2 September 2016

College President, Dr Suzy Lishman calls for an end to the junior doctors' contract dispute

Earlier this week the BMA Council voted to approve further industrial action in the long-running dispute with the government over the new contract. Junior doctors will stage a full withdrawal of labour for five days each month between now and Christmas, between the hours of 8am and 5pm. While the College is not a trade union and does not get involved in negotiating terms and conditions of employment, we do have a duty to maintain standards for the benefit of patients, which involves ensuring that junior doctors are properly trained and supported.
 
I’d like to start my response by reiterating my strong support for junior doctors and concern for safe patient care. As I have said in previous statements, trainees are integral to the delivery of effective, safe patient care and treatment in the NHS and deserve a contract that is fair and reflects the value of the work they do. 
 
A key driver of the new contract appears to be the government’s desire to provide routine seven-day services within the current NHS budget. It is clear that the NHS is currently struggling to provide a five-day service in many areas and that expansion to cover weekends will require significant investment, particularly in workforce. Spreading a five-day service across seven days without that investment just dilutes the provision of healthcare, and inevitably its quality, every day of the week.
 
Others working in healthcare can expect their contracts to be changed in the near future so it is in everyone’s interest to get the contract right for the junior doctors. This is an issue that concerns all of us.
 
You may have seen the recent statement from the Academy of Medical Royal Colleges:
The Academy of Medical Royal Colleges is disappointed at the prospect of further sustained industrial action by junior doctors. 
 
We are acutely aware that the NHS is under extreme pressure at the moment. Patient safety and quality of care must be the priority. 
 
We know there are genuine concerns about the contract and working arrangements, but we do not consider the proposed strikes are proportionate. Five days of strike action, particularly at such short notice, will cause real problems for patients, the service and the profession. 
 
I am not so much disappointed as frustrated by the fact that junior doctors are still in a position where they feel they need to take industrial action. No doctor makes the decision to strike lightly; junior doctors are as concerned as anyone about patient safety and quality of care – what this highlights is just how disillusioned they are feeling. This sends a very strong message to the government that urgent action is needed to bring this dispute to an end and that imposing the contract will not help deliver the improvements in patient care that they had hoped for. There needs to be a focus now on putting aside previous grievances and finding solutions.
 
The BMA Junior Doctors Committee has made it clear that industrial action will be called off if the government stops imposition of the contract and returns to the negotiating table. I urge the government to do this. I appreciate the desire to get things settled quickly but believe that investment now in a fair contract will reap benefits in the longer term. All involved must put aside concerns about who wins or loses – the winners should be patients and the future of their NHS care. 
 
What does this all mean for pathology specialties? If the strikes go ahead I know that senior pathologists will do everything they can to minimise the effect on patients. I urge all fellows to respect the decisions of their junior colleagues, whether that is to take industrial action or not.
 
I have spoken to many pathology trainees about the contract over the last few months, weeks and days. The response has been mixed; many would be better off under the new contract. Others would see an eventual reduction in pay as their experience, non-resident on call work and time out of training for research will not be recognised in the way they currently are. Some support the proposed strikes as a way to communicate their unhappiness with both the current and proposed contracts. Others do not want to strike, for a wide range of reasons.
 
I fully accept that not all the junior doctors’ grievances relate to the proposed contract and that there are aspects of their training that the College can improve or influence. We are working closely with the Trainees’ Advisory Committee and the HEE Working Group for Improving Quality of Training to identify and rectify these issues.
 
It is clear that no one wants to see a continuation of the longest industrial action in the history of the NHS. If we are to deliver the quality of care that patients demand and deserve, we need to invest in the workforce to deliver it.
 
I urge the government to return to negotiations and both sides to come to an acceptable compromise as soon as possible so that junior doctors can get on with caring for patients.
 

Dr Suzy Lishman, President 

This blog from Professor Sir Simon Wessely, President of the Royal College of Psychiatrists, is worth reading.