A Labour government led by Jeremy Corbyn will re-nationalise and restore our NHS, but it really is up to everyone to make sure there is an NHS left to restore. #OurNHS demo this Saturday marks the start of that movement.
Coaches are coming from across the country. Click here to find out about coaches coming from your area. And if you’re able to help steward on the day or help make placards tomorrow, please email email@example.com
So bring your friends and family to join Momentum, Jeremy Corbyn, John McDonnell and many thousands of others to stand up for our NHS.
Nye Bevan famously said the NHS “will last as long as there are folk left with the faith to fight for it”. Now it’s time to fight.
A contract which ACAS, the BMA, NHS Employers and the Department of Health agreed would be put to a referendum of junior doctors and medical students is being imposed upon them in October. Despite them rejecting the contract.
This contract is worse for less than full time trainees, which means it discriminates against women, those with disabilities and carers.
They still do not believe they have adequate protections for whistleblowing or hours safety through the guardian role in this new contract.
This contract will make it harder to recruit into specialities such as Emergency Medicine, Acute Medicine and Paediatrics.
Lots of other reasons related to the contract around issues such as non-resident on calls, locum arrangements, removal of annual pay progression,
What do they want?
The Government not to impose a contract on junior doctors it agreed to put to a referendum.
To return to negotiations starting with the ‘heads of terms.’ This is where ‘7 day services’ and the Government’s manifesto pledge should be discussed. Not brought into negotiations half way through.
A contract which doesn’t discriminate against protected groups, values their work and promotes the recruitment and retention of doctors.
Why won’t the Government agree to this and why are negotiations not continuing?
Because they are more interested in a political victory than a safe and secure health service.
Isn’t 5 days of strike action extreme?
This Government is prepared to impose a contract rejected by 6 out of 10 doctors. It has refused to talk about any alternative. The BMA Junior Doctors Committee feel they have no other options left.
Will this industrial action be safe for patients?
There is a clear escalation procedure between NHS England and the BMA. If patient safety is threatened then junior doctors will be called back to work.
Didn’t the BMA agree to this contract?
No: the Junior Doctors Committee agreed to try and find a negotiated contract and put that negotiated contract to a referendum of junior doctors.
58% of Junior doctors and medical student members of the BMA rejected this contract. A bigger mandate than for Brexit.
What can I do to support junior doctors?
Write to your MP and ask them to call on the Government to halt imposition.
We have received this message from a junior doctor:
Junior Doctors have announced a week of strike action starting 12th September, with further strike action called in October, November and December.
Current plans are for 8-5 full walkouts of all junior doctors. Aim is to prevent imposition of this contract and return to negotiations about the ‘heads of terms’ of future negotiations. It is a plan to halt the government’s attempts to bleed NHS staff dry through demanding 7 days resources from 5 days of services.
It is an incredibly bold plan, which has understandably been greeted by outrage from the right and nervousness from many.
Please be as publicly supportive of junior doctors as you can be. Please engage with prominent voices in your areas and ask them to be publicly supportive of junior doctors.
During the past year we have learnt an incredible amount. From how to organise a picket and dealing with the media, to contract law and equality impact assessments.
On Wednesday (last week) we were taught a lesson by the Government. A lesson on media management. The power of the Government to define a story in its own terms. When the news of the deal broke and we were faced with an onslaught of media and press reaction. ‘The war is over,’ ‘the deal is done,’ ‘BMA agrees terms with NHS Employers.’ It left a lot of Junior Doctors scratching their heads. Is it? Have we just lost?
The appearance of Jeremy Hunt on the national news did nothing to reassure us. His usual mix of factual inaccuracies and scorn for Health Professionals driving many into a frenzy. How could the BMA have done a deal with this man, and how could any deal be any good with the claims Hunt has made?
But if you look beyond the spin, the picture is a lot less clear cut, and there are parts of the deal which are very good for Junior Doctors, and directly oppose Hunt’s narrative on the contract. There are bits of the contract which quite frankly are not good enough and will the apparent return to a position of a cost neutral contract leave Junior Doctors open to more attacks down the line?
There is a lot for Junior Doctors to consider, and there is much to discuss as we plan the way forward. Industrial action and tough negotiation has won us concessions from the government that I did not believe were possible. The Junior Doctors Committee will meet on the 3rd June prior to the referendum of all Junior Doctors (and penultimate and final year medical students) to articulate a way forward.
