Three minutes is never enough, but here I go. First, we have heard a lot about seven-day working and a seven-day NHS. That does not occur only within the hospital. I would like to restate the point made by my hon. Friend Dr Wollaston in the Westminster Hall debate on the e-petition that, most important of all, we need to look at how we can reduce in the first place unplanned admissions to hospital from the community. Secondly, I echo what Dr Whitford said. We here have a responsibility not to exploit junior doctors and their willingness, sense of vocation and commitment to the NHS.
It is worth looking at some of the deficiencies of the 2003 contract. As I understand it, a doctor working 47 hours can be paid the same as one working 41 hours. That cannot be right. A doctor working daytime can be paid exactly the same as a doctor working only nights and late shifts. A doctor progressing to a post of greater responsibility might not get any extra pay for that. There are multiple flaws in the existing contract that need to be addressed as part of the growing trajectory towards improving terms and conditions each time we reassess the contract.
I recognise that there is a desire on all sides to get back round the table, and I strongly urge all sides to do that. I hope it can be done, but there is no contract that I can see lurking in the Minister’s bottom drawer waiting to be unveiled. In the report from the Doctors and Dentists Review Body three scenarios were set out. There are a further six, I understand, in circulation and in preparation by the NHS Employers organisation. There is so much to discuss, so many alternative scenarios, that it would be a dereliction of duty for all sides not to get back round the table.
We should note that in what has been proposed, by reducing the maximum number of hours to 72, there would be no more of the four nights in a row that some junior doctors have had to work, and no more seven consecutive nights on particular rota shifts. There is much that is positive in the contract, yet I recognise why there are concerns. I urge Dr Malawana who wrote to the Secretary of State to look again at what my right hon. Friend is seeking to achieve. There is clearly a willingness to discuss how to redefine daytime work, how to judge what we pay for Saturdays, how we change flexible pay premiums. There is so much that can still be discussed that we are missing an historic opportunity here to set in stone for another decade a much better contract and a much better set of criteria for fairer working practices for our very, very hardworking junior doctors.