I am delighted to be able to take part in this most important of debates.
It is worth saying at the outset that the most important issue we face when talking about changing these contracts is patient safety. We do well to recognise that our No. 1 priority should always be patient safety, and about the service that the NHS delivers to the patients who require its health and assistance at the most important time of their life. In order to deliver the improvements, level of service and safety that we require, we need to have an engaged workforce who are willing and enthused about their work. It is important to recognise the challenges that NHS staff face and the long hours that they have delivered over a number of years, putting themselves at great risk, frankly, in working what would be regarded in any other industry as silly hours. We clearly need to change those working practices to make sure that patient safety is once again brought right to the top of the agenda.
It is important to recognise that these negotiations are not about cash. This is not about saving money or changing the system so that the Government can spread things thinner; it is about delivering an NHS service over seven days of the week to make sure that when someone has that moment when they need the NHS to step in to save their life or to help them, the service is there and able to deliver.
Junior doctors currently receive between four and five incremental pay rises, depending on the time they serve. In most other industries, increments in pay should be about qualifications and the way in which someone has worked through them, not simply about the amount of time they have served.
We must get to a point where we can deliver a seven-day NHS and eradicate the weekend effect. As hon. Members have mentioned, some patients are starting to change the way in which they engage with the NHS because they are concerned that, if they are admitted on a weekend, that will affect the care they receive. It is important to ensure that that does not happen. There will inevitably be changes to work patterns, and current contracts will have to change. At the same time the Government will ensure that there is extra pay for time that doctors work at weekends.