BMA (Contract Negotiations)

Jeff Smith Excerpts

Monday 21st March 2016 Westminster Hall

[Helen Jones]

My hon. Friend is quite right, and I will come on to that point later. There are staff shortages in the NHS that the contract may well make worse.

In the end, as in any dispute, the issues can be resolved only by negotiation, and in truth the two sides are not all that far apart. Huge progress was made when Sir David Dalton was brought into the talks, but there are still outstanding issues to be resolved. For instance, the Government trumpet a 13.5% increase in basic pay. What they do not say is that that increase will be paid for by cuts elsewhere. For example, payments that are made as a reward for length of service will go. I have yet to hear from the Government their assessment of what impact that change will have on retaining staff in the NHS, or how it will work for members of staff who take time out, whether for academic study—we need doctors who are both academics and good clinicians—or for maternity leave. What will happen to women who work part time, and so on? If we lose a number of women doctors in the NHS, the service will be in a great deal of difficulty.

Guaranteed pay rates when people change specialties are also going. In the past, if someone changed specialty later on in their career, their pay was guaranteed. That will not be the case any more. That change is bound to have an effect on recruitment in areas where we are already short of doctors, and I have seen no real impact assessment of that yet.

Of course, the big issue for many doctors is the change to standard time and premium time. The Government are increasing standard time from 60 hours a week to 90 hours a week. In the past, doctors were paid extra for working between 7 pm and 7 am, and for working at weekends. Standard time will now increase to run to 9 pm on weekdays and 5 pm on Saturdays. Doctors who work more than one in four weekends will get a premium payment. It is difficult to work out the effect of that change on individual doctors; it depends on how many weekends they work now, what their specialty is and so on.

The Government’s pay guarantee lasts for only three years, and given the Secretary of State’s remarks, junior doctors fear that the change is a back-door way of introducing longer hours. It certainly makes it cheaper to roster doctors at weekends. The Government say they will fine hospitals that roster people for more than a certain number of hours, but the doctors say that offer is not good enough. That is not an unbridgeable gap; it could be resolved. However, the result of what has happened and the Secretary of State’s comments is distrust and suspicion among doctors about what his real motives are. That is combined with a disastrous drop in morale in the NHS. The latest NHS staff survey shows that the percentage of junior doctors reporting stress has risen from 20% to 35% in five years. The proportion of staff saying that they feel pressurised to come into work when they are ill has gone up from 16% to a whopping 44%.

That loss of good will and drop in morale matters, because NHS staff are known for going the extra mile, working longer than they are paid for and doing things they do not have to do. That extends from the consultants who come in on their day off to see certain patients to the nurses and support staff who bring in a birthday card for an elderly person who has got no one else. I well remember that when my son was born, I was there for three shifts in the maternity department. After he was born, the registrar from the first shift came back to see me, to check that I was all right and to see whether I had had a boy or a girl. It is impossible to put a price on such things, and the Government risk losing all that and doing huge damage to the NHS if they do not solve the dispute.

[Jeff Smith (Manchester, Withington) (Lab)]

Will my hon. Friend give way?

[Helen Jones]

Yes, I will give way once more.

[Jeff Smith]

I am grateful to my hon. Friend. I met a group of junior doctors recently. For the first time, many of them are considering going abroad to work. None of them want to, but they are so demoralised by this Government’s actions that they are considering it. One of them told me how much she loved her job, but she said, “I would never let my daughter train as a junior doctor.” Does my hon. Friend agree that if the Government carry on down this route, we will not have a junior doctor workforce to rely on?

[Helen Jones]

My hon. Friend is right. That is an awful and sad thing to hear from people who are dedicated to the NHS, but yes, there has been a huge increase in the numbers of junior doctors thinking of moving abroad.

The answer is not the imposition of a contract, it is to get back into negotiations. It is about funding for weekend working, not just for doctors and nurses but for the lab staff, the diagnostic staff and the support staff that we need. It is about valuing the staff and showing that they are valued, because many junior doctors believe that the Secretary of State undervalues their work and has sought to undermine patients’ trust by implying that they are responsible for a number of deaths. That really needs to be corrected.

I have a message for the Secretary of State today: you get real. You are a member of Her Majesty’s Government —a senior Minister. Take responsibility. Yes, we need to get the BMA around the negotiating table again, but you need to make an offer that brings it there. You need to make that offer, because you are the person in charge.

It is already clear, in fact, that it is possible to improve weekend working without the new contract. There are trusts that have done that—Salford Royal is one example, as my hon. Friend the Member for Manchester, Withington (Jeff Smith) will know. There is also a rumour that the Department is close to a deal with consultants that will not require the proposed changes. Perhaps the Minister will tell us whether that is true.

To continue my message to the Secretary of State: man up. Admit that you got things wrong. Admit that you mishandled this. Make a gesture and get people back around the negotiating table. If you do not, it is not only the junior doctors who will hold you responsible. The public will hold you responsible as well—in fact, they already do.

When polls ask who is to blame for the dispute, the overwhelming answer is that it is the Government. That is not surprising, is it? If a member of the public is asked, “Who do you trust most, this nice doctor in your local hospital or Jeremy Hunt?”, it is not a difficult decision for them to make. It is time for the Government to stop heading down this road, before we end up with disastrous consequences. It is time for them to get people back around the table, because if they do not the NHS will suffer incredible damage, not simply through doctors leaving but through the loss of their good will. Both the staff of the NHS and the public in this country deserve better.