Published On: Mon, Mar 21st, 2016

New Junior Doctors Contracts Proposed by the NHS Risk Patient Safety

The new contracts proposed by the NHS for junior doctors are facing huge resistance, with many arguing that the contracts are too “heavy handed” and will result in harm to patients.

The proposed contracts will extend the hours in which junior doctors can be asked to work “standard time” from 7am-7pm, to 7am-10pm. This means that many will no longer be paid overtime for working evenings or weekends. With an already-existing shortage of doctors in some areas (acute medicine, 48%; renal medicine, 48%; and geriatrics, 14%), reducing pay incentives and increasing hours is only likely to exacerbate the shortage.

Risk of Medical Negligence

Junior doctors have lashed out at Jeremy Hunt, British Secretary of State for Health, arguing that [t]he proposed contracts fail to offer safeguards on hours and working conditions necessary to ensure the safety of all the patients treated within the NHS, and risk a return of exhausted doctors and rise in medical errors inherently linked to clinicians forced to work under such unsafe conditions.

The Royal College of Obstetricians and Gynaecologists has also warned that because of the proposed changes, [t]here is now a significant chance of returning to the ‘bad old days’ of over-burdened junior doctors in danger of giving sub-standard care. If left unchallenged, the proposals could significantly compromise safety and the lives of mothers and babies in England.”

These issues are not just valid health concerns, but also financial ones, as the NHS already deals with large expenditures due to medical negligence and medical mistakes, which may be set to increase with the new contracts.

The Cost of Medical Mistakes

photo Dr. Michael Rauzzino,. Screenshot/video NBC

photo Dr. Michael Rauzzino,. Screenshot/video NBC

The direct costs of medical negligence that fall upon the NHS are no small amount either, with amounts to the tune of £2.5bn a year. The NHS Litigation Authority (NHSLA) has already described the £1.3bn spent each year on litigation costs alone as one of the “shocking costs of poor care”: a cost that could potentially increase if junior doctors are expected to work longer hours, risking their patient care quality.

The escalating costs of litigation are also to blame, with legal bills steadily increasing even if actual case numbers decline. The NHS has pointed the finger at the lawyers themselves, stating that excessive charging is the culprit behind these rising costs. However, lawyers have complained in return that cases related to the NHS have become so time-consuming, to the point that legal expenses are eaten up while the service “drags its feet”.

A firm of medical negligence solicitors, Patient Claim Line, notes that the way that the NHS operates is most definitely a factor in rising legal costs. Potential medical negligence claims take significant amounts of time to investigate and assess, with time frames of six months or more before the case is processed through the NHS system. The slow process and significant red-tape is a major factor in the rising expenses for these types of mistakes.


One major sticking point in implementing these new contracts is that none of England’s 152 foundation trust hospitals will be able to force their junior doctors to accept the contract that the NHS is proposing. Instead, each hospital will need to offer better terms to their doctors on a case-by-case basis.

This possible loop-hole looms in the background, and has the potential to disrupt Jeremy Hunt’s plans to impose the controversial contract on the junior doctors. The benefit will be that the bitter dispute is over, and junior doctors will be able to negotiate fairer contracts, but the entire incident only serves to reduce trust and confidence in the NHS.

Shadow health secretary, Heidi Alexander, notes that “[t]he fact that hospitals are trying to find ways around contract imposition underlines the extent to which the decision to impose a contract that nobody wants would destroy morale in the NHS.” It seems that no matter how the dispute is resolved, someone will suffer loss; perhaps it seems obvious that the person suffering should not be the patient.

Guest Author: Jose Calvo

photo/ screenshot YouTube

photo/ screenshot YouTube

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