Junior doctors speak out over contract row on the eve of Leeds protest

IT was caring for his poorly grandmother that made Tom Bamford want to become a doctor.

“My gran was ill when I was younger and our house became a bit of a hospital for months on end. I became involved in her care and it interested me, it was something I really wanted to do,” he says.

Tom is 23 years old and a fifth year medical student in Leeds and next year he will become a junior doctor. It should be cause for celebration, the chance to put into practice all those years of hard work and training. But Tom is worried about the kind of job he might be walking into. So much so that tomorrow evening he will join hundreds of other medical students at a rally in Leeds city centre in protest at proposed changes to junior doctors contracts.

Organisers are expecting more than 2,000 people to attend the rally, including 92 year-old Harry Smith, the Barnsley-born writer and activist who is a vociferous supporter of the NHS.

The demonstration is linked to a row between the Government and junior doctors, backed by the British Medical Association (BMA). The two sides are locked in dispute with junior doctors due to be balloted on industrial action next month.

The Government has said it plans to impose a new contract on junior doctors up to consultant level, next summer. The contract will reclassify doctors’ normal working week to include Saturdays and up to 10pm every night except Sunday.

Medics argue they will lose out financially as evenings and Saturdays will be paid at the standard rate rather than a higher rate. They say this amounts to pay cuts of up to 30 per cent.

Health Secretary Jeremy Hunt has indicated to the BMA that he will consider extending the current proposals so that more working hours on a Saturday could be paid at a higher rate. But the BMA argues that Mr Hunt has failed to offer any guarantees on key issues such as pay and protection for doctors who wish to work less than full-time or take parental leave.

Dr Johann Malawana: Why new NHS contracts are unfair for doctors and unsafe for patientsThe Government has described the existing arrangements as “outdated”, pointing out they were introduced during the 1990s. Ministers drew up plans to change the contract in 2012, but talks broke down last year.

For those, like Tom, who are about to join the NHS, this is about their future. “As students we’ve worked really hard for six years and part of the reason we’re doing this is because we’re interested in medicine and are passionate about caring for people,” he says. “I’m excited about a career in medicine but at the same time it’s disheartening to see how people, who are doing the job you’ll be doing, are being treated.”

Junior doctors claim that those working in specialities where there is a lot of weekend and night working, such as anaesthetists and those working in emergency care, will be hit hardest.

Tom hopes to specialise in obstetrics, which deals with pregnancy and childbirth, but he admits if the changes go ahead he may have to reconsider. “Obstetrics involves a lot of out of hours work, so if I could choose a different speciality where I’m working more nine to five hours and get paid relatively similar, then why would I choose something where I’m going to be working all the hours God sends?”

The basic starting salary for a junior doctor is around £24,000, but Tom says his chief concern isn’t about potentially having to work longer hours for less pay. “It’s not just about money, it’s about the effect it will have on the safety of patients because the contract removes safeguards on working hours, and if you’ve got tired doctors they will make mistakes. That’s what worries us as students.” Which is why he will be among those protesting tomorrow. “It feels like we have to do something because if we do nothing now it will be difficult to change later.”

Like Tom, Nick Spencer will begin life as a junior doctor next year. He, too, feels compelled to show some solidarity with his future colleagues. Not that either of them are your typical rabble rousing militants. When I ask them if they have been involved in a protest like this before they shake their heads. “We’re the kind of people who are taught to just get on with things,” says Nick.

However, they have been moved action by the government’s perceived attitude towards junior doctors. “If we make a mistake at work we can kill someone. We’re not asking for a pay rise and we’re not asking for our hours to be reduced. We’re just asking for our job to be left as it is and to be appreciated.”

But what about junior doctors who are already working on the NHS frontline?

Dr Alia Yaqub is a senior registrar with 10 years experience and has worked all over Yorkshire. She points out that junior doctors cover a broad spectrum of people - from those fresh out of university to people like herself. “Junior doctors aren’t a small group, they are the bulk of the workforce of the NHS. They are the people doing emergency operations in the middle of the night, they’re the people who make the phone calls to people’s relatives. They’re the ones that people see when they come to hospital.”

There is genuine anger among many junior doctors who feel they are being treated with disdain. “I don’t think there’s a reasonable person in the country who, if they were told they were going to have a 30 per cent pay cut to work more hours, wouldn’t be affronted by that. I don’t think that makes us uppity or greedy.”

Alia, who will be joining protesters tomorrow, believes the contract changes are part of an “assault” on the NHS itself. “This is about patient safety and the future of the NHS. I have a two year-old daughter and I would like there to be an NHS for her when she grows up. But if we don’t stand up and try to fight for this now we’ll have lost the battle.”

She is concerned that if the contract changes go ahead then young doctors may be tempted to move abroad. “My worry is we will continue to lose people in droves. I’ve worked overseas and I came back because I wanted to work here and raise a family here. But we risk losing part of our skill base to other countries.”

On top of this, she’s worried about the kind of message this sends out to would-be future doctors, “Why would a 16 year-old who is deciding what career they want look at us and think ‘that looks good?’ Do we really want to discourage intelligent people from choosing a career in health care? I don’t think we do.”

Which is why, Alia says, so many junior doctors and medical students are taking a stand over this. “We think it’s only fair that the public is made aware of what is happening to their NHS. I read a quote recently from Aneurin Bevan [the Minister of Health who helped create the NHS in 1948]. He said, ‘the NHS will last as long as there are folk left with the faith to fight for it.’ And that’s we have to do, fight for it. I hope the public will be with us on this.”

Junior doctors contract dispute

Earlier this month, Health Secretary Jeremy Hunt tried to reassure the British Medical Association (BMA) that contract changes aren’t a cost-cutting exercise, junior doctors would not receive reduced pay and that longer hours wouldn’t be imposed.

He said that negotiations began due to a “shared view” that the contract needed reform. “The best deal for junior doctors will be achieved by the BMA coming to the table to negotiate.”

But Dr Johann Malawana, BMA junior doctor committee chair, responded by saying they still need “concrete assurances” over pay, safeguards and how unsociable hours are defined.

Labour is urging the government to drop its contract plans and re-enter talks.