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UK Govt’s war on the working week sets a nasty precedent

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Last month, I wrote about Australia being the lucky country.  We have beautiful beaches, sunny weather and, at least in comparison with the DiTs working in the Britain’s National Health Service, great working conditions.

While the AMA and the Council of Doctors in Training have and continue to work hard for the conditions we enjoy, our English colleagues have had to go on strike following long and unsuccessful negotiations with the UK Government.

The British Government is seeking to impose new working conditions on their doctors in training that are complex and have far-reaching implications. Significant changes in working hours and award rates would result in a notable reduction in total salary for DiTs who currently start their internship on the equivalent of $A50,000.

Under the contract, normal working hours will be considered to stretch from 7am until 10pm, and to include Saturday in addition to the traditional week.  This means that the ‘working week’ will leap from the 60 hours between 7am and 7pm on weekdays (a big enough shock to many Australian DiTs), to a huge 90-hour week. By redefining what the normal working week looks like, the contract would result in the loss of compensation for working antisocial hours.

Further, there is a push to remove logical pay progression, as well as a cut in pay for on-call work. This will lead to a decrease in the penalty payments that many junior doctors depend on.

Without penalty pay, there is no difference between 9pm on a Saturday night and 9am on a Tuesday, and there are concerns the new arrangements would result in DiTs working to excess.

It also sets a dangerous precedent about what is seen as ‘normal’.

Other changes include the removal of GP trainee subsidies (which aim to increase GP trainee salary to closer to that of their hospital colleagues), and the axing of pay protection for trainees who go on maternity leave, train part time or re-train in a new specialty.

The BMA Doctors in Training are asking for five guarantees before they re-enter negotiations with the Department of Health:

–          proper recognition of unsocial hours as premium time;

–          no disadvantage for those working antisocial hours compared with the current system;

–          no disadvantage for those working less than full-time and taking parental leave;

–          pay for all work done; and

–          proper hours safeguards protecting patients and their doctors.

If any politician, clinician, patient or otherwise thinks these are unreasonable demands then we have a problem. If this is all that our NHS counterparts are after, then we should certainly be worried.

It makes it easy to feel lucky to be an Australian DiT, doesn’t it?  But let’s look at this more closely.

If we really think about it, the people affected by this new contract are us (albeit with funny accents and ‘bleepers’ instead of pagers).

They are doctors who are working as hard as they can to care of their patients and develop their medical careers.  They are the doctors who staff the hospitals overnight, on the weekends and on public holidays, and they are doctors who may one day work alongside us.

This should matter to Australian DiTs because we have seen a trend of cost cutting in health.

And really, that is what the changes outlined above are really about – not patient safety, and not efficiency.

We have seen the Federal Government remove millions of dollars in health funding, targeting our general practitioners, our primary health care and, most recently, the MBS.

How long do we have to wait before we are told that we are too expensive, too inefficient, or too entitled?

Ultimately, we should be sitting up and taking notice because, one day soon, this could be us.