Sarah Mehigan, from Freshwater’s team of healthcare specialists, shines the spotlight on the key issues at play around the proposed changes to junior doctor contracts.

Junior doctors up and down the country are continuing to flock to social media, outraged by proposed contract changes involving “pay cuts of up to 30 per cent”, which include scrapping overtime rates for work carried out between 7am and 10pm every day of the week except Sunday.

The Independent has also reported that thousands of people are planning to attend a further protest on Saturday 17 October outside the Houses of Parliament against changes to NHS junior doctor contracts.

It is perhaps premature to judge whether there is likely to be industrial action. But what is certain is that this is continuing to build significant momentum, with a petition supporting strike calls having already attracted 89,000 signatures.

Healthcare professionals are talking of fears around patient safety associated with working longer hours, for less pay, under additional pressures.

One junior doctor who contacted the BBC to play back the views of their colleagues said: “There are already rumours and rumblings about the need for industrial action. This is a decision that no medic will take lightly, but I suspect that the government has pushed an already overwhelmed work force to the brink.”

It is argued that proposals to scrap ‘banding’ – which currently acts as a means of compensating anti-social working hours – could result in junior doctors being confronted with significantly less financial reward for weekend and out-of-hours shifts.

But this is not all about pay. Far from it. Amid reports that morale within the NHS is at an all-time low, there are increasing concerns that doctors will become tired and demoralised and that this is sounding alarm bells when it comes to the quality of patient care. In fact, Former Health Minister Dr Dan Poulter recently told the Independent: “It is impossible to reconcile these excessive working hours with safe patient care.”

Furthermore, a number of the Royal Colleges are drawing attention to growing recruitment and retention issues, arguing that after years of training and racking up hefty student debt, the dramatic shake-ups to junior doctor contracts could result in further medics setting sail for over-seas work or indeed moving to other professions.

In just three days, the General Medical Council received 1,644 requests for Certificates of Current Professional Status, which are needed for work abroad. Typically, it receives just 20 to 25 a day.

The Secretary of State for Health Jeremy Hunt MP told the House of Commons on Tuesday (13 October): “According to an independent study conducted by The BMJ, there are 11,000 excess deaths because we do not staff our hospitals properly at weekends.”

This claim has been met by challenge and criticism from junior doctors, quoting this same figure in context of the original report, which states: “Data suggests that around 11,000 more people die each year within 30 days of admission to hospital on Friday, Saturday, Sunday or Monday compared with other days of the week. It is not possible to ascertain the extent to which these excess deaths may be preventable; to assume that they are avoidable would be rash and misleading.”

Meanwhile, Jeremy Hunt has insisted: “I want the new contract to improve patient safety by better supporting a seven day NHS.” He is urging the BMA to come back to the negotiation table and says that he shares the same aims for the new contract to promote patient safety and fairness for doctors.

As social media activity alone continues to add fuel to the fire, the debate certainly doesn’t show any signs of slowing down. So stay tuned at #JuniorContract.


Freshwater’s healthcare team has significant experience of working with health and social care organisations and NHS trusts, offering services from integrated communications to crisis management, as well as delivering events and training. 


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Impact Report 2017

Impact report 2017