On February 11th 2016, the Secretary of State for Health Mr Jeremy Hunt announced in the House of Commons that he will be unilaterally imposing a new contract on doctors-in-training in England, causing widespread outrage and condemnation throughout the profession. It is regrettable that we are put in this position, whereby our resilience and conviction to stand up against a government that has badly miscalculated its actions in this way, is tested.
The British Orthopaedic Trainees Association (BOTA), like the British Orthopaedic Association (BOA)1, wholeheartedly and fervently rejects the imposition of a new contract, especially given the huge concessions made by the British Medical Association (BMA) in negotiations held, in what was thought to be good faith, but in fact were seemingly a front for a predetermined course of action.
The effects of Mr Hunt’s actions today will echo in the National Health Service for generations to come. Orthopaedic doctors in training are no less disenchanted, disillusioned, undervalued, and denigrated than those in any other medical speciality. We are fighting the same battle, side-by-side, with the British Medical Association (BMA). That is one to protect our patients, ourselves, and our beloved National Health Service. We fear that the NHS will not be sustainable, as the very group of people that help keep it functional, are forced out of the vocation they chose many years ago.
Junior doctor rotas in orthopaedics, have some of the largest gaps of any medical speciality. A significant proportion of these rotas are made up of Foundation Year 2 doctors. In August 2015, a record high of 48% of this cohort decided not to pursue their career in the NHS2. BOTA fears that the effects of the announcement today will lead to a greater number choosing the same path, forcing an already stretched system to breaking point.
Many junior doctors, in the registrar tier of orthopaedics, work busy non-resident on calls where increasingly, coming in to review unwell trauma patients in the early hours is the rule rather than the exception, and will see a dramatic cut in pay following an initial period of payment protection. This will further worsen the recruitment and retention crisis we are experiencing in Trauma & Orthopaedic surgery today, with a reduction in competition for specialist training jobs from 11:1 (2005) to less than 2:1 (2015).
BOTA strongly urges the Secretary of State for Health and the Prime Minister to step back, reflect, and take independent advice on the certainly damaging, and potentially irreversible, effects that the imposition of a new junior doctors’ contract in the name of improving care in the NHS on the weekends, will have on the wider Health Service. Please listen to the tens of thousands of junior doctors that only want to provide the nation with the greatest level of care possible.
We support the BMA to continue to take appropriate action to ensure that the threatened contract, which BOTA feels will jeopardise the future care we can provide our patients in the NHS, is not imposed. Furthermore, we urge the government to return to the negotiations with the BMA with an aim to find a contract that truly protects our patients, and treats hard-working junior doctors fairly, which this new contract certainly does not achieve.
British Orthopaedic Association. BOA Statement: Junior Doctors – imposition of contract. Accessible at http://www.boa.ac.uk/latest-news/boa-statement/
UK Foundation Programme Office. F2 Career Destination Report 2015. Accessible at http://www.foundationprogramme.nhs.uk/pages/home/keydocs