Junior Doctors’ Contracts

Charlotte Leslie Excerpts

Wednesday 28th October 2015 Commons Chamber

[Charlotte Leslie (Bristol North West) (Con)]

I welcome this debate brought by the hon. Member for Lewisham East (Heidi Alexander) as a chance to offer some light, as opposed to the heat that has sadly dominated so much of this debate.

The House has often heard me quote the thinker and poet T. S. Eliot when he warns of the folly of trying to devise

systems so perfect that no one will need to be good.

This speaks extraordinarily to the NHS. The NHS is not a system; it is the people who work in it. That is why it is so important that we nurture and value our NHS staff in the ways so brilliantly expounded by my hon. Friend the Member for Totnes (Dr Wollaston)—those staff who work day in, day out, and, as the daughter of a surgeon I can vouch, at weekends and on Christmas days, too.

I was extremely concerned to hear the British Medical Association’s claims that this modernisation of the junior doctor contract would lead to dangerously long working hours and less pay for our junior doctors—cuts of 30%, it said. I began to look into this more closely. I noticed that the pay calculator had been taken down, but when I looked at the detail I became very surprised. In the proposals I could not see the kind of longer hours and the less pay scenario I had heard from the BMA with such certainty and to which many junior doctors, completely understandably, have been reacting with such worry and concern. I could not see anything approaching the authoritarian and draconian measures the BMA had led me to believe my own Government were imposing.

At most, I think there are areas where we need very careful negotiation and clarity with a doctor membership body so that we can work with doctors—that is incredibly important. I would have thought the BMA junior doctors committee would be very concerned for that to happen.

I cannot find evidence that the Government are imposing longer hours on doctors. What I did note was the new absolute limit on overtime worked, which is preventing dangerously long hours and those awful weeks of nights, and the current situation where doctors routinely work over the 48-hour working time directive often slightly off the record to get in the training that they need. I would have thought measures to tackle that would have been welcomed.

I know that huge numbers of people work during Saturday daytimes, but there needs to be further discussion on the agreement of what constitutes antisocial hours for doctors on a Saturday. Again, I would have thought the junior doctors committee would have valuably contributed towards that, and in fact the Government say the same.

To read the BMA submission we would think that less pay was a key aim of the whole exercise, but the plans make clear that there will not be an overall pay cut and that average earnings will remain the same. Yes, the distribution will be different to overcome the obvious unfairnesses in the system where a doctor working normal hours will get paid more than a doctor working antisocial hours, but I am not sure that is something to complain about. Yes, there will be a reward for progress as opposed to the time the doctor has been in training, but that is in line with many professions and I am just not sure that someone who takes longer in training to reach the same standard as a high-flyer should get paid more.

[Helen Whately]

I support my hon. Friend on that point. It is uncomfortable but true that in almost any profession outside the NHS if someone takes time out for parental leave the clock stops on their career progression. They gain other skills; they do not just press on with their career, but they can go back to it afterwards.

[Charlotte Leslie]

My hon. Friend is absolutely right. In addition, I am just not sure it should be possible for supervisors with more responsibility to be paid less than those they are supervising. I am slightly confused about the BMA stance on this. When I spoke to it about the European working time directive, it assured me that it was not just time spent in training that mattered, but the quality of that training. Now in its submission it seems to have completely reversed that position and says that it is just time spent on the job that matters. That confuses me.

As the Government accept, there is a need for discussion on how doctors moving between different specialities can have their pay protected, but that is again something on which we must absolutely enter into discussion with junior doctors. I plead with the BMA to come to the table. The consultants committee in the BMA has done that and I applaud it for doing so. A part of the drive to get more consultants in at weekends is to improve the quality of junior doctor training which has suffered under the European working time directive.

I also note that one paragraph in the BMA’s submission states:

“Much of the subsequent detail that has been discussed in the news was never fully outlined as part of the previous negotiation process.”

That demonstrates that the Government are still completely open to talking about many things, yet the BMA almost seems to lament that fact. In the light of this, I simply do not understand why the BMA will not return to the table. I celebrated the BMA’s “No More Games” campaign. We do need to de-politicise the NHS, but I am really concerned that the junior doctors committee is bringing that laudable aim by the BMA, and the work on that which the BMA does, into disrepute.