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What now for the junior doctors' contract?

Doctors in training asked questions about the implications of the BMA not re-entering contract negotiations in a second webchat

Dozens of trainees took part in the event on Monday evening and asked whether the BMA would return to negotiations, consider industrial action and about the threat of a contract being imposed.

Last week, the BMA junior doctors committee decided not to re-enter talks with NHS Employers for a new contract for UK doctors in training because of the Government’s heavy-handed attempts to push through a deal without sufficient safeguards for doctors, and patient care.


Re-entering talks

In response to a question, BMA junior doctors committe co-chair Kitty Mohan said the association would only reconsider talks if they are ‘genuine, meaningful negotiations with no arbitrary deadline or the threat of an unacceptable contract’.


Industrial action

Answering another question on the prospect of industrial action, Dr Collier said going ahead with this could not be taken lightly and doctors would need to consider what they wanted to achieve before entering the ‘strict legal process’.

Another post asked if patient and doctor safety concerns were grounds for a legal challenge.

BMA junior doctors committe co-chair Andrew Collier replied: ‘Sadly a legal challenge on patient/doctor safety would not be within the scope of contract law.

'However, if doctor/patient safety was threatened there would be other tools available to us to ensure safe working.’


Contract imposition

Responding to a question on an imposition, Dr Mohan added: ‘We remain hopeful that ultimately we will be able to reach a positive agreement for juniors with the Government, but if this is not possible we take seriously our responsibility to provide the strongest possible representation to our members at this crucial time.’

The Scottish Government has already assured BMA Scotland that it would not impose a deal on trainees north of the border.


Pay progression

One doctor in training asked if the proposals would see a trainee downgraded a pay increment if they were, for example, a specialty trainee 6 on a ST8 pay grade owing to time spent in other specialties.

Dr Mohan replied: ‘At the moment, if you decide that your chosen specialty is no longer right for you, or if there is a reason you can no longer pursue it, you can retrain in a new specialty and your pay is protected.

'Under these proposals, if you changed your specialty you would have to start again from the bottom of the payscale, meaning a potentially significant pay cut for trainees who may have mortgages to pay or families to support.

'It is fair for doctors — and best for the NHS — if trainees who want to switch specialty are not forced out through financial necessity, but able to stay in the NHS and retain a wealth of experience from their previous specialty.’


Impact on medical students

Asked about the impact of the proposals on medical students, Dr Mohan said many students graduate with debts of more than £100,000 and face further training costs on a starting salary of £22,000.

‘The likely loss of income that will come from an increase in "standard" hours [times during the week deemed to not be anti-social and therefore attracting only basic pay] and the remove of banding payments, plus the loss of pay progression if they take time out of training, mean that many medical students will face careers that are just as demanding but less well-paid than the ones they signed up for,’ she said.



Concluding the webchat, Dr Collier said: ‘One thing that has been shown over the past few weeks is that, regardless of where you work, or what stage career you are in, we will all be affected by these changes.

'But if we stand together we can show Government that it has underestimated the unity of the profession and if we stand united we can get the deal we deserve.’

Read the full webchat

Read more on the contract proposals

Find out more about what the changes mean for you