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20 November 2015
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Where are we now – making a decision to strike? #juniorcontract

The junior contract rally on 16 October marked an unprecedented time in the history of the National Health Service. Tens of thousands of junior doctors protested against changes to contracts which could result in compromised patient care. It was wonderful to witness the unity and passion of a profession unwilling to cower to the threat of imposition.

The government has listened and responded in some ways. Concessions have been made around scientific research, out-of-programme experience, increases to basic pay and Saturday banding. There are still many things to discuss – removal of monitoring, gender equality and improving the overall working life of a junior doctor. This new offer is not perfect but is a step from which further negotiations can develop.  

We are all aware (Department of Health included) that a full elective seven-day service, although aspirational, is entirely unattainable in the current financial crisis the NHS finds itself in. Working towards a safer model at weekends is something which all doctors have been doing for a number of years and are very willing to contribute to continual improvements.

Mistakes have been made by the Department of Health throughout this process. Phrases such as “a sense of vocation and professionalism brought back” and “get real” have been used. The implication that a lack of doctors working at weekends led to needless patient deaths has caused deep hurt and mistrust to a profession continually making personal sacrifices to deliver the highest standards of care. If we are waiting for an apology, however, we will be waiting a long time. Junior doctors have achieved a huge amount in the last six months in raising issues that matter and we can be proud of this.

The one group though that does not deserve to suffer in all of this is patients. Junior doctors are absolutely critical to the running of hospitals and we need to be clear that our absence will affect patients. Consultants will most likely cover for us but they cannot be all things to all people and are limited in number. The NHS is currently balancing on a financial knife edge and a strike in winter has the real potential to tip the balance in the direction of disaster. Taking industrial action must be an individually made decision, and as a compassionate profession we must support all colleagues, no matter what decision they make.

Stop, turn off social media and read everything. As doctors we all recognise our responsibilities and know that it is essential to read the current proposed contract and all related material ensuring we are fully informed. Be aware of the risks – a strike, without question, will generate criticism and be linked to poor patient outcomes. If you decide that the need to strike outweighs the risks, then you will be able to tolerate any negative repercussions and know that you made an informed decision which you believe will ultimately benefit patients.

Unity has been one of the most outstanding features throughout, let’s not lose that in the weeks ahead. Safe patients, safe doctors.

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About the author

Judith Tweedie's picture

Judith Tweedie

Jude is the Chair on the FMLM Trainee Steering Group. She was a National Medical Director's Clinical Fellow with FMLM and the Royal College of Physicians of London.

Jude trained in cardiology and general internal medicine in Belfast, Northern Ireland. Alongside general training, she also undertook advanced specialist modules in echocardiography and cardiac magnetic resonance imaging.

Jude completed her undergraduate medical degree at the University of Aberdeen. During this time she attained an intercalated degree researching novel techniques in the diagnosis of paediatric asthma. Foundation and core training were undertaken in Glasgow and Edinburgh before returning to Belfast for registrar training. 



8 years 7 months ago

Just wanted to clarify that

Just wanted to clarify that the basic pay rise of 11% wasn't a concession per se. The DDRB report always recommended a basic pay increase to offset the removal of banding. With pay protection and pay premia (for those who qualify), this amounts to doctors not getting a pay cut in the majority of cases up to 2019. However this obviously disadvantages those in their final year of medical school. And as you've rightly pointed out the proposed contract still discriminates against LTFT trainees, especially women, and the removal of banding and penalty fees arising from monitoring concerns doctors in how hours safeguards can be enforced with any real strength. But the real issues is that there is no trust between the BMA and the DoH. Third party mediation is the only way forward at this stage to avoid industrial action.

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