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Fair pay for unsocial hours in NHS

Friday, February 12, 2016

GMB Call On Prime Minister To Remove Jeremy Hunt From Doctors Dispute And For Fair Payment System For Unsocial Hours Working In NHS

Paying additional monies for hours which are qualitatively different to weekday hours should not be something workers should be asked to give up or bargain on says GMB.

GMB, the union for staff in the NHS, commented on the imposition by Jeremy Hunt Secretary of State for Health of a new contract for junior doctors. See notes to editors for copy of oral statement to House of Commons dated 11th February.

Rehana Azam, GMB NHS Officer,  said "Employers paying additional monies for unsocial hours is a widespread and longstanding practice in all sectors running 24/7 in both private and public sectors including the NHS. The additional money is to reward workers for working at night and at weekend and is to attract workers to work these unsocial hours.

NHS staff including junior doctors work 24/7 days including unsociable hours. The proposal to front load junior doctors basic pay is just a con trick which does not recognize this and all NHS staff can see that.

Mr Hunt isn't just moving around the furniture he is taking vital pieces away. A swings and roundabouts approach to paying for unsocial hours does not work as the incidence of such work varies from worker to worker and from week to week. That is why industrial relations experts attach the additional payments to the hours for a fairer system.

The Secretary of State for Health said the new junior doctor’s contract wasn't about saving money. Yet in his own words he has announced that he will cut unsociable hour rates for junior doctors working unsocial hours. The Secretary State for Health said the junior doctors dispute wasn't about politics, yet in announcing to impose the contract he is trying to deliver a Conservative party manifesto pledge. What's clear is the Secretary of State for Health is unable to resolve a serious industrial dispute.

GMB calls on Prime Minister, David Cameron to remove Jeremy Hunt from these negotiations and this dispute. Jeremy Hunt has lost the confidence and trust of all NHS staff.

GMB also calls for the imposition of the contract to be suspended and for expert industrial relations negotiators to be brought in to reach an agreeable resolution. If this does not happen there is a danger the imposition will have a seismic wave effect on industrial relations across the NHS and will only stoke industrial relations unrest across the NHS.

Any talks must address the absolute nub of the problem which is the announced cuts to unsociable hour’s allowances.

Asking workers to give up the widespread and longstanding practices of paying additional monies for hours which are qualitatively different to weekday hours should not be something workers should be asked to give up or bargain on.

GMB has already opposed proposals to cut unsocial hours payments in the ambulance service which also runs 24/7 every week. GMB will not hesitate to defend hard fought terms and conditions including unsociable hour’s payments should there be any negative impact on staff as a result of the proposal to impose the contract.

There is a window of opportunity and the government will be foolhardy if they don't stop and strive to achieve an agreement over an imposition.”


Contact: Rehana Azam, GMB National Officer on 07841 181656 or Justin Bowden on 07710 631351 or GMB Regional Officers: Birmingham & West Midlands Samantha Jones 07939 874272 or  London & East of England Dave Powel 07710 631 349  East Midlands, Les Dobbs on 07966 327 967, North East and Cumbria, Chris Jukes on 07870 176 733, North West, Lisa Ryan 07703 468 968 or Maria Almond 07718 113110, Northern Ireland, Michael Mulholland on 07974 018 413, South East, Nick Day on 07717 510 047, Wales & South West, Paul Gage on 07980 753 117 and GMB Press Office: 07921 289880 or 07974 251823.

Notes to editors

Copy of Oral statement to Parliament dated 11th February 2016:

Jeremy Hunt updates Parliament on the junior doctors' contract

Health Secretary announces introduction of new junior doctors' contract.

Mr Speaker, nearly 3 years ago to the day the government first sat down with the British Medical Association (BMA) to negotiate on a new contract for junior doctors. Both sides agreed that the current arrangements, drawn up in 1999, were not fit for purpose and that the system of paying for unsocial hours in particular was unfair.

Under the existing contract doctors can receive the same pay for working quite different amounts of unsocial hours; doctors not working nights can be paid the same as those who do; and if 1 doctor works just 1 hour over the maximum shift length it can trigger a 66% pay rise for all doctors on that rota.

Despite the patent unfairness of the contract, progress in reforming it has been slow, with the BMA walking away from discussions without notice before the general election. Following the election, which the government won with a clear manifesto commitment to a 7-day NHS, the BMA Junior Doctors Committee refused point blank to discuss reforms, instead choosing to ballot for industrial action. Talks did finally start with the ACAS process in November but since then we have had 2 damaging strikes with around 6,000 operations cancelled.

