Junior Doctors’ Contracts

Mary Creagh Excerpts

Wednesday 28th October 2015 Commons Chamber

[Mr Hunt]

Chief executives of trusts and NHS employers have been very clear that this is about reform of contracts for both consultants and junior doctors, because the reduction in medical cover at weekends happens with both the consultant and the junior doctor workforces. Also, as I will go on to say, it puts huge pressure on junior doctors at the time when they do not have senior support and the ability to learn from it, and that is exactly what we want to sort out.

Junior doctors are not to blame for the weekend effect. The situation would actually be far worse without them, because they perform the lion’s share of medical evening, night and weekend work. In many ways, they are the backbone of our hospitals. However, the BMJ study this year showed that there is evidence that junior doctors felt clinically exposed at weekends, and nothing could be more demotivating for a doctor than not being able to give the standard of care they want for a patient.

[Mary Creagh (Wakefield) (Lab)]

The right hon. Gentleman has prayed in aid the weekend effect and quoted Sir Bruce Keogh, his own NHS medical director. Is he aware that Professor Keogh has also said that

“it is not possible to ascertain the extent to which these excess deaths may be preventable; to assume they are avoidable would be rash and misleading”?

[Mr Hunt]

Yes, and I agree with that, but it would be equally rash and misleading to say there are no avoidable deaths. Professor Keogh was saying that lives could be saved if we tackled this. All these studies are saying that 15% more people die than we would expect if we had the same level of cover at weekends as we have during the week. Therefore, as he says, the moral case for action is unanswerable.

--- Later in debate ---

[Mary Creagh (Wakefield) (Lab)]

It is a pleasure to follow the hon. Member for Blackpool North and Cleveleys (Paul Maynard).

I welcome my hon. Friend the Member for Lewisham East (Heidi Alexander), the shadow Secretary of State for Health, to her new position.

I have three puncture marks on my left hand. They come from 2001 when I was admitted to accident and emergency suffering a life-threatening event, an ectopic pregnancy. It took four attempts before a junior doctor successfully inserted a line into my hand. He apologised to me and said, “I’m sorry, I’ve just worked for 24 hours without a break and I just can’t see straight.” I am grateful to that doctor, both for his compassion and for his honesty, and I will always be grateful to the junior doctor who wheeled me up to theatre at midnight and operated on me, saving my life.

Such overwork is what led the Labour Government to change the junior doctors contract. Under that contract, employers face financial penalties if junior doctors work longer than contracted. This Government want to remove these vital safeguards in the new contract and, instead, ask employers to follow the working time regulations. But in medicine, mistakes cost lives. The safeguards need to be much stronger than generic working time regulations, especially as junior doctors work a number of extra hours over and above what they are contracted to work, as we have already heard.

I have further concerns about the proposed changes. Currently, Mid Yorkshire Hospitals NHS Trust, which manages Pinderfields, Wakefield’s local hospital, carries vacancies in all specialties, like most other large trusts. Vacancies are particularly hard to fill in A&E, obstetrics, paediatrics and medicine.

Junior doctors provide all types of patient care—emergency care to mothers in labour, care for new born babies, specialist elderly medicine, cancer care and surgery. We have heard that almost 3,500 doctors applied for paperwork to leave the UK and work abroad in the first 10 days after the Government announced their threat to impose the new contract.

I have concerns that the contract will discourage junior doctors from gaining clinical experience and contributing to medical research. Currently, pay progression is an annual increment, irrespective of their stage of training. NHS employers want to change that. That will impact on doctors who work part time or who are taking maternity leave, because they will not get an annual increment at their stage of training, so will not get pay progression.

[Cat Smith (Lancaster and Fleetwood) (Lab)]

Will my hon. Friend give way?

[Mary Creagh]

I will not give way.

The Prime Minister said this morning that he was a feminist, but women junior doctors know that his warm words hide the cold reality of direct discrimination. Will the Minister tell us whether an equality impact assessment has been done on the proposals?

Finally, we have discussed the weekend effect, but Fiona Godlee, the editor of the British Medical Journal, has written to the Secretary of State criticising him for misrepresenting the research. He must think again and both sides must negotiate.