Tuesday morning. This can only be an attempt to have doctors work more hours, which is bad for patient safety.

It Punishes The Busiest Specialties

Junior doctors already working long hours in A&E, in GP surgeries, and in paediatrics will all suffer as a result of the new contract. These busy specialties are already struggling to recruit new doctors and will likely see an exodus of staff under the new contract. If this happens, the NHS will genuinely tip over the edge and experience a real ‘crisis’.

It Punishes Women and Academics

The new contract removes annual pay progression, which is awarded based on level of experience. This is the only annual pay increase doctors get, as their baseline salaries usually get 0% increases each year. Thanks to the removal of annual pay progression pregnant women, academics, and doctors who work less-than-full-time (e.g. parents who also work) will receive less pay.

It’s Being Forced Through By The Government

The contract negotiations between the government and the BMA doctors’ union were essentially a sham. The government came to the table with a list of demands, unwilling to haggle. Naturally, the BMA walked out.

Hunt Lied About Weekend Deaths

Jeremy Hunt’s line, about increased weekend deaths being due to doctors not working weekends, is a lie in more than one way. Firstly, junior doctors already provide a 24/7 service for the NHS. Secondly, the authors of the scientific paper used by Hunt have stated that any attempt to link weekend deaths with junior doctors’ working patterns would be ‘rash and misleading’.

Hunt Lied About The 11% Pay Rise

With the removal of ‘banding’ payments, junior doctors stand to lose around 30% of their pay package. Jeremy Hunt has offered an 11% increase in basic pay to compensate for this. Not only is this not a ‘pay rise’, but the 11% figure doesn’t relate to anything in the actual contract details, and thus seems to be a ‘sound bite’ used by Hunt in an attempt to discredit doctors.