BMA (Contract Negotiations)

Debate between Catherine West and Ben Gummer

Monday 21st March 2016 Westminster Hall

[Catherine West (Hornsey and Wood Green) (Lab)]

It is a pleasure to serve under your chairmanship, Sir David.

When someone decides to become a doctor, they do not expect it to be easy—there are years of study, huge student debts, antisocial working hours, and the pressure of knowing that the decisions they make every day can be the difference between life and death—but they have a right to expect that the Government will value and appreciate their training and dedication. Our NHS needs more doctors, not fewer. When we or our loved ones get sick, we all want the comfort of knowing that the brightest and best are providing their care, so the fact that we are having this debate means that today is a sad day. Although I congratulate my hon. Friend the Member for Warrington North (Helen Jones) on introducing the debate, it is a pity that we have to have it. The Department seems determined to sabotage the relationship with junior doctors and is handling the negotiations poorly.

The contract has been described as unsafe and unfair. When I have met junior doctors from the Muswell Hill and Crouch End area we have spoken about how expensive childcare is, how they hope to be able to move out of their mothers’ and fathers’ houses, and how they hope to have a career and serve in the NHS. However, they feel that all of that is at risk. They are working every hour God gives them, but they feel that there is no genuine respect and that they will eventually find it very difficult to remain in London, purchase a home and continue to serve in the NHS. They are even thinking of trying to work abroad. There is a real risk that the Government’s approach will take us back to the bad old days of overworked doctors who are too exhausted to provide safe patient care.

One doctor told me that they had £40,000 of student debt after six years of training and were just starting out on a salary of £22,600. They said that the reclassification of unsocial hours would see them lose about 30% of their salary and leave them struggling to pay their rent and bills. The new contract that has been imposed will see incomes fall by 20%—

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

That is not true.

[Catherine West]

If it is not true, I look forward to clarification from the Minister. We would not like to see a couple who are junior doctors having to leave their jobs because the cost of childcare is more than it pays to work as a doctor.

The situation is turning into a shambles. I hope that the Secretary of State for Education is watching, so that last week’s big announcement about the reorganisation of education does not end up in a similar situation in a year or two. First millions of pounds was wasted on an unnecessary top-down reorganisation, then staff and patients were made to pay the price of the Government’s financial mismanagement. Will the Minister clarify whether 75% or 80% of trusts are currently in deficit? We are already in the middle of a workforce crisis, so the last thing we need is more doctors leaving. I have heard that 1,644 physicians have registered with the General Medical Council for certificates to allow them to work overseas; will the Minister clarify the exact number? The GMC normally receives only about 20 applications a day, but since Christmas, with the Government’s disastrous handling of the situation, the number has shot up.

I have written to the Secretary of State to urge him to get on and sort out the situation. The Government have to accept that compromise is necessary. As my hon. Friend the Member for Hammersmith (Andy Slaughter) said, there is a deal to be done. Why put patient safety at risk when it is really not necessary? I was proud to stand in solidarity with the fantastic junior doctors at my local hospital, Whittington hospital, as well as those at North Middlesex hospital on the other side of my constituency. There really does seem to be a lot of willingness to talk; I just hope that that is reflected in the approach of Ministers.

The Government’s current approach is wrong. They should be much more flexible, and they should want to open negotiations and talk rather than impose things. Junior doctors are vital to the future of the NHS, and it is clear that if we want to move towards a seven-day NHS and improve patient care, we have to ensure that the staff we rely on are supported and valued. It is deeply worrying that the BMA has described the contract as “unsafe and unfair”, and that the Royal College of Paediatrics and Child Health has stated that it could be

“gravely damaging to the health and wellbeing of children”

and could

“adversely affect recruitment, retention and the morale”

of junior doctors. I look forward to hearing the Minister clarify those points.

--- Later in debate ---

[Ben Gummer]

They are not excluded. It is important that that person does not become a BMA nominee, but we want the guardian to make sure they command the respect not only of the junior doctor workforce, but the trust itself. It is important to make sure that person gets that degree of buy-in from both sides, and I hope that the final solution we arrive at will satisfy that.

[Catherine West]

Does the Minister agree that, traditionally, whistleblowers have not been treated respectfully and that perhaps the current approach of imposing things is not the right step forward in changing the culture?

[Ben Gummer]

There has been a problem for decades with whistleblowers being listened to. That is what gave rise in part to the tragedy at Mid Staffs and the Secretary of State is trying desperately to do something about it. He cares passionately about it and his recent speech, which the hon. Member for Lewisham East (Heidi Alexander) welcomed, was about trying to create those safe spaces within trusts so that people feel they can speak openly. Indeed, recently at the social partnership forum, which I chair and where we hear contributions from trade unions, I heard of a very effective scheme recently developed in Somerset which showed a good way of getting people of all grades in a trust able to speak up.

I, too, am delighted that the hon. Member for Bristol West (Thangam Debbonaire) has been able to take her seat again. She has come back at an exciting time in politics—one that may be more exciting for her than the last six months. She asked about the funding for seven-day services. All I would say is that within the five-year forward view are two parts that are connected. The first is the commitment to have seven-day services in urgent and emergency care, which is reflected in our mandate for the service, our manifesto pledge at the last election and the request for £8 billion of cash funding connected with the £22 billion of efficiency savings in the service. That is the funding that is being provided to achieve not only that commitment, but everything else in the five-year forward view. Hon. Members have questioned whether that money is sufficient and I point them to the statement by NHS England today in which it was very clear that that is the amount that was asked for and that is the amount that they were glad to get.

The hon. Member for Central Ayrshire spoke about the opt-out, and I want to give clarification for the record to ensure that we are clear about it. In parts of the emergency care pathway, the opt-out has an effective impact and indeed affects part of the urgent care pathway. Ensuring the opt-out is removed is one of the areas we are keen to progress and was the origin of the Secretary of State’s statement, which related to that and not to junior doctors at the beginning of this process. It is important that we do that specifically around urgent and emergency care, and other hospital services, but we have never, ever wanted to extend by the process of our negotiations elective care at weekends. That is not part of our commitment, which has always been squarely about ensuring consistency of standards in urgent and emergency care.