• By: Matthew Billingsley, George Gillett

The outcome of the junior doctor contract negotiations could have a major impact on current medical students’ pay and working conditions. Below is a timeline of the major flashpoints, and an overview of the changes being proposed.

October 2013—Talks begin between NHS Employers and the BMA

NHS Employers, acting on behalf of the government, and the BMA, the trade union for doctors in the United Kingdom, start discussing the terms of the new contract, with a view to implementing it by April 2015.

October 2014—BMA walks away from the negotiation table

After a year of negotiations the BMA pulls out of talks citing concerns about patient safety, doctors’ welfare, and a lack of evidence underpinning the changes. Kitty Mohan, co-chair of the junior doctors’ committee at the time said the contract proposals lack a “fundamental grasp” of the way in which NHS staff work and that doctors are “upset and frustrated” with how their work was not being “valued, noticed and recognised.”

November 2014—DDRB steps in

After the breakdown of talks, the government commissioned the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to review the contract proposals.

July 2015—DDRB report published

The DDRB report says that the current contract is no longer fit for purpose and is hindering the achievement of the NHS’s goals to improve patient care and outcomes, and is unaffordable in the current financial climate. The report includes several recommendations that upset junior doctors (box 1). NHS Employers in England agreed that the DDRB report should be the basis for finalising new contractual arrangements. NHS Northern Ireland, Scotland, and Wales all rejected the new contract and have decided not to enforce it.

August 2015—Junior doctors vote against re-entering contract negotiations

The BMA’s junior doctor committee rejects further negotiations with NHS Employers, citing the proposals in the DDRB report as “unacceptable.”

August 2015—Jeremy Hunt threatens to impose the contract

Jeremy Hunt, secretary of state for health in England, threatens to impose the new contract if an agreement cannot be reached between the government and the BMA by early September 2015. The chair of the BMA, Mark Porter, accuses Jeremy Hunt of making a “wholesale attack” on doctors.

This month also saw the hashtag #imatworkjeremy take off in reaction to Hunt’s speech at the King’s Fund, where he said the new contract was necessary in order to deliver a seven day NHS. Many healthcare staff took exception and proceeded to post photos on Twitter of themselves on working at weekends.

September and October 2015—Protests in the streets

Tens of thousands of junior doctors and supporters protest in several UK cities against the changes proposed in the new contract.

October 2015—Pay rise offer rejected

Just before the BMA was due to ballot its members for strike action, Jeremy Hunt offered junior doctors an 11% rise in their basic pay. The BMA dismissed this as effectively a pay cut because junior doctors’ overtime hours are still being reduced, which can make up as much as 40% of their income. The Department of Health also refused to enter conciliatory talks with the BMA, mediated by ACAS, an organisation that resolves employment disputes.

19th November 2015—98% of junior doctors vote to strike

The BMA represents 37 155 of junior doctors in England and 98% of them voted in favour of taking strike action in protest against changes to their contract. The BMA announced the dates of one day of industrial action and two days of strikes in advance so that junior doctors and their employers could make arrangements to cover the withdrawal of their services. The knock on effect was that some operations and procedures were cancelled.

30th November 2015—Strikes suspended

On the eve of the first day of industrial action, the BMA agreed to suspend the strikes until the 13 January and negotiate with the government, after Jeremy Hunt agreed to pause the imposition of the new contract. Despite the strike action being called off, 4000 operations were cancelled and the BMA and Jeremy Hunt both accused each other of stalling on talks that could have averted this inconvenience for patients.

13th January 2016—Deadline to agree new contract

The BMA and the government have until mid January to come to an agreement on a new contract. It is unclear at the time of going to press what concessions each side would be willing to make to resolve the dispute. If an agreement cannot be met, then the BMA may set new dates for industrial action.

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