Leading Article: The topsy-turvy world of junior doctors' conditions

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The Independent Culture
WERE THE great Victorian fantasist Lewis Carroll writing today, he would, no doubt, find great inspiration in the "through the looking glass" way we treat junior doctors.

One could imagine Alice wondering why such a group of people, who are instantly recognisable as belonging to a profession, are paid by the hour rather than given a salary. She might also ask why, given that we rely upon them in matters of life and death to be, above all, alert, are they required to work perhaps 56 hours a week and to be on call for a further 16 hours? Why, when they routinely work more than their statutory 40-hour contract, is the overtime they receive paid at half rate rather than double the normal rate? Why, she might wonder, if such absurdities are so widely recognised that the very phrase "junior doctors" easily summons up a folk image of harassed young medics, their eyelids kept open with match sticks, has no one done anything to address these issues? And why are these poor, hard working, young men and women now threatening to go on strike, when the most likely effect of such action would be both to harm the very patients they claim to care for and rob them of the considerable public sympathy which they presently have for their cause? Curioser and curioser.

Enter, large as life and twice as natural, the Health Secretary, Frank Dobson. Not exactly walrus and not exactly carpenter, Mr Dobson can at least recognise that he finds himself in a topsy-turvy world. He has pledged to end the junior doctors' dependence on overtime payments and to bring in a new "professional" contract. He tells us that "the existing contract can mean that if the junior doctors' hours are reduced they would get less pay, because it is related to the hours they work. It is an absurd situation. We do need to get away from this concept of hourly pay for professional staff".

Mr Dobson has indicated that he is sympathetic to the junior doctors' cause. Of course, when he sits down with the British Medical Association, which is representing the juniors, for talks on 26 August he may disappoint them with some variation on the Carrollian line that "the rule is, jam tomorrow and jam yesterday, but never jam today". The junior doctors would then be entitled to consider stepping up the pressure, short of industrial action, and to draw increasing public attention to the nonsenses of the conditions that they are expected to cope with.

As ministers look ahead, the last thing they need is for yet more embarrassing stories about exhausted junior doctors to add to the incipient public feeling that they are failing to deliver on the National Health Service. It might even be the case that the Conservatives begin to make political capital out of the NHS at Labour's expense. Now that really would amaze Alice.

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