Junior doctors exceeding 'new deal' hours: Contracts designed to shorten working week dismissed as a paper exercise. Celia Hall reports

TWO-THIRDS of junior doctors say they are working without extra pay for more than their contracted 'new deal' hours, wrung out of years of negotiation.

Their leaders yesterday accused Virginia Bottomley, the Secretary of State for Health, of being ill-informed about the new deal, which they say is 'largely a paper exercise'.

Managers did not know how juniors were expected to work and as a result contracts bore little relation to the intensity of work demanded, they said.

Dr Edwin Borman, chairman of the British Medical Association junior doctors' committee, said that many revealed they were working 10 hours a week more than their contracts state. 'We are running into stalemate on the deal. The amount of success has been minimal.'

The new deal was not a complete failure, and the record in East Anglia was good. But in Mersey, North Western and West Midland health regions, implementation was very poor and it was patchy in Scotland, he said. In a survey of 450 juniors this summer, nearly 60 per cent said they worked extra hours and one-third said they had no contracts. Results of the survey are published today in the BMA News Review.

Results also show that a quarter of young doctors now regret entering medicine and 60 per cent said their morale had dropped since the NHS changes began. Dr Borman said it cost between pounds 150,000 and pounds 200,000 to train a doctor and 4,000 qualify each year.

Asked what would improve their job satisfaction, 40 per cent said fewer hours, 25 per cent said more money for the NHS and 20 per cent, higher pay.

Dr Paul McLaren, of the BMA junior doctors' committee, said yesterday: 'The new deal contracts show reducing hours but junior doctors are in fact being asked to work longer, compromising the care they give to patients. What has emerged is how little idea managers have about how many hours juniors work and even about how many juniors they are employing.'

In the new deal, no junior doctor should work more than 83 hours a week. There are three types of contract: full 24- hour a day shifts with 100 per cent work intensity attracting a 60-hour contract; partial shifts with 70 per cent work intensity in which a doctor would anticipate four hours' sleep a night, attracting a 72- hour contract; and rotas with 50 per cent work intensity, eight hours' sleep a night and an 83-hour contract.

Most juniors have 83-hour contracts. 'But they are not getting seven or eight hours' sleep a night and they are working at higher intensity than every before,' Dr Borman said.

The survey also asked about hospital accommodation; 36 per cent said rooms were poor or very poor and 43 per cent said accommodation was reasonable.