Jeremy Hunt MP is the Secretary of State for Health, and is MP for South-West Surrey.
There are few jobs tougher in Britain today than working in NHS hospitals. The pressure is intense, with demand constantly rising as our population ages, consumer expectations higher than ever before, and decision-making often literally a matter of life and death. Junior doctors are the backbone of the NHS, and form the frontline in dealing with those pressures.
So it is incredibly irresponsible for their union, the British Medical Association, to mislead them with scare stories about how their pay and conditions will change under the Government’s proposed contract changes. In the summer, the BMA put a pay calculator on their website – so wildly inaccurate that they have since had to take it down – which told junior doctors their pay would be cut by 30-50 per cent.
Anyone who works as hard as junior doctors do would be rightly furious when informed of such a plan; I imagine I would man the barricades myself. But in fact what we have proposed is protected pay, reduced maximum hours and increased pensions, in a much better deal for doctors, so it’s time to set the record straight.
No-one working legal hours will see their pay cut – nor do our proposals reduce the overall pay bill. Instead, they are about improving patient care by tackling higher mortality rates at weekends, and ensuring junior doctors work safe hours. This is what we promised to the British people, and what they voted for us to deliver: the commitment to a truly seven-day NHS was the first pledge on the first page of our election manifesto.
The NHS values that we all prize and passionately believe in are that every British citizen should get the best healthcare free of charge, wherever you live and whenever you fall ill. So if you are committed to these values, as this Government is, you don’t just back them with the extra £10 billion of funding we’ve promised – you also take action when there is clear evidence that standards fall short at weekends.
Six academic studies in the last five years have indicated a link between higher weekend death rates and reduced weekend services. The latest, published in the BMA’s own journal in September, said mortality rates were 15 per cent higher following admission on a Sunday compared to a Wednesday. To change this, we have to improve weekend services across a range of areas, from making diagnostic tests like MRI scans and ultrasound scans available, to integrating health and social care so that patients can be discharged at weekends, to improving clinical cover at weekends.
Of course, many junior doctors already work at weekends, but to get the right numbers of doctors to meet patient need we must reform Labour’s contracts from the early 2000s, which force hospitals to roster three times less medical cover at weekends. You don’t need exactly the same levels of cover at weekends because some planned operations will only happen during the week. But for urgent and emergency care, no-one should worry that they will not get the right care if they are admitted at a weekend.
We know that we can only do this with the help and support of doctors. So we are proposing a fairer deal with many measures to make their quality of life better. A reduction in Saturday working rates will be offset by an 11 per cent increase in basic pay, which will mean doctors’ pensions pots also go up. Around three quarters of doctors moving to the new contract will get a pay increase, with the remainder getting pay protection compared to their current contract. Tired doctors are bad for patient safety, so we are cutting the maximum working week from 91 to 72 hours, and introducing a new maximum shift pattern of four night shifts or five long day shifts – compared to the current contract which permits seven consecutive night shifts or 12 consecutive long day shifts. That’s why the NHS Medical Director, Professor Sir Bruce Keogh, has said these plans will improve patient safety.
Happy, motivated doctors give the best care, so it would be profoundly wrong to say there is a choice between the interests of patients or those of doctors. At hospitals like the Salford Royal and Northumbria, where they have already introduced seven-day services, it’s staff who are the greatest advocates for the changes they’ve made. These reforms will make those same standards of weekend services possible across the NHS.
The Conservative Party made a promise to the British people to deliver seven-day services in hospitals, so we must press ahead with that commitment. Change to working patterns is never easy, but my strong preference is to get round the table and agree with doctors how we deliver our manifesto pledge in a way that they consider fair, and my door remains open for negotiations.
I know how hard junior doctors work. We want to make their lives better, not worse, so I am appealing to them again today to choose talks not strikes, and work with us to deliver the safest and highest standards of care available anywhere in the world.