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When I stood for the position of UK JDC chair three years ago, the challenges facing the BMA’s junior doctors committee appeared insurmountable. We had been locked in a bitter and protracted dispute over a contract that led thousands of us to the streets. Junior doctors across the country had been forced to carry out effective and sadly necessary strike action to ensure we secured terms that recognised and valued our NHS workforce, to obtain a contract that was fairer and safer for doctors and patients. Despite the deafening outcry and visible protests, we ended up at referendum with a divided membership not unlike that which we have with Brexit.
Following imposition our influence was diminished; the contract was imposed against our agreement, collective bargaining with employers was suspended, and our members were demoralised and drained, faced with a raft of implementation problems across the country. We had given up the mandate for industrial action, but had no official mechanism to secure improvements. This is the context in which I became chair of UK JDC, and one I knew was unacceptable – our members undoubtedly deserved better.
Over the past three years, JDC has worked hard to overcome these considerable obstacles, to ensure the work of junior doctors is valued and the problems we face are recognised and addressed by those with the power to do so, across NHS workplaces and in the halls of government. My priority as I took over the position of chair was to tackle these problems head on, to do the necessary and painstaking work of negotiating and campaigning for improved terms – for safer working hours, for the additional money we all know is required to deliver the staffing and care our patients deserve, and for more equitable terms that recognise and embrace the diversity of our workforce.
We won the right to negotiate while remaining in dispute, and entered into the 2018 review with a different approach, starting with evidence-based working groups. After these three years of hard work, we presented you with a contract that was overwhelmingly approved by the membership, in clear contrast to the terms our members rejected in 2016. This included increased safety limits and improvements to rest provisions, significant additional money (that we had been told was a pipe dream), measures to improve less than full-time training, and greater recognition for unsocial hours.
I am proud to have overseen this significant achievement for junior doctors, and of the brilliant work JDC has done over the past few years. This, of course, is one part of the many other things we have achieved, and it would be impossible for me to list them all.
Most notably, we were proud to finally deliver a number of huge steps forward for equality, with the guarantee of shared parental leave for all junior doctors in England and enhanced rights to child bereavement leave. The work to extend these rights across all four nations has already begun. The gender pay gap review in medicine is long overdue, and I know the ongoing work we are doing to identify and address issues will continue to be crucial for the BMA going forward.
We have also addressed inequalities faced by junior doctors by successfully lobbying for access to additional work for less than full-time trainees, for special allocation for those with caring responsibilities or disabilities to ensure they can obtain training posts in the areas in which they need to live and work, and by improving the interdeanery transfer system.
We secured millions of pounds in funding to address fatigue that junior doctors too often face, placing these funds in the hands of trainees locally up and down the country, to be spent in accordance with our Fatigue and Facilities charter, so we could make trainees driving home tired and ending up in accidents a thing of the past. We secured millions of pounds more to support return to training for those who have had career breaks or time out for maternity.
The work of our education and training committee on Health Education England’s Foundation Review has the potential to significantly improve the working lives of junior doctors. It should ensure increased access to training and flexibility, by creating new less than full-time training schemes, improved support for applicants with health or caring needs, a reduction in induction burdens, and dedicated time for professional development.
We have also fundamentally changed the shape of study budgets in England, finally moving to a long overdue system that covers all mandatory costs of training, and is open to aspirational funds, so we can finally address some of the cost barriers to truly widening participation.
I am also particularly proud of the work we have done and continue to do to support the mental health of doctors and medical students, who are too often left with little support in a health service that relies on them to care for others, but does not always provide the necessary support for them. Together we created a wellbeing hub, centralising all services offered across the four nations so they are accessible to all doctors.
We have tried throughout my time as chair to prioritise speaking with our membership. I have travelled across all four nations, carried out multiple visits across our regions to speak to our trainees in their workplaces, and notably always made time to engage on social media and via email. I hope we have pushed forward the way that we engage and communicate with people through the Facebook and Twitter pages we started, and the training we have created and improved for reps locally and beyond.
I have had the pleasure of working with some of the most brilliant and diligent people in the NHS and the wider health landscape. I know that many challenges facing junior doctors continue and are not to be downplayed, and that much work still needs to be done to ensure that the wins we have secured are enacted.
On Saturday, I will step down as chair of the JDC, and as I do so, I would like to pay tribute to the dedicated people I have worked with throughout my time as chair, and the individuals and groups we have worked with across so many organisations to help us to make progress in so many areas.
Taking forwards all of this crucial work through all the crises we have faced, whilst continuing in my training, has been beyond challenging. It has been the most demanding three years of my professional and personal life, not just due to JDC, but also having been the first doctor at the tragic scenes in Westminster during this time. It has, however, been the privilege of my life to be the chair of UK JDC for these three unforgettable years, to lead junior doctors out of the largest industrial dispute in recent decades back to collective bargaining, and to deliver a contract that is undeniably safer and fairer for junior doctors.
I know that I will be leaving the JDC in very capable hands, and finally coming back to do what I have always loved, clinical practice in the East End of London. I know that whoever is elected to JDC chair will have a wealth of experience and strong support behind them, not only from the committee, but the entire Association, and will take forward this work with a strong structure and foundation.
To those on JDC, the wider membership and Association, and junior doctors across the four nations, it has been an absolute privilege to serve on your behalf, and I am confident that we are well equipped as we move forward to the new challenges facing our trainees, workforce and NHS.
 Full list of changes available here: https://www.bma.org.uk/collective-voice/influence/key-negotiations/terms-and-conditions/junior-doctor-contract-negotiations/agreed-new-contract-deal-for-junior-doctors-in-england
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