The Welsh junior doctors committee launched a referendum of junior-doctor and final-year medical student members in Wales last month, asking whether you wanted to accept the introduction of a new contract that we had negotiated with NHS Wales Employers and the Welsh Government. 

The result of this referendum is that members did not vote to approve the new contract. 36% of members voted in favour of introducing the contract and 64% voted against. 

WJDC accepts the clear message the membership has given on this issue and will not be proceeding with the introduction of the negotiated contract. Instead, we will now be listening to members to understand, in the light of this decision, what you want us to do next. 

There will be time as the dust settles to better understand the reasons why many members did not feel confident enough about the proposals in order to vote in their favour. However, we know from the referendum explainer events we undertook across Wales and from the other feedback we received that two issues with the proposals stood out in particular: the move to a pay progression system that would not recognise years of service and the length of the day and week paid at plain-time rates.  

These are areas we knew would be difficult changes for many members; we fought long and hard for alternative solutions throughout the negotiations. However, unfortunately, they remained areas where Welsh Government and NHS Wales Employers would not compromise at that time. It is now up to them whether they are willing to revisit their positions in light of our members’ decision. 

It is still the case that the terms and conditions of service under which we work must be reformed. The current contract is unfair and unsafe: its lack of rota safeguards and facilities provisions leads to burnout and delayed training and a less safe health service for trainees and for patients.

The rota monitoring system is defunct and doesn’t accurately reward us for the real work we contribute to the NHS, nor does it ensure we are working in safe limits. This principle of improving trainee safety and welfare – enabling you to do the work that you do sustainably – will always be the first principle of contract reform. 

At the same time, we must continue to campaign for junior doctors in Wales to be paid what they are worth. We have seen consistent erosion of junior doctors' pay and, with a new era of austerity in Westminster on the horizon, we will have to fight all the harder as a profession to ensure we get fair pay rises. Pay is also a safety issue: as the cost-of-living crisis bites, many of us will find it harder to focus on our work with money worries looming. 

Thank you to everyone who voted in the referendum – the vitality and engagement of our membership is our greatest strength in pursuing the contractual reforms and pay rises that our profession desperately needs. 

We will continue to keep junior doctors and final-year medical students in Wales informed at each step via our blog and social media channels, along with member emails and newsletters.

We’re also looking into more avenues where we can talk to you in person. If you have any questions in the meantime, please email [email protected]  

Milan Makwana is BMA Welsh junior doctors committee deputy chair for terms and conditions of service