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That’s how much the DDRB values our on-call commitments.
On the one hand, the DDRB says it wants to extend high-quality services seven days a week. On the other, the doctors providing the on-call work that keeps hospitals going at evenings and weekends are being treated in a derisory way.
Our on-call commitments are currently reflected in the banding of our post. Under the DDRB’s recommendations, this would go. Its replacement? A supplement for on-call commitments that are likely to bear no relation to the work to the work involved.
In its report, the DDRB notes that NHS Employers called for a flat rate availability allowance of 5 per cent of basic pay. It notes that the BMA, and also I suspect the vast majority of doctors it represents, found this proposal ‘derisory, for very challenging, urgent, possibly life-saving work’.
Unlike a good number of the employers’ proposals, the DDRB doesn’t simply rubber-stamp what the employers and Government wants. But neither does it give any cause for hope that it will address our concerns about the whole system of on-call exploiting the doctors who prop it up.
The DDRB says the allowance should vary according to the frequency of on-call working, and it’s for the BMA and employers negotiating the contract to agree on the funding available. But given that it ‘notes’ the on-call supplement is between 1 and 8 percent for other medical staff, the 5 percent supplement looks a very possible outcome.
Apply that 5 percent to the vast number of hours that some doctors work on-call, and it’s clear that on an hourly basis they would be well below the minimum wage.
It’s not that residential on-calls are a matter of sitting at home watching CSI. I’ve worked a number of shifts on this kind of rota and many do not even comply with the European working time regulations.
We might be in the hospital, in the A&E department, in someone else’s home scared that police are taking too long to arrive while someone suffers a psychotic episode.
And bear in mind that this change could make everyone’s on-call commitments much worse. Think of the perverse incentive it creates for employers – the more work they manage to push to on-call hours, the more they will save. Why have two doctors, when you can have one with horrendous on-call commitments and a minuscule allowance?
Medicine is a vocation, we all expect to work extra hours, and I don’t know a single doctor who clocks on and off. All we ask is for fairness in what we do.
Zead Said is an ST5 in general adult psychiatry in south Yorkshire
Visit the BMA website for more information and updates on junior and consultants contract