An Imposed Contract

Well, the dust has settled, for the moment anyway.  So perhaps now is a good time to have a look at what has actually been imposed on “junior” doctors.

Let’s start with the money.  Though I actually don’t know any doctor (or any nurse for that matter) who is really in it for the money.  But let’s put the figures on the table anyway.  The basic starting salary after the Imposed Contract is implemented will now be £27,000 compared to £22,636 presently paid, an 18.9% increase.  And no matter what way you look at it, three quarters of doctors will receive a take home pay rise.

So, what’s the catch, the trade off?  Well, it’s difficult to see what negatives exist.  Yes, there is the issue of Saturday working.  But it looks like some sort of compromise was in the mind of the English Health Secretary when he came up with what would be in the Imposed Contract.

Doctors currently receive time plus 30% for any hours worked between 5pm-9pm on Saturday and 7am-9pm on Sunday.   But balance that with the Imposed Contract where Doctors working one in four Saturdays or more will receive a pay premium of 30% for all Saturday hours.  And Doctors receive time and a half for any hours worked Monday – Sunday between 9pm – 7am.  I’m not sure what the Doctors problem is there.

But perhaps the most crucial area is safety.  And that is all down to Working hours. 

Well, under the Imposed Contract the maximum number of hours worked every week by junior doctors will fall from 91 to 72.  And the maximum number of consecutive nights a doctor can work will be cut from seven to four.  And no doctor ever rostered two weekends in a row.  That’s sounds like the doctor you or I will see will generally have been working less hours and therefore be more able to take a decision relating to our health.

But will it work? Well, every hospital is to have a safety guardian to monitor safe working.  And back to finance, there will be penalties for hospitals that breach safe working hours to be paid to the safety guardian and reinvested in junior doctors education and training. 

I’m sure some junior doctor could come right back at me with a view in total contrast to what I’ve just given. 

But from where I’m standing, the Health Secretary is at least trying to get a grip on an NHS that is badly out of control.  I’m sure what he is doing is not perfect.  But for me, those who simply say that anything the government is trying to do is wrong are missing the point.  There is something far wrong with the NHS.  And at least someone is trying to have a go at taking it forward against all the key players, the BMA and the Unions who are a barrier to reform and change.

One final point.  All these doctors who say they will up sticks and go to Australia, good luck to them, if they get in.  They will find a private insurance based system.