Junior doctors: Government retreats on some of its cuts to out-of-hours pay, says leaked letter

A 48-hour junior doctor strike scheduled for next week was called off on 19 January

Junior Doctors and supporters picket outside Sandwell General Hospital in West Bromwich as they and other doctors stage a 24-hour strike across the NHS (Getty Images)

The Government has retreated on some of its cuts to junior doctors’ out-of-hours pay, according to a leaked confidential letter from their chief negotiator.

A 48-hour junior doctor strike scheduled for next week was called off on 19 January, with the British Medical Association claiming “early progress” had been made in negotiations.

It has now emerged that the decision followed an offer by Sir David Dalton, the hospital chief executive leading talks on behalf of the Government and NHS Employers, to adjust which evening and weekend hours would attract out-of-hours pay premiums.

Sir David also made new assurances that no junior doctor will have to work consecutive Saturdays and that any medic working one in three Saturdays would receive extra out-of-hours payments on those days.

The letter, dated Saturday 16^th January, was leaked to the Health Service Journal. Talks between the BMA and the Government will resume on 27 January, after discussions this week facilitated by Acas mediators failed to reach a resolution to the long-running dispute, which has already led to industrial action. Another strike, which would see junior doctors walk out of all services, including emergency care, is still scheduled to take place in February.

Under the Government’s original contract proposals, unsocial hours which attract additional payments, previously defined as hours outside 7am – 7pm Monday to Friday, would have been cut back to all hours outside 7am – 10pm, Monday to Saturday.

Plain time – the hours which attract no extra payments – would have increased from 60 hours a week to 90 hours – threatening a big pay cut for many junior doctors.

The Government later offered to begin paying out-of-hours rates at 7pm on Saturday. In their latest offer, revealed in the leaked letter, they propose a further retreat to 5pm on Saturdays, and 9pm on weekdays.

The new contract includes an 11 per cent increase in basic pay to compensate doctors for cuts to their out-of-hours income, but doctors fear many of them will still be worse off – particularly in their take-home pay, because out-of-hours payments are not subject to pension contributions, whereas basic pay is.

Dr Johann Malawana, chair of the BMA’s junior doctor committee, said that there were still differences on “key areas”.

Alongside the pay dispute, the BMA are fighting to restore rules which see hospitals forced to pay junior doctors high premiums if they work beyond their contracted hours. Doctors say these have been the only successful protections against doctors working too many hours each week and suffering burnout, and believe that alternative safeguards proposed by the Government will be toothless.

Danny Mortimer, chief executive of NHS Employers, said he was “hugely disappointed” that the letter had been leaked.

“We continue to have detailed and constructive discussions with the BMA,” he added.

A Department of Health spokesperson said: “Talks are ongoing between representatives from the British Medical Association, NHS Employers and the Department of Health, and, as agreed with Acas, we will not be commenting on the details of these talks. We are committed to creating a contract that is fair for doctors and delivers safe care for patients seven days a week.”