The BMA junior doctors′ council will meet on Friday 3 June to decide its response to the ″deal″ that the BMA has made with the government.
I will be arguing for the council to reject the contract and to campaign for a “no” vote in the contract referendum. The proposed new ″negotiated″ contract for Junior Doctors has caused a great amount of debate and discussion. It has caused a certain amount of division. It highlights a clear demand from some to continue the fight. There are still important issues with the contract, particularly for part-time trainees, those who mainly work high intensity evening shifts (often Accident and Emergency), and around cost neutrality and the wider state of the NHS.
There is plenty of opposition amongst junior doctors to the contract, and there are some who want to accept. But there is not a clear ″yes″ and ″no″ camp, more like a ″hard yes″, ″soft yes″, ″soft no″ through to a ″hard no″. The ″soft no″ is the ″almost there but not quite option″. Clear progress has been made in the last round of negotiations. But the negotiators did not extract all they wanted from negotiations. The equalities issues were not fully addressed and the contract will be implemented before a lot of the positive elements are a reality. From the system of exception reporting to the accelerated training system — these do not exist yet, and to introduce this contract without even knowing if they will work is unfair and unsafe. Those arguing the ″hard no″ say that the government can not be negotiated with in good faith.
The government demands any deal is ″cost neutral″, has utter contept for health workers and is running the NHS into the ground. A ″hard no″ may require us to halt negotiations and discussions of a new contract altogether, until the future of the NHS is less in the balance. On the yes side the ″hard yes″ declares a victory over weekends and patient safety. Everything will be back to ″normal″ and the fight abandoned. The ″soft yes″ argue that we accept but are critical and want to keep up the pressure for further negotiations. A ″no″ vote comes with risks. The government will almost certainly move back to imposition of the contract by August, likely rowing back on some of the better bits. But we have stopped imposition before and we can again. And we must not give up the political fight for a fully-funded, safe, NHS. I am arguing ″no″ because I think the proposed contract has big problems.
The main one is the supposed ″cost-neutrality″. The contract means junior doctors will be paid ″for all work done″, and that will cost more than the current budget. In a year’s time when the pay bill has grown due to the NHS paying doctors for the work they do, how will the government respond? In order to keep the pay bill cost neutral will it cut doctor numbers? Will it ask hospitals to cut services? Will it try to close whole wards or hospitals?
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