Junior Doctors’ Contracts

Jim Cunningham Excerpts

Wednesday 28th October 2015 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The hon. Member for Lewisham East (Heidi Alexander) described what a junior doctor is, and that is really important. Many people think that being a junior doctor is just for the first couple of years, and isn’t it character-forming to work a bit hard and not have a lot of money? However, in the NHS, which is quite a hierarchical beast, a junior doctor is a junior doctor all the way until they are not a junior doctor and they become a senior doctor: either a consultant, as I was for the past 19 years, or a GP. That means we are talking about people who might be in their 30s, with children, families and mortgages. They are not youngsters who are able to move around flexibly and have very few financial commitments. It is important that we remember that.

It is obviously quite some time since I started as a junior doctor. More than 30 years ago, in 1982, we had absolutely no limits on hours. My light week was 57 hours; my heavy week was 132 hours. You just had no idea what your name was by the end of a weekend. It took more than 10 years of my career before the first new deal started to come in, in the early 1990s, and trusts or hospitals had to pay an additional premium to junior staff if they worked excessive hours. The definition of excessive hours at that time was still pretty lax, but it was the first step. It was tightened up in 2003, when the European working time directive came in. The Secretary of State talks about taking away those safeguards, but that he will replace them with something else. But with what? They have served us well. When trusts are in financial difficulties, the pressure on them to save money is likely to outweigh completely any little safeguard. The 48-hour working time directive does not come with punitive safeguards, and the financial one was important.

It is important to remember that the basic pay is already for 7 o’clock in the morning to 7 o’clock at night, Monday to Friday. That is a pretty long day for most people. It is proposed that the time covered by basic pay should be extended to 7 o’clock in the morning to 10 o’clock at night and include Saturday. What many people do not know is that a junior doctor starts at under £23,000 a year—below the benefit cap we have been arguing about. The salary is made up largely of out-of-hours.

[Mr Jim Cunningham (Coventry South) (Lab)]

Does the hon. Lady not agree that in any other walk of life that would be intolerable, yet we put up with this situation in the national health service? Secondly, does she agree we still have not seen the £8 billion the Government promised, during the general election, to put into the NHS?

[Dr Whitford]

I totally agree with that.

As mentioned on both sides of the House, people do not work in an NHS hospital to make a lot of money. It is not high up the list of ways for the smartest people in our country to make money; it is a vocation, which means we have a responsibility not to exploit them. The Secretary of State says that no one will lose money, but what will happen to the people who start next August? After the first hours change, when I started my surgical career in Belfast, the “two in three” rota—every third evening off and no weekends off for a year—was no longer legal, and the hospital henceforth considered extra hours to be voluntary service. The NHS is a hierarchical organisation, bullying exists within it, and the junior doctor is in a weak position. These safeguards have worked well for a long time, and I would be reluctant to see them go.