Junior Doctors’ Contracts

Sarah Wollaston Excerpts

Wednesday 28th October 2015 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

I start by declaring a relevant personal interest in that my daughter is a junior doctor, and one of many hundreds who have moved to Australia to work. Because of that very clear conflict of personal interests, I shall abstain in this evening’s vote. I want to speak, however, because I have relevant personal experience, as before I came to this place I taught junior doctors and medical students for 11 years.

I can tell the House that this dispute is about far more than pay. It is about junior doctors feeling valued. The junior doctors I used to teach, including F2 foundation year doctors, felt that they were not being supported at the weekends, disliked the inability sometimes to work in the same county as their partner and disliked obstructive attitudes about rostering. That presents us with an opportunity to bring all those issues into the negotiations in this current dispute.

One thing I do know is that young people do not go into medicine because they are motivated by pay. I hope that the House sends a very clear message to junior doctors that we value what they do and are grateful for what they do on behalf of patients. What we must do is avoid a strike at all costs. A strike would be immensely damaging for patients. I would say to junior doctors that there is no meaningful industrial action that they can take that would not harm their patients. I urge them to step back from such a move. A strike would be damaging not only for patients, but for the professional reputation of doctors, and of course politically. That should not be the consideration. Our main consideration should be how we encourage junior doctors to walk back through the door of the Secretary of State’s office, as he has stated. The best way to do that would be to start again.

Many elements of the dispute feel similar to the one we had in 2007, when I was teaching junior doctors, over the medical training application service—or MTAS, as it was known. It was a very unloved, unlovely scheme that collapsed, after a much-needed apology, in 2007. The Government of the day went back to the drawing board and started again. I think it would be right to do so on this occasion. We need to remove the barricades that are preventing junior doctors from walking back through the door. It would be right to take away the preconditions, the red lines and the threat to impose—and start again, looking at all the issues in the round.

Junior doctors share many of the Government’s objectives. They want to improve care for patients; they recognise that shortage specialties in the NHS are a real issue and that if we are going to put patients first, we need to incentivise entry to specialties such as accident and emergency, general practice, psychiatry and so forth. We need mechanisms to make that happen. They recognise, too, the need to address variation across the NHS, including with respect to weekends, but we need to look at that in the round. It is not just about senior and junior doctors either; it is about nursing, access to diagnostics, being an outlier on a ward that someone should not be in because the hospital is over-full.

[Kevin Foster (Torbay) (Con)]

I am sure that my hon. Friend would agree that one thing about which junior doctors want certainty is no longer having whole weeks of nights or having to work beyond 72 hours. The Government need to be clear about how they will achieve that.

[Dr Wollaston]

I thank my hon. Friend for his intervention. There is much to be welcomed in the new contract, but we need honesty about some of this. I am very pleased that the Secretary of State has given an assurance today that no junior doctor will be worse off, but I hope that when he sums up the debate, he will tell us what will happen to a junior doctor working 70 hours a week, perhaps in a specialty such as accident and emergency or anaesthetics. If the pay envelope is the same and some junior doctors will be better off, the maths indicates that some will be worse off and we need to clarify which ones. We need much more clarity, not just about whether an individual will be no worse off as a result of changing from one job to the next over the transition period, but about what will happen to the pay for that post over the coming years.

While I welcome many of the elements of the junior contract, I feel that, because the debate has become rather toxic, we should take the opportunity to begin again to examine all the issues in the round, and ask junior doctors themselves to work with the Secretary of State in establishing how we can achieve our common aims on behalf of patients. We should also take the opportunity once more to welcome junior doctors and value everything that they do.