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The Junior Doctor Contract

The controversy surrounding the junior doctor contract began in 2013 and has continued to divide the public and the media. The Department of Health (DoH) introduced the contract with the aim of making pay fairer. The end goal was to spread both emergency and elective services across the seven days of the week. 

There have been several sporadic negotiation attempts with the DoH by The British Medical Association over points in the proposed contract, including: rota shift patterns and pay. The biggest argument is that many junior doctors do not feel the contract is safe for patients or fair for doctors. This has led to industrial action and walk-out strikes. 

The old Junior Doctor contract

Previously junior doctors were paid at the standard rate for shifts which fell between 7am to 7pm from Monday until Friday. FY1 doctors would earn a basic salary of £22,865 working these hours. 

This was a basic salary that would increase as doctors progress through their training. However, junior doctors are also required to work on-call shifts outside of their standard hours. This would earn them an extra monetary supplement, known as banding, which could add an additional 40 to 50% to their basic salary.

The new Junior Doctor contract

The new system of pay and working hours for junior doctors was overhauled as of April 2017. This meant that there were four points of nodal pay along the training path introduced.

Depending on how many weekends a doctor works and their nodal level, they are awarded an extra percentage of their allowance. For example, a junior doctor who works one in every two weekends gets an additional 10% of their basic pay, whilst those who only work one in eight weekends gets 3%.

On-call allowances were affected too. The time served concept was abandoned and the basic salary was linked only to the level of responsibility held. Basic pay increased by 10-11% but is now determined by on-call and weekend allowances, with no banding system in place.

What are the main concerns of the new contract?

What action was taken?

A group of Junior Doctors took their concerns surrounding the contract to the Court of Appeal in September 2016 where they contested that the proposed imposition of the contract was not legal. The Judge did not agree with their arguments and ruled in favour of the Department of Health. 

Issues arising from the initial contract were addressed in a 2018 review, with three key aspects of the contract updated:

What was the result?

In June 2019, it was announced that negotiations had come to an end after Junior Doctors accepted a new contract. The BMA JDC endorsed the improved contract and BMA members (who are Junior Doctors or final/penultimate year medical students in England) then had the opportunity to vote in an independent referendum on whether to accept the changes.

This brought an end to the four year-long dispute over the proposed contract. The new deal will benefit approximately 39,000 junior doctors in England – all of whom are medics below the level of consultant.

Dr Jeeves Wijesuriya, the chair of the BMA’s Junior Doctors Committee (JDC), said members had approved the new deal as it was recognised that it involved enhanced shared parental leave and better rest facilities. “We have made major strides towards a better future for all junior doctors.” He said. 

The main benefits of the new deal:

Current Health and Social Care Secretary, Matt Hancock said: “I’m delighted that we have successfully brought to an end the Junior Doctor dispute with this landmark agreement. Improved working conditions and an 8.2% four-year pay rise will give Junior Doctors and current medical students the support they fully deserve.”

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