Here are my thoughts on some of the issues:
Pay & Weekends
Currently junior doctors receive a pay uplift for unsociable hours (called banding.) The new contract splits this pot of money into sections. A pay premium for hours worked at night, retains a banding for Non-Resident on-call (NROC) and introduces a graded banding for weekend work.
This graded banding, based on the number of weekends worked is vital for Junior Doctors. It means there will be an escalating cost to increased weekend working, putting trusts off from rostering more doctors at weekends. Because it is a banding system it applies to the entire weekend. The risk of a junior doctor being asked to work repeated Saturdays as plain time has gone. Junior Doctors have got what they wanted, a financial disincentive to routine weekend working, and Jeremy Hunt is left trying to spin a defeat into victory.
Pay for all work done
When we look back at this contract negotiation I believe this will be seen as the biggest mistake made by the government.
Late last year the Junior Doctors Committee stated that it wanted pay for all work done. A reasonable request. The previous version of the contract honoured this on paper, but not in practice by stating that if a Junior Doctor could predict the hours they were going to be overworked they could request to be paid for these hours. Any junior doctor could tell you this was a joke, and would never work in practice.
The ACAS agreement states that we will now be able to claim for these hours before, during or after the period of extra work. This means the system will now be able to cope with the realities of the work. Doctors will be able to ask for this time to be added to annual leave or claim it back as pay if there is no space in the rota for them to take the leave.
This will be overseen by the Guardian. This newly created role with have oversight over a number of aspects of safety, rotas and exception reporting. The mechanism of reporting overworking. This was rightly described as a weak point in the previous contract. But it has been beefed up, and crucially will now be under scrutiny by Junior Doctors.
Unfortunately it is here that the ACAS document doesn’t stand up so well to scrutiny. The March contract offer was rightly attacked for its discrimination towards women, lone carers and the disabled. While this contract makes some moves in the right direction, many of these are of speculative benefit.
The reality of the loss of annual pay progression is a less equal contract. A week point of the new contract is also evening working. Particularly important for carers. The governments desire for the political victory will currently see this contract implemented before much of the work around rotas, equality issues or safety has been completed. Not a good starting point for a complicated, divisive new contract.
Jeremy Hunt argues this contract is ‘cost neutral.’ What he means by this is that compared to October 2015, this new contract would not cost any more than our current contract. Therefore if we were to transport ourselves back to October 2015 and put all Junior Doctors on the new contract the pay envelope would be the same.
Nobody believes this contract is cost neutral. An accurate estimate of the extra work done by Junior Doctors is difficult, but there is clearly a lot of it. If we start paying out for that cost neutrality is blown out the window.
But by saying it, and if Junior Doctors do not oppose it, it gives the Secretary of State political leverage for further cuts. In a years time when the pay bill has grown due to the NHS actually paying doctors for the work they do how will the government respond. In order to keep the pay bill cost neutral will it cut doctor numbers? Will it ask hospitals to cut services? Will it try and close whole wards or hospitals?
Junior Doctors have put themselves in an incredibly powerful position. We should not lose faith in our collective power now. Baring any surprises in the terms and conditions released on or before the 31st May I will be voting ‘no’.
Hospital Workers Strike At Maudsley, Lambeth, Lewisham And Bethlem Hospitals On Monday 21st March For A Living Wage, Sick Pay And Unsocial Hours Payments
With a profit of $1.4bn, American multinational outsourcing provider Aramark can well afford to pay their staff a proper wage says GMB.
GMB, the union for staff in the health service, is holding a strike at four South London Hospitals on Monday 21st March for 175 members working as cleaners and hostesses for private contractor Aramark.
GMB members will make history by leading the first strike against Aramark in the UK, having voted 97% in favour of industrial action. They will be seeking a living wage and fairer arrangements for sick pay and unsocial hours payments.
Picketing is taking place at the following addresses:
Bethlem Royal Hospital
Monks Orchard Road
108 Landor Road
Ladywell Unit Lewisham Hospital
University Hospital Lewisham
Lewisham High Street
Many of the staff who keep the hospital sites clean and prepare and serve food to patients are paid as little as £7.38 per hour and receive only 10 days of sick pay per year. Sick pay is only provided after the first 3 days of illness and workers in their first year of service receive no sick pay at all.
