It is important to make the point that these reforms are categorically not about saving money—their impact on the pay bill for junior doctors will be cost-neutral—so any suggestion that they represent a pay cut for junior doctors, as The BMJ has claimed, is dishonest. Junior doctors’ basic pay will increase, as will their pension contributions, and they will be awarded pay rises for progression, rather than simply time served, which is in line with most other industries.
NHS employers, who are part of the NHS Confederation, the only body that speaks on behalf of the whole healthcare system, have said in a briefing note that the previous increases, linked to time served, were unfair and did not reflect real progression in terms of increased skills and greater responsibility. The world has changed. People are living longer and have busy lives, and our population is increasing, meaning there are pressures on our health service that were not there 10 years ago. NHS employers have also said that the current contracts are not fit for purpose.
Doctors provide a vital public service, but the NHS must adapt to the needs of the people they serve. This means we need more services available at weekends and in the evenings, and we need doctors to give people the peace of mind that comes from knowing they can get the help they need when they need it.
Opposition Members claim that the reforms will have a detrimental effect on patient safety, but what is safe about a young trainee medic working the maximum 91 hours per week? The reforms will drastically reduce this to 72 hours in seven consecutive days, meaning we will be working our new doctors less hard, while striving towards the seven-day NHS the Government were elected to deliver.
I would like to turn to some of the concerns raised in the BMA’s briefing document. On page 3, it claims that the reforms will not protect doctors from having to work “dangerously long hours”. As I have said, the reforms will reduce the number of hours junior doctors have to work and introduce new safeguards on work-life balance by ensuring that all work schedules are mutually agreed between doctors and employers. No junior doctor will be expected to work more than a 48-hour week or more than four consecutive night shifts, and thanks to the Government’s reforms to childcare all working parents with three to four-year-old children will have access to 30 hours a week of free childcare. The rise in childcare costs claimed by the BMA are therefore a fallacy.
In conclusion, these reforms will bring doctors’ contracts into line with modern lives and working practices. They are important and right. They will improve outcomes for patients, which is the most important thing, and improve conditions for junior doctors. I welcome the Government’s amendment to the motion, and I implore all colleagues from across the House to follow us into the Lobby this evening.