The Government’s new contract for junior doctors would discriminate against women, discouraging them from entering the profession and penalising any doctor who takes time off to raise a family, senior medics have warned.
Under the new contract, trainees who decide to work part-time would see their pay increase more slowly than their colleagues.
More than one in 10 junior doctors works less than full-time, the vast majority of them women – often those returning from maternity leave.
Dr Andrew Hartle, president of the Association of Anaesthetists of Great Britain and Ireland said the contract would disproportionately hit their pay. He also expressed concern that proposals to remove some safeguards around shift breaks would be especially detrimental to doctors working during pregnancy.
The Association of Surgeons in Training has also voiced concern. In a letter to the BMJ, the group’s president Rhiannon Harries said the contract would have a “devastating effect” on efforts to recruit and retain women surgeons.
The latest criticisms come as doctors published a letter, sent to Health Secretary Jeremy Hunt last week and backed by the heads of 14 medical Royal Colleges and Faculties, expressing “very great concern” about the contract.
In the letter, Dr Clifford Mann, president of the Royal College of Emergency Medicine said the contract proposals had implications for “the future of medicine and patient care as a whole”. Royal Colleges and Faculties play no role in negotiating contracts, and such a unified intervention is extremely rare. Dr Mann has also written to doctors union the British Medical Association, urging them to return to the negotiating table, after NHS Employers, the arms-length body responsible for contract talks, insisted their proposals were not final.
The existing contract entitles junior doctors to an automatic annual pay rise, from a minimum starting salary of £22,600.
The BMA’s junior doctor committee is expected to decide on 26 September whether to ballot members over industrial action.
The existing contract entitles junior doctors to an automatic annual pay rise, from a minimum starting salary of £22,600. The new proposals split juniors into just six pay grades, with those who take time out to raise a family, or due to sickness, progressing more slowly than full-time colleagues.
It is also proposed that normal working hours – currently 7am to 7pm Monday to Friday – be extended to 7am to 10pm, Monday to Saturday. While out-of-hours pay for night shifts and Sunday working may increase, the overall effect could be a pay cut for many doctors.
Dr Hartle said any such reform would set a precedent for the out-of-hours pay of other NHS staff.
“This is not just about doctors. One of my particular concerns is that if the Government establishes with doctors that normal working time is up to 10pm, and Saturdays, then the next step will be the hundreds of thousands of lower paid staff,” he said.
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“My nursing colleagues rely on payments they receive for working unsocial hours as a core part of their income. We suspect that if they establish that normal working time is 7 till 10 and Saturdays, if that’s imposed for nurses, therapists, technicians, who are earning significantly less than doctors and are predominately female, the knock-on effect for the NHS will again be a significant disadvantaging of low-paid, female workers.”
Kitty Mohan, co-chair of the junior doctor committee: “These changes would penalise those who take time out to start a family, or work part time. In reality this means women will disproportionately hit, risking a real step backwards for workforce equality.”
Danny Mortimer, chief executive of NHS Employers said: “The government made it clear across the public sector that pay progression based on time served should not be a feature of employment contracts. This is already the case in contracts held by the large number of female staff that the NHS employs in non-medical posts and doctors currently enjoy benefits that they do not.
“It is proposed that moving forward, pay will be linked to the level of responsibility that the person holds, rather than time served. What we must focus on is ensuring all junior doctors are supported to progress in their careers, as valued members of the health service, and are rewarded for their hard work.”
A statement issued by the Department of Health said the Government was “prepared to be flexible” on how much basic pay could be increased, how unsocial hours should be “recognised” and how much funding should be assigned to specialties with staffing shortages – an apparent concession to GP trainees who at risk of losing pay supplements.