In January I asked Sir David Dalton, Chief Executive of Salford Royal, to lead the negotiating team. Under his outstanding leadership, for which the whole House will be immensely grateful, progress has been made on almost 100 different points of discussion, with agreement secured with the BMA on approximately 90% of them. Sadly, despite this progress and willingness from the government to be flexible on the issue of Saturday pay, Sir David wrote to me yesterday advising that a negotiated solution is not realistically possible.

Along with other senior NHS leaders and supported by NHS Employers, NHS England, NHS Improvement, the NHS Confederation and NHS Providers, he has asked me to end the uncertainty for the service by proceeding with the introduction of a new contract that he and his colleagues consider both safer for patients and fair and reasonable for junior doctors. I have therefore today decided to do that.

Tired doctors risk patient safety, so in the new contract the maximum number of hours that can be worked in 1 week will be reduced from 91 to 72; the maximum number of consecutive nights will be reduced from 7 to 4; the maximum number of consecutive long days will be reduced from 7 to 5; and no doctor will ever be rostered on consecutive weekends. Sir David Dalton believes these changes will bring substantial improvements both to patient safety and doctor wellbeing.

We will also introduce a new Guardian role within every Trust, who will have the authority to impose fines for breaches to agreed working hours based on excess hours worked. These fines will be invested in educational resources and facilities for trainees.

The new contract will give additional pay to those working Saturday evenings from 5pm, nights from 9pm to 7am, and all day on Sunday. Plain time hours will now be extended from 7am to 5pm on Saturdays. However, I said the government was willing to be flexible on Saturday premium pay and we have been: those working 1 in 4 or more Saturdays will receive a pay premium of 30%, that is higher on average than that available to nurses, midwives, paramedics and most other clinical staff. It is also a higher premium than that available to fire officers, police officers or those in many other walks of life.

Nonetheless it does represent a reduction compared to current rates, necessary to ensure hospitals can afford additional weekend rostering. So because we do not want take home pay to go down for junior doctors, after updated modelling I can tell the House these changes will allow an increase in basic salary of not 11% as previously thought but 13.5%. Three-quarters of doctors will see a take home pay rise and no trainee working within contracted hours will have their pay cut.

Mr Speaker, our strong preference was for a negotiated solution. Our door remained open for 3 years, and we demonstrated time and again our willingness to negotiate with the BMA on the concerns that they raised. However, the definition of a negotiation is a discussion where both sides demonstrate flexibility and compromise on their original objectives, and the BMA ultimately proved unwilling to do this.

In such a situation any government must do what is right for both patients and doctors. We have now had 8 independent studies in the last 5 years identifying higher mortality rates at weekends as a key challenge to be addressed. Six of those say staffing levels are a factor that needs to be investigated. Professor Sir Bruce Keogh describes the status quo as ‘an avoidable weekend effect which if addressed could save lives’ and has set out the 10 clinical standards necessary to remedy this. Today we are taking one important step necessary to make this possible.

While I understand that this process has generated considerable dismay among junior doctors, I believe that the new contract we are introducing - shaped by Sir David Dalton, and with over 90% of the measures agreed by the BMA through negotiation - is one that in time can command the confidence of both the workforce and their employers.

I do believe, however, that the process of negotiation has uncovered some wider and more deep-seated issues relating to junior doctors’ morale, wellbeing and quality of life which need to be addressed.

These issues include inflexibility around leave, lack of notice about placements that can be a long way away from home, separation from spouses and families, and sometimes inadequate support from employers, professional bodies and senior clinicians. I have therefore asked Professor Dame Sue Bailey, President of the Academy of Medical Royal Colleges, alongside other senior clinicians to lead a review into measures outside the contract that can be taken to improve the morale of the junior doctor workforce. Further details of this review will be set out soon.

Mr Speaker, no government or health secretary could responsibly ignore the evidence that hospital mortality rates are higher at the weekend, or the overwhelming consensus that the standard of weekend services is too low, with insufficient senior clinical decision-makers. The lessons of Mid Staffs, Morecambe Bay, and Basildon in the last decade is that patients suffer when governments drag their feet on high hospital mortality rates – and this government is determined our NHS should offer the safest, highest quality care in the world.

We have committed an extra £10billion to the NHS this Parliament, but with that extra funding must come reform to deliver safer services across all 7 days. That is not just about changing doctors’ contracts: we will also need better weekend support services such as physiotherapy, pharmacy and diagnostic scans; better 7-day social care services to facilitate weekend discharging; and better primary care access to help tackle avoidable weekend admissions. Today we are taking a decisive step forward to help deliver our manifesto commitment, and I commend this statement to the House.

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