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Junior doctors committee annual report 2004

Chairman’s message
Three big issues dominate the agenda for the Junior Doctors Committee at the moment:
- European Working Time Directive [EWTD]
- Modernising Medical Careers [MMC]
- The inadequate provision of flexible training, called less-than-full-time training in Scotland

The ‘teams’ structure introduced eighteen months ago has been working extremely well. The JDC is doing more than ever. The teams have now been fully incorporated as subcommittees of the JDC itself.

EWTD
The JDC has been, and will continue to, try to find the best arrangements to preserve and enhance training whilst changing our hours to fit with European legislation and high court judgements.

The Departments of Health appear to be unclear themselves what they feel the impact will be. We still do not know how compensatory rest will be worked out. This is despite highlighting this problem several years ago and putting forward sensible proposals at that time. This degree of chaos in a private company would results in heads rolling.

We are trying to agree some joint guidance for trusts with the Department of Health and the Academy of Medical Royal Colleges. In addition the JDC and wider BMA will be producing specific guidance to members on what to do in August, their rights and how the BMA can, and will, support them.

The EWTD and problems with its implementation are being explored by the Hours of Work and Medical Staffing Subcommittee [HOWAMS] (Chairman – David Macklin) together with the Terms and Conditions of Service and Negotiating Subcommittee [TCSN] (Chairman – Jo Hilborne).

Other areas being looked at by HOWAMS include:
Handovers – How to make them happen, happen better and include training value. Monitoring – We may all dislike it, but it’s vital to show how we’re working. HOWAMS is helping trusts learn from those who do it best, to make it less of a chore. New Deal – It hasn’t gone away, nor have the mechanisms for rebanding. We have won every appeal for junior doctors so far.

Negotiating
In addition to the EWTD, as above; TCSN have been involved in discussions with the DoH to try to resolve anomalies in the Terms and Conditions, to rework the disciplinary procedures and to try to retain useable accommodation for juniors.

We have agreed to all the branches of practice (the ‘Craft committees’ i.e. Seniors, Juniors, Staff Grades etc) looking to form a joint negotiating position on accommodation.

Flexible Training
Flexible training will have run out of money by the time you read this. It is getting increasingly hard to get less than full time training. Not only are the criteria getting more and more restrictive but so are the options for training (usually 60% on fixed days or job-share). This is clearly unacceptable. JDC has mandated the TCSN subcommittee to enter discussions with the DoH on how to expand the number of places and to allow discussions of the pay scale to make it fairer and more flexible, especially as the hours come down.

Modernising Medical Careers
The proposed reforms of postgraduate training have been dominating the JDC’s Education & Training team agenda. Pilots for foundation programmes (incorporating the PRHO and SHO1 years) are now underway in several deaneries. We are seeking assurance that no junior doctor’s career will be disadvantaged by participation in a pilot scheme.

It is currently envisaged that what will follow from the two-year foundation programme is a ‘run-through grade’ of specialist training, incorporating the current SHO and SpR grades. JDC is represented on the Department of Health’s Modernising Medical Careers Delivery Board and we have established a dialogue with the Deputy CMO and Chairman of the Postgraduate Medical Education & Training Board to feed in trainees’ views.

We organised the first joint forum between the JDC and the Academy of Medical Royal College’s Trainees Committee on 4 March. Concerns were shared that, while a reform of the SHO grade is welcome, the proposed reforms go beyond the Department of Health’s initial remit, and threaten to reduce the quality of the current CCST by proposing radically shortened higher specialist training. A consensus statement was produced at the end of the meeting, which we hope reflects the views of all trainees on this matter. The statement can be found on the junior doctors’ pages of the BMA website www.bma.org.uk.

Study leave
The team has produced a report: Valuing learning: a discussion paper around the future requirements for study leave for doctors in training. This paper calls for an end to the current ‘postcode lottery’ of study leave provision. The paper has been endorsed by the Academy of Medical Royal Colleges Trainees Committee and will shortly be published as a joint document.

2004 has been an especially busy year for the committee and shows no signs of slowing down. I remain very grateful to all the members of the committee for their hard work in ensuring we continue to respond quickly to consultations from the DoH and other bodies. We are also setting the agenda for preserving and improving the training and quality of lives of junior doctors during these turbulent times.

Simon Eccles
Chairman of the Junior Doctors Committee
April 2004