In an unprecedented move, 13 leaders of medical Royal Colleges and Faculties have expressed their concerns over the government’s junior doctor contract proposals.
The colleges, who have no responsibility for negotiating contracts, are concerned at the consequences of recent announcements on patient care and the future of medicine as a whole.
On 15 September 2015 the government announced it will impose a new contract on junior doctors working in England from August 2016. This followed the BMA’s refusal to re-enter negotiations on the contract as it currently stands.
The government’s contract involves a significant expansion in the hours that are paid at a standard rate, and removes safeguards over long working hours.
In a letter to Health Secretary Jeremy Hunt, on 18 September, they say the proposals “represent a real and immediate threat to the current stated priorities of the NHS, namely recruitment and retention of front line staff and the provision of services across seven days”.
It suggests that recruitment will be damaged in those specialties with more evening and weekend work, and provide a disincentive to going into research.
The original medical leaders signing the letter include Dr Anna Batchelor, President of the Faculty of Intensive Care Medicine; Dr Liam Brennan, President of the Royal College of Anaesthetists; Professor Jane Dacre, President of the Royal College of Physicians; Dr Suzy Lishman, President of the Royal College of Pathologists; Professor Carrie MacEwen, President of the Royal College of Ophthalmologists; Dr Clifford Mann, President of the Royal College of Emergency Medicine; Dr Giles Maskell, President of the Royal College of Radiologists; Professor Neena Modi, President of the Royal College of Paediatrics and Child Health; Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists; and, Sir Simon Wessely, President of the Royal College of Psychiatrists.
The letter continues: “We would urge the government to create the conditions where both NHS Employers and the BMA can reopen dialogue and constructively work towards a contract that supports staff to deliver the best care for patients.
“Whilst we recognise the current financial envelope, we would expect both parties to bring forward proposals which equitably address the needs of patients and support recruitment and retentions to all medical careers.
“Failure to do so will regrettable demoralise our current workforce and leave providers ever more reliant on locum and agency staff.”
Since the letter was sent, four more leaders of medical Royal Colleges have signed up to the concerns expressed in the letter. They include Professor Maureen Baker, Chair of Council of the Royal College of General Practitioners; Professor Derek Bell, President of the Royal College of Physicians of Edinburgh; Professor Frank Dunn, President of the Royal College of Physicians and Surgeons of Glasgow; Mr Ian Ritchie, President of the Royal College of Surgeons of Edinburgh.
The Royal College of Surgeons of London is notably absent from supporting the letter.
Earlier this week, trainee members of the trainee committees that sit on the Academy of Medical Royal Colleges Trainee Doctors Group (ATDG) also wrote an open letter to the Secretary of State.
The contentious issues surrounding an imposed contract include the removal of annual pay progression and its replacement with pay increases only at points of responsibility; the removal of annual increments from those taking time “out of programme”, for example for research training, other additional experience, or parental leave; the removal of banding and the rebranding of evening and weekend working as ‘normal hours’; and, the removal of financial penalties for trusts that breach working hours safeguards.