Imposing a punitive new contract on young doctors will exacerbate already serious staffing shortages in key areas of frontline NHS care, their leaders have warned Jeremy Hunt.
In a sharply worded letter they have told the health secretary that forcing junior doctors to work even more antisocial hours while ending overtime pay will weaken the NHS for generations.
The interjection puts extra pressure on Hunt to reconsider his decision to impose new terms and conditions on the NHS’s 53,000 junior doctors in England, which has sparked angry protests.
The proposed changes have already raised fears of an exodus of expensively trained medics to other countries, such as Australia, after figures showed 1,644 young doctors had already began the process of applying for the certification needed in just three days last week.
“The proposed contracts fail to offer safeguards on hours and working conditions necessary to ensure the safety of all the patients treated within the NHS, and risk a return of exhausted doctors and rise in medical errors inherently linked to clinicians forced to work under such unsafe conditions,” the letter to Hunt says.
The letter is by the trainee doctors group (ATDG) of the Academy of Medical Royal Colleges, which represents the professional interests of all the UK’s 240,000 doctors.
“Imposition of the contracts presents an immediate risk to the provision of healthcare throughout the UK, and an ongoing threat to healthcare for generations to come,” it adds.
The ATDG, which represents about two-thirds of junior doctors, outlines its “significant concerns” about the contract’s “implications for patient safety and maintenance of a sustainable medical workforce”.”
The claim the new contract will deepen existing shortages in areas which already require doctors to work a lot out of hours, such as A&E units, acute medicine, children’s services and general practice.
Recent official NHS figures, covering the arrival of the latest round of new junior doctors in August, show that acute medicine was still short of 48% of the new recuits it needed, as was renal medicine (48%) and geriatrics (14%).
“The proposed new contract regards most evening and weekend work as normal time, which is a further disincentive to recruitment into posts that involve substantial evening and weekend commitment,” the letter says.
The new contract will extend the normal working week in which doctors can be told to work their 48 hours from 7am-7pm Monday to Friday to 7am-10pm Monday to Saturday. Many will also see their pay cut because they will no longer be paid overtime for working evenings and Saturdays.
The Royal College of Obstetricians and Gynaecologists criticised the plans as unacceptable and added that “if left unchallenged [they] could significantly compromise safety and the lives of mothers and babies in England”.
The new contract would seriously damage the morale of the 1,600 junior doctors who provide most of the care in NHS maternity units, the RCOG said. “There has been the failure to consider the already difficult working conditions in the labour ward and this will lead to early retirement or an exodus from across the profession, consequently harming patient care.”
It added that expecting junior maternity doctors to see evenings and Saturdays as normal working hours involves “a significant chance of returning to the ‘bad old days’ of over-burdened junior doctors in danger of giving sub-standard care”.
The new contract will also deter junior doctors from choosing to work in obstetrics and gynaecology, which is already short of 20%-25% of the medics it needs, the RCOG said.
Responding to the ATDG letter, a Department of Health spokesperson said: “Our starting point is for stronger safeguards that go beyond legislation to make sure doctors do not work unsafe hours. But we want to engage with the doctors themselves on the details which is why we are disappointed that the British Medical Association junior doctors committee has decided against reentering negotiations.”
