The National Health Service (NHS) in England faces massive disruptions as medical residents there have threatened to withdraw services. They are protesting attempts to impose a new contract that expands the number of hours these ‘junior doctors’ are expected to work at a basic pay rate.
A strike vote is being conducted by the British Medical Association (BMA), which represents most of the 53,000 residents in England (the NHS in Scotland and Wales are not involved in the dispute).
Medical residents are being asked whether they’re prepared to conduct the first-ever strike by residents in England or support industrial action — short of outright withdrawal of services. Balloting closes Nov. 18.
Residents have the support of many medical royal colleges in the United Kingdom.
“I hope that I am never in that situation,” said Dr. Tom McLaughlin, president of Resident Doctors of Canada (RDoC), when asked to comment on the dispute.
He said RDoC is sympathetic with the cause of the junior doctors and is “opposed to imposed settlements,” he said.
McLaughlin said the current situation in England could not happen in Canada, not only because residents negotiate at the provincial level, but also because most resident associations have the right to arbitration if they reach an impasse in negotiations.
However he noted residents tend to be in a vulnerable position when negotiating new contracts because they are often perceived to be an easy targetdue to their standing in the system.Contract negotiations between the BMA and the government over the residents’ terms and conditions of work broke down October, 2014 . The current contract has not been updated since the late 1990s.
The government has said it will impose a new contract starting in August 2016, after residents rejected a last-minute offer to increase their basic pay rate by 11%. This has prompted the BMA to call the strike vote.
At the core of the dispute is the government’s intention to greatly expand the availability of emergency medical care on weekends and evenings, and how much residents would be paid to provide such services.
According to published accounts, what concerns residents most is the plan to extend their regular working hours from 60 to 90 hours a week and to 10 pm every night except Sunday. As a result, residents say they will see their pay drop by up to 30% — especially for family practice residents. The present hours-worked requirement is 7 am to 7 pm weekdays, considered “plain time”, with hours worked outside this period remunerated at higher rates.
In contrast, the department of health maintains its proposals offer residents a better deal.
News reports are making much of the fact that thousands of residents have applied for certification from the General Medical Council to work overseas, prompting fear of severe physician shortages in England.
If residents vote in support of industrial action short of a full withdrawal of services, the BMA is proposing an emergency-care-only model in which residents would provide the same level of service as is available on Christmas Day.