Norman Lamb has said that the Junior Doctors’ strike scheduled to take place from 8 am tomorrow should be a wake up call for the Government:
If strikes go ahead tomorrow this should be a wake-up call to the Government that it needs to take a more constructive approach to resolving this dispute. They cannot solve the capacity and funding problems in the NHS by forcing this contract on junior doctors.
Growing demand for services, coupled with a funding settlement which doesn’t keep up, are the fundamental problems facing health and care and yet the Government is refusing to take real action to address this.
What we need is a cross party commission to fundamentally review NHS and care funding, to ensure we can give a fair deal to both patients and NHS staff in years to come.
Forcing through changes to the junior doctors contract is completely the wrong thing for the Government to be focusing on at this critical time in the future of the NHS.
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"Corporations have neither bodies to be punished, nor souls to be condemned, they therefore do as they like"
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ANDERS LARSON
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23 Comments
Perhaps Norman could let everyone know just what exactly he knows, in order to be so unequivocal in his viewpoint that the current dispute is all the governments fault.
Personally, I’ve yet to see any reliable evidence from those not directly involved that the government is wholly to blame and that the BMA haven’t, as they have done in the past, been deliberately misleading…
My opinion is that the BMA are not interested in a “cross-party” agreement. They’ve been so aggressive about it that it seems they won’t touch anything heavily influenced by the Tories. The BMA needs to accept responsibility for this.
Eddie, it has been reported that an agreement between the NHS employers and the BMA was personally vetoed by Jeremy Hunt (possibly because it did not align with the government’s political ambitions):
http://www.independent.co.uk/life-style/health-and-families/health-news/jeremy-hunt-vetoed-deal-to-end-junior-doctor-dispute-which-was-supported-by-the-nhss-own-negotiators-a6861606.html
When asked about this in Parliament he avoided answering the question:
http://www.independent.co.uk/news/uk/politics/jeremy-hunt-dodges-question-about-whether-he-personally-vetoed-a-deal-to-end-the-junior-doctors-a6863206.html
His refusal to deny the story speaks volumes.
What Norman is saying in effect that this current impasse is because Government is trying to piecemeal change areas of NHS funding without an overarching strategy looking to the future. Surely his suggestion for an all party commission to examine the needs and funding strategies for the NHS is sensible , as we need to stop it becoming a football. All parties proclaim their support for the NHS(except Nigel Farage and even he was knocked back by his party) so it should be possible.
Jeremy Hunt is under pressure to save money because Osbornes charter for budget responsibility is going down in flames, the Commission could help Hunt and bring about a cost effective all embracing NHS.
But I dont hold my breath
@Peter – from the reports I fully understand where Jeremy Hunt and the government is coming from on this, namely the NHS is a 24x7x365 service, hence weekends are normal working days – something the BMA acknowledges in their claims that junior doctors already work weekends through existing rostering arrangements, but doesn’t want to acknowledge in the contract. i.e. the BMA is living in the past in pretending that doctors only need to work weekdays and that they should receive additional payments for working outside of normal hours.
Once you accept that the NHS is a 24x7x365 service and that it needs to be staffed accordingly, there is no real reason why normal weekend shifts worked by salaried staff should be paid any differently to other shifts. Once the cost of a weekend shift is the same as a weekday shift, there is little or no financial cost to a hospital in running a full service at the weekends…
Certainly, in my career, once I had completed my probationary period and changed from hourly paid to salaried, I no longer received overtime pay, even though working the hours necessary was still expected.
As I’ve said before, I doubt we are getting the full story and truthful answers from either party to this dispute.
Roland, the NHS is already a 24x7x365 service in some aspects of what it does. My local A&E never closes. Elective wards, however, are not 24x7x365 and I have seen no strong evidence that there is a desire for that to change. If I was in for a hip replacement, the thought of my operation being at 3am on a Sunday morning is not one which appeals and I doubt that I am alone in that. Monday to Friday daytime for such a procedure seems much more sensible. What that means is that, depending on which aspect of the NHS a doctor (or a nurse) works in depends on whether there is a real demand for them to be available every hour of the day. For NHS staff with families of school age Saturday is one of the only two days in the week where they have the opportunity to spend quality time with their family, and if they are required to work (and I have no problem with that expectation) I also consider it reasonable for them to receive some additional compensation for doing so.
typo in title
I know we’re not in government any more, but we should still be able to spell it 🙂
@Peter Parsons
It is particularly galling that Lib Dems passed on the opportunity to put a spanner in the works of the Jeremy Hunt machine a few years ago by abstaining in the vote to refer him to the independent adviser on ministers’ interests despite apparently believing he should be referred.
