Wednesday, October 21, 2015

What is the junior doctors row about? BBC

The government in England and junior doctors are locked in a dispute with the British Medical Association even preparing to to ballot its junior doctor members about industrial action. What is this row about and does this mean doctors could end up on strike?

What has caused the dispute?

Junior doctors' leaders are objecting to the prospect of a new contract.
The government has described the current arrangements as "outdated" and "unfair", pointing out they were introduced in the 1990s.
Ministers drew up plans to change the contract in 2012, but talks broke down last year.
The government has indicated it will impose the new contract next year in England.
Scotland and Wales have both said they will be sticking to the old contract, while Northern Ireland has yet to make a decision.
There are many different elements to what is being proposed, but the main dispute relates to the proposal to cut the number of working hours classified as "unsociable".
At the moment, doctors receive a higher rate of pay when they work outside of 07:00 to 19:00 Monday to Friday.
But the new deal would see this extended to 07:00 to 22:00 Monday to Saturday - meaning the number of working hours classified as "normal" will be increased by 50%.

Will doctors lose out financially?

Some will, undoubtedly. NHS Employers has said basic pay will be increased, but the full details of this have not yet been published.
It means that in all likelihood there will be winners and losers. In specialities where there is little unsociable working - dermatology for example - earnings could go up.
But for others who do a lot of weekend and night working - anaesthetists and those in emergency care - pay could drop. The BMA has suggested earnings could fall by 15% for some.
NHS Employers has said average earnings of the 50,000 junior doctors in England will remain unchanged and the health secretary has said the "great majority" of doctors would remain as well paid as they are now.

Is there a wider context to this?

Yes. You may have noticed the government is intent on improving the range of services available seven days a week.
It has already found itself at loggerheads with the BMA over plans to change the consultants' contract - talks are under way on that.
Junior doctors already work weekends - in fact, they provide the bulk of the medical staffing on Saturdays and Sundays.
But the financial benefit of extending what constitutes "normal hours" to a Saturday is obvious.

Could doctors go on strike then?

Doctors can take strike action, but only if it affects non-emergency care.
The last time this happened was during the pensions dispute in 2012, but that was the first time such action had been taken for almost 40 years.
Doctors still attend work - so they are ready for urgent and emergency cases.
But three years ago, GP appointments, routine hospital check-ups and non-emergency operations such as knee and hip replacements were affected.
Obviously not all of these services are dependent on junior doctors, but services could still be disrupted.

Another option would be a work-to-rule, with junior doctors just working their hours and not doing unpaid overtime.


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