Nadine Houghton, GMB regional organiser said: “GMB members are serious about fighting for something that any worker should be entitled to: A wage they can live on and a sick pay scheme which ensures they won’t be forced into poverty as a result of falling ill.
“Aramark make a profit by paying workers as little as possible. GMB members in South London and Maudsley NHS Trust are now saying enough is enough, they should be rewarded properly for the work they do.
Our members are proud to be making history by leading the first strike in the UK against Aramark. Predominantly low paid women workers, the bravery our members are showing in this fight against an aramark multinational is inspiring. One woman was telling me how she was punched in the face by one of the patients while she was serving food on the ward – all for £7:38 ph!
Aramark is a $14.3 billion, American owned, multinational outsourcing provider. They can afford to pay their staff a proper wage.”
Contact: Nadine Houghton on 07714239227 or Andy Prendergast on 07984492726 or GMB press office on 07970 863411 or 07739 182691
Notes to editors
1 GMB press release dated Thursday, January 21, 2016
Dispute Looms At Of South London And Maudsley NHS Trust As Pay Talks With Contactor Aramark For £10 Per Hour Living Wage Stall
Next step is seeking permission for official strike ballot and there will protest demonstrations on 2nd and 9th February says GMB.
A dispute looms as pay talks covering 175 GMB members employed as domestics and hostesses by private contractor Aramark at four sites of South London and Maudsley NHS Trust (SLAM) have stalled.
The pay talks which have broken down cover members at the Maudsley, Lambeth, Bethlem and Ladywell sites where GMB is seeking a living wage of £10per hour and an end to two tier arrangements on sick pay and shift allowances.
GMB officers will now seek permission to proceed to an official strike ballot. GMB will also be calling demonstrations outside the sites as part of the campaign for a living wage and an end to the two tier workforce in the NHS.
Aramark is an American owned multinational outsourcing provider turning over $13billion. It pays many staff on the SLAM contract as little as £7:30ph for providing front line services to mental health patients.
Nadine Houghton, GMB regional organiser said: “It’s unfortunate that we have been forced to ask our members whether or not they are prepared to strike but we have consistently told Aramark that our members provide a front line service in a mental health trust within London and as such they deserve to be paid a genuine living wage of £10ph, full sick pay and proper shift allowances.
Our members are working around many vulnerable individuals, sometimes they are verbally and even physically attacked and yet many of them are unable to take sick leave as they are not paid for this, some of them also receive no extra pay for working weekends and bank holidays. they have rejected the offer that Aramark made to them as it went nowhere near satisfying the members demands.
GMB will continue to press for a living wage to be set at £10 per hour as agreed at GMB Congress. Members make clear in their experience you need at least £10 an hour and a full working week to have a decent life free from benefits and tax credits. Less than £10 an hour means just existing not living. It means a life of isolation, unable to socialise. It means a life of constant anxiety over paying bills and of borrowing from friends, family and pay day loan sharks just to make ends meet.”
The British Medical Association (BMA) has announced three further 48-hour strikes of junior doctors. The BMA also announced that it is to seek a judicial review into the government’s plans to impose new contracts.
The dates planned for industrial action are 9 March, 6 April and 26 April. All are scheduled to begin at 8am. Emergency cover will be maintained.
Health secretary Jeremy Hunt’s controversial push to impose new terms and conditions on all 45,000 junior doctors has exacerbated the bitter and long-running dispute.
We publish, below, a detailed critique, by science writer Les Hearn, of Jeremy Hunt’s “evidence” of excess deaths at weekends, used to justify imposing the new contract. This article first appeared in Solidarity:
Lies, damned lies, and Jeremy Hunt’s statistics
The government’s argument in their attack on junior doctors’ pay and conditions has been that they had a manifesto commitment to introduce seven-day access to all aspects of health care and that this was necessary to reduce excess deaths among weekend hospital admissions.