Peter Watson 10th Feb ’16 – 2:20pm…………….@Peter Parsons………It is particularly galling that Lib Dems passed on the opportunity to put a spanner in the works of the Jeremy Hunt machine a few years ago by abstaining in the vote to refer him to the independent adviser on ministers’ interests despite apparently believing he should be referred………
When in opposition pre-2010 we demanded umpteen ‘enquiries’…In government??????
NHS bosses are thinking of recommending the contract gets imposed. Lib Dems should consider this. We cannot simply allow doctors to write their own contracts, however nice they may be.
http://www.independent.co.uk/news/uk/politics/nhs-bosses-say-jeremy-hunt-should-impose-contract-on-junior-doctors-a6864851.html
Having doctors write their own contracts and imposing on them are two equally bad sides of the same coin. Imposing changes on current staff without their agreement is also most likely illegal (depending on what the changes are), so it will mean two different contracts, one for existing staff and one for new staff, which is a recipe for confusion. Jeremy Hunt needs to allow the BMA and the NHS employers to come to an agreement without sticking his oar in, however, his own political career interests probably means he won’t.
Is it just me who is offended when those trained at considerable expense to the state threaten to take their newly (and not so newly) acquired skills to the other side of the world, regardless of whether or not they have a good case? From now on every newly qualified doctor or nurse should be required to spend at least their first four years working In this country before venturing abroad. As most, I believe, receive bursaries, if they do decide to leave they should be made to pay back some, if not, all of the money they have received from the taxpayer. Not very liberal; but it might concentrate a few minds.
As far as funding the NHS is concerned, if we are not prepared to consider an insurance based scheme we should consider a health tax or a hypothecated 1% on the standard rate of income tax.
Peter – “the NHS is already a 24x7x365 service in some aspects of what it does.”
Precisely my point.
Elective wards, however, are not 24x7x365
If the ward has beds in and patients may stay overnight or over a weekend then they are and require doctor cover, even if it is ‘on-call’. Hence junior doctors assigned to such wards will still be on rotas and be expected to work some unsocial shifts, including Christmas Day.
So it makes sense that employment contracts reflect the operational requirements of the NHS…
If I was in for a hip replacement, the thought of my operation being at 3am on a Sunday morning is not one which appeals and I doubt that I am alone in that. Monday to Friday daytime for such a procedure seems much more sensible.
This is a bit of a red herring, firstly operations are currently scheduled during the day, at my local hospital this is 7 days a week, I’ve not seen any proposals to change this (and certainly the BMA haven’t raised this as an issue). Also you may find that many elective procedures such as hip and knee replacement do get operated upon as a batch at the weekend or over a bank holiday (aside: whether the new contract will make such arrangements less remunerative is open to debate).
The catch is that junior doctors work across the various services, during their career and hence the contract needs to reflect this.
For NHS staff with families of school age Saturday is one of the only two days in the week where they have the opportunity to spend quality time with their family, and if they are required to work (and I have no problem with that expectation) I also consider it reasonable for them to receive some additional compensation for doing so.
So who will work the weekends, Easter Bank Holiday, Christmas Day etc. shifts?
The new contract does compensate them by a substantial increase (11%) in their base salary; which might come in handy when applying for a mortgage…
Peter – Imposing changes on current staff without their agreement is also most likely illegal
Obviously either not worked in the private sector or not read your employment contract…
John – Is it just me who is offended when those trained at considerable expense to the state threaten to take their newly (and not so newly) acquired skills to the other side of the world
Whilst I sympathise with your viewpoint, remember their training was largely paid for by student loans which will become payable if they leave the NHS…
Also seeing the TV interviews of obviously recently qualified doctors, I suspect much that is being said is bravo rather than the result of cool rational thought. I’ve seen the same in other professions, people complain about how much contractors/consultants get paid for doing a job they could do, challenge them to take up contracting and few do…
Peter – Imposing changes on current staff without their agreement is also most likely illegal
Obviously either not worked in the private sector or not read your employment contract…
Roland, I do work in the private sector, I do read my contract and I also know something about employment law having served as a union branch secretary in a previous life. I suggest you have a read of this:
http://www.gannons.co.uk/services/employment-law/employers/alter-employment-terms/
Such changes as proposed require the employee’s consent, they can’t just be imposed.
For NHS staff with families of school age Saturday is one of the only two days in the week where they have the opportunity to spend quality time with their family, and if they are required to work (and I have no problem with that expectation) I also consider it reasonable for them to receive some additional compensation for doing so.
So who will work the weekends, Easter Bank Holiday, Christmas Day etc. shifts?
