This is the scenario facing doctors in training as proposed contractual changes could see their standard-paid hours — those which do not attract ‘premium’ pay — significantly increase.
During contract negotiations the BMA opposed this recommendation by the Doctors and Dentists Review Body, which has been described by junior doctors as an attack on their professional and personal lives at a time when they already feel overworked and undervalued.
Doctors from a range of specialties have emailed the BMA with concerns that the proposals will lead to burnout and cause them to rethink their career options.
London specialty trainee 3 in endocrinology Bernard Freudenthal says: ‘We are used to working weekends, but it should only be in so far as is necessary and we should be rewarded for it.
'To blur the difference between usual working and non-working hours will remove all incentive for employers to use the workforce efficiently.
'To blur the difference between usual working and non-working hours will remove all incentive for employers to use the workforce efficiently'
'We came into [medicine] with an expectation that we will work out of hours, but if the Government runs us into the ground, doctors will simply emigrate and aspiring intelligent people will cease to want to join.’
Birmingham GP trainee Helen Cole says: ‘Working as many antisocial hours as we do is already very disruptive for my family.
'My toddler doesn't know whether she is coming or going and the times she does see me and my husband [also a doctor] together she assumes she is going on holiday — it is so rare!
'Take away the banding and we will have to increase our hours to make ends meet. Again, a career change heading my way.’
Leeds core medical trainee 2 James Quinn says: ‘We are highly trained professionals, dealing with illness and death on a daily basis and making critical decisions and therefore our pay should reflect this.
‘The review removes safeguards [against the] exploitation of doctors by employers who exceed our contracted hours. This could impact on patient safety and the safety and personal well-being of doctors.’
Read foundation doctor 1 Melody Redman's blog on anti-social hours
What does an increase in standard hours mean in practice for doctors in training?
Standard or ‘plain-time’ working hours are 7am to 7pm, Monday to Friday and any work that falls out of this time is paid at a premium as part of doctors’ pay banding to reflect the impact of the unsocial hours on doctors’ personal lives.
The DDRB recommends extending standard hours to 7am to 10pm, Monday to Saturday.
This would mean that an hour of work at 9pm on a Saturday evening would be paid in exactly the same way as an hour at 9am on a Tuesday morning, essentially making Saturday the new Tuesday.
Another proposal suggests splitting remaining premium hours into two different rates, with Sunday hours between 7am to 10pm paid at a lower rate than work at night — night-time being the hours between 10pm and 7am every day of the week.
The DDRB proposes increasing standard hours — working time that attracts standard pay — by 30 hours a week.
This does not mean that doctors will work an additional 30 hours a week, rather that the time period in which they are paid at a standard rate has expanded and also includes Saturday — a day normally paid at premium time.
What does the BMA think of this?
The BMA opposed any extension to plain-time hours for junior doctors during contract negotiations.
Junior doctors routinely work outside of plain time and are committed to continue doing so in order to provide their patients with high-quality care around the clock.
However, evenings and weekends are precious opportunities to spend time with friends and family and it is only fair that doctors’ pay reflects this when work requires they lose this free time.
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