The government’s approach seems to amount to forcing junior doctors to work more at weekends for less pay. But, unless they also force them to work longer hours, this must reduce the number of doctors on weekdays. If the original problem of excess deaths was due to a lack of junior doctors at weekends, the result would be to equalise death rates by lowering death rates following weekend admissions and raising those following weekday admissions. Health Secretary Jeremy Hunt was very keen to talk about the evidence of excess deaths to justify his actions and, of course, evidence is very important. He claimed “We now have seven independent studies showing mortality is higher for patients admitted at weekends.” We will look at this evidence.
The DH says there is significant evidence of a “weekend effect” where patients admitted over the weekend have higher rates of mortality.1 The DH lists eight pieces of what they call research in support. 1. The major study cited by DH is from the British Medical Journal (Freemantle et al., 2015):2 one of its co-authors is Bruce Keogh, National Medical Director of NHS England. It found that death rates were higher for patients admitted on Fridays (2% higher), Saturdays (10% higher), Sundays (15% higher) and Mondays (5%) than on other days. Since the overall death rate within 30 days for all admissions is 1.8%, this means that the 15%-higher Sunday rate is 2.1% or 3 in 1000 “extra” deaths. We need to understand why and this is where it is important to look at how ill patients are on the day of admission. Risk The study informs us that, while 29% of weekday admissions are emergencies, on Saturdays the figure is 50% and on Sunday 65%. Using another criterion, mortality risk from all factors except day of admission, while 20% of weekday admissions were in the highest category, 25% on Saturdays and 29% on Sundays were in this highest risk of dying group. On these bases, we would expect an increased death rate for weekend admissions of anywhere between 25% and 125%. The observed “excess” of 15% on Sundays should be a cause for congratulation.
This paper is an update of the previous study by Freemantle et al. (2012)3 (see 5 below), also including Keogh. The findings were broadly similar except that the death rate on Saturdays and Sundays were very significantly lower than the average for weekdays. In the update this curious fact, which certainly needs discussion and explanation, is barely mentioned. To summarise, death rates for admissions on Saturdays and Sundays are increased by 10 to 15% but death rates for those already in hospital are reduced by 5 to 8%. Thus, the main source of support for the government’s Seven Day NHS plans does not provide any evidence for it. The weekend death rates for all patients are in fact far lower than one would predict from the seriousness of their illness. Read the rest of this entry »
With no agreement reached on key issues, junior doctors will provide emergency care only for 24 hours from 8am on 10 February.
Despite the best efforts of our negotiating team, and hours of talks facilitated by Acas, we have not managed to reach agreement with NHS Employers and the Department of Health on the new junior doctors contract.
As a result, the industrial action we planned for 10 February will be going ahead. However, rather than the planned full walkout, the action will mirror that of 12 January. Junior doctors in England will be offering emergency care only for 24 hours from 8am on Wednesday 10 February to 8am Thursday 11 February.
We are aware that some trusts have sought to nominate junior doctors to have one or two doctors to be on standby for every ward, other than out-patient departments and elective procedures, for the duration of the industrial action (IA). The BMA has taken expert legal advice on this issue.
Dates of industrial action for junior doctors in England
The BMA is calling on junior doctors in England to take official industrial action on 12 January, backed by a near-unanimous vote in favour in accordance with trade union legislation. Many members of the public have expressed support for our action, but we do not condone or encourage any form of unofficial industrial action or unlawful activity.
We have announced three days of action in total:
12 January 2016 – COMPLETED
Emergency care only between 8am on Tuesday, 12 January and 8am on Wednesday, 13 January (24 hours).
26 January 2016 – SUSPENDED
Emergency care only between 8am on Tuesday, 26 January and 8am on Thursday, 28 January (48 hours)
10 February 2016
Emergency care only between 8am on Wednesday 10 February and 8am on Thursday 11 February (24 hours).
In 2012 the Government asked the BMA to look into negotiating a new contract for junior doctors. After two years, negotiations stalled because the contract on offer would not have provided sufficient safeguards for junior doctors and their patients – either today or in the future.
The DDRB, an independent body, undertook a review and provided recommendations for a new contract. After the recommendations were released the Government asked the BMA to re-enter negotiations with the recommendations as the basis. We could not agree to the unsafe and unfair preconditions proposed, and so the Government said they would impose a new contract from August 2016.
