Junior Doctors’ Contracts

Emily Thornberry Excerpts

Wednesday 28th October 2015 Commons Chamber

[Heidi Alexander]

I do agree. I was talking about a seven-day NHS. A truly 24/7 NHS does not just mean consultants being more readily available; it means 24/7 access to diagnostic tests, social care, occupational therapists—the list goes on. If the Secretary of State has a magic pot of money to pay for all that, bearing it in mind that the NHS can barely pay for the work that it is currently doing, I am all ears. If his plan is to deliver seven-day services by spreading existing services more thinly, he should come clean and say so.

[Emily Thornberry (Islington South and Finsbury) (Lab)]

My hon. Friend makes a very powerful speech. I bring her back to an earlier point which needs emphasising. At the moment trusts have to provide rosters that are not only fair but safe, so that junior doctors get time off. Now it seems that trusts will no longer have to pay attention to those rules and will no longer be fined if they do not follow them.

[Heidi Alexander]

There are very serious concerns about the proposed new contract, and my hon. Friend is right to highlight them.

The sad thing is that it did not have to be this way. Instead of using the dispute with junior doctors to suit his own political ends, the Health Secretary should have listened. He should have understood the depth and strength of concern before it got to the point where junior doctors feel as though they are the first line of defence in a fight for the future of the NHS. Instead of telling junior doctors that the BMA was misleading them, he should have respected their intelligence and responded to their concerns. At the very least, he should have heeded the words of the present Prime Minister, who said this about junior doctors when addressing a rally in 2007:

“There’s a simple truth at the heart of this: you came into the NHS not because you wanted to get rich or famous, but because you have a vocation about curing the ill, about serving your community.”

The Prime Minister went on to say in his conference speech a few days later:

“I will never forget walking on the streets of London marching with 10,000 junior doctors who felt like they were being treated like cogs in a machine rather than professionals with a vocation to go out and save lives”.

It is time the Health Secretary started treating junior doctors like the intelligent professionals they are. When I spoke at the junior doctors rally in London 10 days ago, I delivered a message for the Health Secretary. He was not working that Saturday so I repeat it for him now: stop the high-handed demands, show you are prepared to compromise and put patients before politics.

--- Later in debate ---

[Mr Hunt]

My hon. Friend is absolutely right. The fact is that this is a package designed to ensure that we eliminate the weekend effect, and it involves both junior doctors and consultants, because they both have their part to play.

[Emily Thornberry]

Will the Secretary of State give way?

[Mr Hunt]

I am going to make some progress before taking any further interventions.

The question for a Government and for a Health Secretary is this: when we are faced with this overwhelming evidence—six studies in five years—should we take action or ignore it? We are taking action. That is why in July I announced that we will be changing the contracts for both consultants and junior doctors as part of a package of measures to eliminate the weekend effect. If we believe in the NHS, and if we want it to be there for everyone, whatever their background or circumstances, we must be able to offer every NHS patient the promise of the same high-quality care, whichever day of the week they need it.

Let me set out for the House what I have proposed. We announced ambitious plans to roll out seven-day services across the country, with better weekend staffing across medical, diagnostic and support services in hospitals, as well as better integration with social care and seven-day GP access. That will reach a quarter of the population by March 2017, and the whole country by 2020. For consultants, we proposed an end to the right to opt out of weekend working, replacing it with a maximum obligation to work one weekend in four. To its credit, the BMA’s consultants committee has agreed to negotiate on that.

For junior doctors, we proposed to reduce the high overtime and weekend rates, which prevent hospitals from rostering enough staff at weekend, and increase basic pay to compensate. We have made a commitment that the pay bill as a whole would not be reduced, and today I can confirm that not a single junior doctor working within the legal limits for hours will have their pay cut, because this is about patient care, not saving money. Incidentally, I made it clear to the BMA at the beginning of September that that was a possible outcome of negotiations, in an attempt to encourage it to return to the negotiating table. Rather than negotiating, it chose to wind up its own members and create a huge amount of unnecessary anger.

--- Later in debate ---

[Mr Hunt]

There is no reason whatsoever. What was strikingly absent from the shadow Health Secretary’s comments was an entreaty to the BMA asking it to come and negotiate. Labour Members can play a constructive role in this, but so far they have declined to do so.

[Emily Thornberry]

Is the right hon. Gentleman going to continue with his plan to change the rules so that trusts that insist on doctors working unsafe hours can no longer be fined for doing so? It will help if he can assure us that those rules will continue and trusts will be fined if they break them.

[Mr Hunt]

They are not fines; they are perverse incentives to doctors to work unsafe hours. We want to go one better than that. We propose to stop hospitals requiring doctors to work five nights in a row or six long days in a row, and to bring down the maximum number of hours that hospitals can ask a doctor to work in any one week. On top of that, we have imposed the toughest hospital regime of any country anywhere in the world that comes down very hard on hospitals that are not providing safe care.