The new contract does compensate them by a substantial increase (11%) in their base salary; which might come in handy when applying for a mortgage…
Roland, I suggest you read what I wrote again. I thought it was quite clear that I have no problem with NHS staff being expected to work weekends (and by extension I’ll include public holidays etc in that), I just don’t hold with the view that Saturday is a normal working day. It isn’t for me, it isn’t for millions. Back in my very first job stacking shelves at the local supermarket part time while in sixth form it wasn’t then either as the full time staff received a Saturday uplift.
As for quoting the 11% figure in isolation – are you are a government representative in disguise (as that is the tactic they all seem to use)? and having recently applied for a mortgage, some mortgage companies do take total income into account, not just base salary, so if total income is not changed overall (and these proposals are intended to be cost neutral), there is no difference to the ability to raise a mortgage from those companies.
Roland,
Are you sure about student loans? Just one other thing. I wish those mainly young doctors on the picket line would look less cheerful. This is a serious matter, not a game. I like the touch with the stethoscope among their shoulders when they are being by the media. Shouldn’t they all be carrying a snake on a pole? Now there’s me being childish!
John Marriott 10th Feb ’16 – 10:02pm……………Is it just me who is offended when those trained at considerable expense to the state threaten to take their newly (and not so newly) acquired skills to the other side of the world, regardless of whether or not they have a good case?…….
By the same token should the ‘cash strapped’ NHS either refuse to employ, or pay the training fees, of doctors, nurses, etc?. After all, these doctors/nurses are needed as much, if not a lot more, in their own countries….
From what I’ve witnessed in a recent hospital visit the NHS would find it extremely difficult to function if that were the case…
Peter “I do read my contract and I also know something about employment law having served as a union branch secretary in a previous life.”
From the linked article:
“Nevertheless, it is quite possible to alter employment contracts. The process requires care and attention to detail. We tell you how to manage the process, what to say to employees and when.”
I suspect given your background, you will know how employers can ‘impose’ new contracts.
Remember Jeremy is a politician, and hence will ‘impose’ the new contract and move on to something new. However, expect the various branches of the NHS to commence the HR process which may take sometime…
Peter – I just don’t hold with the view that Saturday is a normal working day. It isn’t for me, it isn’t for millions.
But you still expect the shops to be open… I think you will find for many millions shift working and weekend working are normal. I note the USDAW only single out Sunday as being different [USDAW Workers Rights Leaflet 211, January 2016].
Which is fundamentally my point, if the business operates 24x7x365 then it is sensible for the staff contracts to reflect this reality, namely, staff will be expected to work some unsocial hours/shifts as part of their normal working hours, ie. these shifts aren’t exceptional or overtime. In which case the rate for normal hours should take these expectations into consideration.
My point about the 11% was that effectively the contract seems to be changing from one of “salary + additional payments” where the ‘additional payments’ are calculated and hence variable to “salary including consideration” with no variable element. I only have the government’s word and the lack of any real data from the BMA to suggest that this change is largely neutral; although from family and friends I can see particular groups of junior doctors who will win and lose.
Yes you can get a mortgage with either, just that the terms do vary because of the risk associated with the variable element… I know from my experience, that opting to take a significant cut in my gross pay (40%) and become salaried (with no overtime payments) was financially worthwhile, even if it did take a few years for the salary to increase to give a similar level of gross pay. [Aside: Also part of my calculation was that salary was pensionable, overtime/bonus’s weren’t. Basically, whilst the headline figures made the decision looked stupid, once you crunched the numbers a different picture emerged… I had a similar experience a few years back with an NHS Consultant friend, who was towing the BMA’s line and hence adamant the contract and pension changes he was being offered were not favourable. Once I had got him to actually read and walk through the proposals and do the math, he changed to someone who couldn’t sign up quick enough – funnily enough, the BMA performed a similar U-turn even though nothing on the table had changed…]
John re: Student Loans
Yes I am sure, medical students are entitled to Student Loans, plus the NHS also provides funding. I’ve not been able to locate a reference that describes how the whole thing works (which is irritating) because I know some arrangement was made that took into account the significantly higher cost of a medical degree and training.
@Roland
https://www.gov.uk/government/news/funding-arrangements-for-medical-and-dental-student-tuition-fees-for-2013-2015-and-nhs-bursary-funding-arrangements-from-2012
I believe that essentially medical students pay fees etc. as normal for four years and in their fifth year the NHS pays the fees and there may be a small additional bursary. I suppose that the maintenance part of their loan builds up over 5 years.
In contrast, I believe that for nursing the NHS pays all of the fees. I have often wondered about the effect of this in flattering the apparent social mobility often claimed since tuition fees increased. But while writing this, I also wonder now if some of the trumpeted increased expenditure in the NHS has simply been shuffling money from the NHS to the universities which would previously have been part of the education budget.