We have consistently and clearly asked Government for the key assurances we would need in order to re-enter negotiations – the first of which was a withdrawal of the threat to impose a contract. These assurances have still not been given to us. In September, the BMA’s junior doctors committee took the decision to ballot junior doctor members on support for industrial action. We have continued to request the key assurances for genuine negotiations. The result of the ballot of more than 37,000 junior doctors in England was announced on 19 November, with more than 99 per cent having voted in favour of industrial action short of a strike, and 98 per cent for full strike action, demonstrating the strength of feeling amongst the profession.
The BMA suspended industrial action planned for December following progress made through talks facilitated by Acas. While progress was made on some issues during negotiations between the BMA, NHS Employers and the Department of Health, the offer that Government made on 4 January was not acceptable to the BMA. As a result, the action planned for 12 January went ahead.
Discussions with the Government continued throughout January, which led to the suspension of the planned 48-hour action on 26-28 January. However, despite the best efforts of the BMA negotiating team, major sticking points, including around the classification of Saturdays, remain. Because of this, the BMA decided that the industrial action planned for 10 February would go ahead, although it would see junior doctors offering emergency care only over a 24-hour period, rather than the planned full walkout from 8am to 5pm.
Find a picket line
The BMA is supporting around 149 picket lines across England. Contact your junior doctor representative, your LNC representative or your Industrial Relations Officer for more information.
Locate your nearest picket link using the map below.
The right to strike is a fundamental human right protected by Article 11 of the European Convention on Human Rights. However, we are aware that an NHS trust has suggested that the proposed industrial action by junior doctors is unlawful, being in breach of the Trade Union Labour Relations (Consolidation) Act 1992 (TULCRA). We have sought urgent legal advice from John Hendy QC, the leading authority in this area of law.
Read our leaflet explaining why junior doctors are taking industrial action, Copies will are also available from local BMA representatives on picket lines.
The junior doctors dispute – in their own words
Few people choose medicine for the glory and the riches. Far more likely is the opportunity to make a difference, to help people – but just because, for most, this is a vocation, that isn’t an invitation to undervalue what they do.
While politicians and commentators may try and portray the junior doctors dispute as being all about money, doctors themselves are clear that it’s more fundamental than that: it’s about valuing what they do – and what they have to sacrifice to do it.
Hear what some of the junior doctors had to say during the day of action.
Key dates as the junior contract negotiations have unfolded:
July 2013 – UK Junior Doctors Committee agreed to enter formal negotiations.
October 2013 – Department of Health grants NHS Employers a mandate to negotiate with the BMA, formal negotiations commence.
October 2014 – Talks stalled in light of the Government’s failure to agree measures to ensure patient safety and doctors’ welfare.
December 2014 – The BMA submitted evidence to DDRB.
March 2015 – DDRB invited stakeholders to give evidence.
July 2015 – DDRB submitted its final report to the Government.
August 2015 – Junior Doctors Committee decided not to re-enter contract negotiations based on the Government’s preconditions and threat of contract imposition.
September 2015 – The BMA voted to ballot junior members in England for industrial action.
November 2015 – In a turnout of 76.2 per cent, junior doctors voted overwhelmingly for industrial action.
November 2015 – Temporary suspension of industrial action by the BMA following talks with NHS Employers and the Department of Health, brokered by Acas
December 2015 – Industrial action in England was suspended following conciliatory talks with NHS Employers and the Department of Health.
December 2015 – BMA Junior Doctors Committee negotiating team entered negotiations with NHS Employers and Department of Health
January 2016 – Talks concluded with no resolution. Industrial action to go ahead.
Junior doctors in Northern Ireland, Scotland and Wales
The Northern Ireland health minister, Simon Hamilton, has said he has “no desire” to impose the junior doctor contract and an imposed contract would be the “worst possible outcome”. BMA will be meeting with the Minister to discuss how we can work together to resolve the situation.
On 18 September 2015, Welsh Government officials issued a statement to BMA Cymru Wales indicating that they will retain the current junior doctor contract in Wales.
The Scottish Government has made clear that there will be no junior doctor contract imposition in Scotland.
Join 160,000 members standing up to unreasonable Government demands
In the uncertain and volatile environment that the Government seems intent on creating for doctors, representation is more important than ever.
A CALL FROM THE BMA – TO OUR FELLOW WORKERS, TRADE UNIONISTS, CAMPAIGNERS AND ACTIVISTS: WE NEED YOU!
