The Secretary of State for Health said junior doctors should be treated as professionals and paid a salary big enough to reduce their reliance on overtime payments. That would remove the "absurdity" in the government plan of reducing their hours, which would reduce their pay.
Details of the proposal were being sent to the British Medical Association and a meeting is set for 26 August between the Health Department and junior doctors' representatives.
A BMA spokeswoman said almost 200 meetings had been arranged in hospitals around the country to build support for the juniors' campaign for better pay and conditions. She said frustration was growing at the lack of progress since the association agreed at its annual conference last monht to ballot all 35,000 junior doctors on industrial action if negotiations on improved out-of-hours pay and conditions broke down. Their chief complaint concerns long hours and poor overtime pay. The basic contract is for 40 hours but on average junior doctors work an additional 16 hours and are on call for a further 16.
One in four works longer hours. Overtime pay is half the normal rate, rather than the double time of the private sector, which means a house officer is paid pounds 4 to pounds 5 an hour for working bank holidays and weekends.
In the ballot, before 24 September, they will be asked whether they would support action short of a strike, including banning overtime and paperwork, and whether they would support strike action, which would mean dealing with emergencies only.
A poll of 2,000 doctors in May showed 95 per cent support for action short of a strike. Mr Dobson said he wanted to end junior doctors' dependence on overtime pay and other supplements and substitute a "professional" contract. He said on BBC Radio 4's Today programme: "What I am determined to do is change their contract entirely. They have a very archaic system in which getting on for a third of their pay is determined by plussages and bits of overtime. It is not a professional contract.
"The [existing] contract can mean if junior doctors' hours reduce they would get less pay because it is related to the hours they work and that is absurd. We do need to get away from this concept of hourly pay for professional staff."
But a new contract would not automatically mean extra pay. "The level of pay is decided by the independent review body and the BMA want to keep it that way," Mr Dobson said. "So the level of pay will be determined by the review body. What we can negotiate is a better and more modern contract."
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