I was a junior doctor – if we want a genuinely 7 day a week NHS, we need more of them.
Junior doctors, even the government concedes, are the backbone of the NHS. They comprise a significant proportion of the workforce of the NHS and already provide medical cover for patients 7 days a week, 24 hours a day. They are a diverse group. At one end of the scale are the newly qualified doctors in their mid 20s straight out of 5 years at medical school. At the other end are the registrars, soon to be consultants, who are approaching middle age with 15 years of specialist training, research experience and numerous postgraduate qualifications. By and large they are not a particularly militant bunch. The last time junior doctors were involved in industrial action was in 1975. At that time hospital doctors were paid a basic salary for a 40 hour week but frequently worked an additional 60 hours a week unpaid. Even under the new contract introduced in 1976 the “overtime “rate for working nights and weekends was a fraction of the basic rate of pay. Junior doctors were said to be the cheapest form of labour in the hospital. And the long hours remained the same – as a junior doctor in the late 80s and early 90s I recall vividly recall the 80 –100 hour weeks, with weekend shifts lasting from Friday morning to Monday evening. It has been an uphill battle to achieve changes in pay for unsocial hours and to modify the culture of long working hours. The changes to be enforced by the government include a reduction in the number of hours paid at a premium unsocial hours rate and loss of the banding system that provides an effective penalty for employers against fatiguing and unsafe working patterns. It is no surprise to me that there is so much opposition to the changes that are now being imposed in such a high handed and uncompromising manner. If the government wants a truly 7-day NHS, it should hire more doctors, not squeeze more out of the existing ones. Given that NHS doctor vacancy rates have increased by 60% in the last 2 years the government should be seeking to encourage talented and motivated young people to enter and remain in the medical profession, rather than alienating an entire generation of junior doctors.