The current situation:
Junior Doctors across England will be commencing industrial action on Tuesday 12th January. We are opposing this government’s attempt to impose an unsafe new contract on the medical profession. It is our view that the proposed contract represents an existential danger to the NHS as an institution.
You may be aware that the BMA had initially suspended its planned industrial action at the start of December and returned to talks with the Department of Health. That decision was made in good faith. However, over the last few weeks, in the course of negotiations with Government we have encountered only intransigence. It is clear that the government perceives our contract issue as pivotal for its attempt to “reform” the NHS towards a neoliberal, commercialised system.
It is therefore evident to us that we have no choice but to transform our 98% ballot mandate into action.
The developments of the next few months will have consequences stretching far into the future. This government is wilfully putting at risk our patients’ safety, the tolerability of our working lives as NHS workers and the very viability of the NHS as a publicly-funded, publicly-provided service.
Why we need YOU
The coming period will be the ultimate test of the BMA’s resolve as a Union. However, we remain mindful of the fact that the BMA is not an abstract entity operating in isolation from wider political developments. There is no way that we can win this on our own. We need all concerned citizens, activists and trade unionists to stand alongside us in this fight.
Over the last few months we have been in dialogue with many trade unionists throughout the country and we have been enormously grateful for their support both at a local and national level. The public messages of support from our allied health worker colleagues, the firefighters, the teaching unions and the TUC and TUCG unions have galvanised junior doctors.
We are therefore well aware that all eyes are upon us and that the institutions which represent the wider working class stand with us in solidarity.
We are in no doubt that Osborne, Cameron and Hunt will use the proposed doctor’s contract as a tool for achieving the destruction of safe terms and conditions throughout the NHS and throughout the public sector. The Conservative Party is attempting to stretch the NHS into an ostensibly 7-day elective service whilst simultaneously launching the biggest assault on NHS resources in its history. The politics of austerity represents a clear and present danger to the nation’s health.
A victory for the Junior Doctors would signify the first real crack in the entire edifice of austerity in the UK.
Please stand with us. And when you need us, ask us. We will stand by you.
Invitation to attend our pickets
On behalf of the entire BMA we thank you all for your incredible support so far. Many of you will have seen the details with regards to the planned action and I will reiterate them below. We invite you to come out and display your visible support for us on the days of action.
The action will begin with an emergency care-only model, which would see junior doctors provide the same level of service that happens in their given specialty, hospital or GP practice on Christmas Day. It will then escalate to full walk-outs. The action as proposed is:
Emergency care only — 24 hrs from 8am Tuesday 12 January to 8amWednesday 13 January
Emergency care only — 48 hrs from 8am Tuesday 26th January to 8am Thursday 28 January
Full withdrawal of labour — from 8am to 5pm Wednesday 10th February
The aim is to picket all major hospitals in England on all three days of proposed action. Pickets will be in the vicinity of the main entrances and will start at 8am, continuing until at least 12.30pm. However, many picket sites will continue into the evening, especially at the larger hospitals.
Along with the pickets there will be parallel “Meet the Doctors” events at nearby transport stops or public spaces. We will direct you to these events from the picket.
Please turn up on the days of action, and give us your support. We will then inform you if other local events are planned on the day. If you are an allied health worker, trade unionist or campaigner please do consider bringing along the banner representing your organisation, your working uniform or similar. We would appreciate it however if banners in explicit endorsement of specific political parties are not displayed and that any selling of campaign literature such as newspapers is relatively discreet.
On the days of action, please do debate us, educate us and invite us to address your colleagues in your workplace or trade union branch.
I would also like to take this opportunity to remind you of another important upcoming date. On Saturday 9thJanuary student nurses, midwives and allied health workers will be marching in opposition to Government plans to scrap the NHS student bursary. The protest will assemble outside St Thomas’s hospital at midday and proceed to Downing St. The BMA will be marching alongside the nursing students and we hope to see you there!
Just as the social democratic consensus in this country began with the inception of the NHS in 1948 so too will the NHS be the site of Britain’s last stand against the all-consuming forces of austerity.
Solidarity is the antidote to the cynicism of those in power. Now is the time to stand together in a common defence of the NHS. If not now, when?
Dr Yannis Gourtsoyannis, Member of BMA Junior Doctors Committee National Executive.