Speech from the Chairman of the Junior Doctors Committee, Dr Paul Thorpe
Wednesday 2 July 2003
Chairman, Officers, Members of RB, my warm greetings and thanks for making the 100th ARM such a relevant and interesting meeting.
Rarely has a year seen so much event, change, and uncertainty for the NHS, the BMA, and doctors in training in particular. As a Yorkshireman by birth, and an Orthopaedic surgeon by trade, I suppose that change is something, I am supposed to fear – but 7 years on JDC and in the BMA has certainly shown me the necessity for inclusive and properly planned changes to the NHS, the BMA and to the lot of junior doctors.
One change I would like to mention at the outset is that after this ARM, we will have a new Chairman of Council. I would like to take this opportunity to thank Ian for the hard work and dedication he has shown over many years service to the BMA, and for his previous support for the Junior Doctors Committee in often troubling times. I am sure I speak for us all when I wish him every success for the future, and express our hope that his successor can follow his example as an advocate for the profession.
Another change is that you will have a new Chairman of JDC, as I waltz with Matilda's scoliosis, and expect to see England win the world cup in proper football. There are always too many people to thank at this time - but I would especially like to thank our secretariat, who put up with my short notice demands and early morning emailing with a patience that amazes me. In a year that saw many changes to the organisation of the committee, they have worked admirably. Peter Corpe has accepted the leadership of the Juniors Division with dynamic energy, and is helping drive the modernisation of the committee- a committee that often leads the way in the Association.
I started my tenure as Chairman during the argument over the Consultant Contract Framework - and we were pleased and relieved to see a poorly designed and discriminatory deal firmly rejected by Consultants, and most significantly by 86% of the future consultants of the UK.
We have all become frustrated at the slow progress in response to calls from the BMA, Royal Colleges, NHS employers and now the Pay Review Body to address the inequities in the framework. We were annoyed at the futile attempts to locally implement the flawed framework or to replace it with a crude Performance-related-pay system.
But change reared its head in the DoH, and the resolve of the consultants at the front line has given new hope that a solution will be found. We congratulate Dr Reid for having the political nous to understand that the way forward is to sit down around the table and talk. However, we want to send him a very clear message too. Do not think that the Government can try to introduce a contract discriminating against new consultants, or failing to recognize the need for consultants to have their workload limited and to benefit from family friendly contracts. If you try, you will receive the same message you did last October. If you truly engage with us, you will find the true power of modernization that the medical profession can lead.
This change in the Department of Health clearly highlighted an anomaly that exists between the opportunities afforded us as doctors and those available to our political masters. Mr Milburn chose to spend more time with his family. Due to his governments refusal to properly fund flexible training for opportunities for junior doctors, he shows what is good for the goose will be denied to the ganders. With MPs voting to control their own workload, while allowing ours to spiral in intensity, I suggest that the best way to spend more time for us all to spend more time with our families is to exchange the doctors surgery for the constituency surgery.
We have continued to be the driving force in preparation for the European Working Time Directive. With publication of such documents as the Good Working Patterns guide, and Time is Running Out; with our involvement in the EWTD delivery board, the pilots schemes, the Changing Workforce Programme and the Hospitals at Night initiative we have used our expertise and foresight to influence many positive developments in preparation for this challenging legislation. I am pleased to announce that we have reached an agreement with the Department of Health and the NHS Confederation on joint guidance to trusts on compensatory rest for doctors in training.
We continue to pressurise for delivery of New Deal targets on accommodation and hours. I am pleased to see the focus on accommodation in the agenda, given the reprehensible behaviour of some trusts towards its juniors. We look forward to taking such trusts to task, by legal action if necessary. As for hours, I remain appalled that, 7 years after it was due to be delivered, 30% of doctors remain outside the hours and rest criteria of the New Deal. I would remind employers that in 1 months time, this will constitute a breach of contract for any junior doctor in the UK. We will support any junior member who wishes to take action against a trust that is shown to breach their contract in this way. The results of the BMAs excellent cohort study – and I recommend that you all read the latest report - show how important this is as an issue for our members. Many of the statistics in the study are cause for concern. 1 in 5 doctors have changed their career paths because of inflexibility of working. 53% of SHOs believe they are still outside New Deal limits – and are not having their hours properly monitored by their employers. The number who say they plan to leave medicine altogether is the highest since the cohort began in 1995. We clearly still have a lot of work still to do
The 'educational' year has been one of the most important since Calmanisation began. We are on the brink of a new body - the Postgraduate Medical Training Board - assuming control of our entire post registration training. We have already given much input into the subcommittees forming the board, as well as the statutory instrument creating it. I am pleased to say that we have at least 4 high quality candidates who are members of JDC applying for membership of the PMetB, and we will hold the Secretary of State to his commitment to directly involve junior doctors in the Board. We have also FINALLY seen the publication of the SHO modernisation report, which transmogrified into the Modernising Medical Careers initiative. Our influence has meant that much of this document is worthy of praise and commendation. However - there are still some worrying threads that remain to be challenged. So let us send a clear message:
Rigid programmes of arbitrary shortened training to satisfy short term political objectives - No thanks
Compulsory service grades, becoming the repository of the disadvantaged and discriminated against - No way
A ‘dumbed-down’ junior consultant grade, undermining the trust of the public in the quality of our training - Over my dead body
Our committee stands firmly for proper education and training for juniors, we have a duty to fight to maintain the high standards of hospital and community care provision, we are resolved that the future GPs and Consultants of the UK will maintain and improve upon the standards of their predecessors.
Well, I have been convinced – change can be a good thing, when it is led by our profession.. Now is the time for you to go out and fight against those who would make real, positive change subservient to political or personal agendas. I am certain that when I return from the sun, sea and Castlemaine 4X of down under, this Association, and especially the JDC, will continue to win that fight.
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