Junior Hospital Doctors (Hansard, 16 July 1991)

§ 9. Sir Anthony Durant
To ask the Secretary of State for Health if he has any plans to meet the British Medical Association to discuss working arrangements for junior hospital doctors.

§ 15. Mr. Eastham
To ask the Secretary of State for Health when he last met representatives of the British Medical Association to discuss junior doctors' hours.

§ 18. Mr. Moss
To ask the Secretary of State for Health what plans he has further to improve the working arrangements of junior hospital doctors.

§ Mrs. Virginia Bottomley
We launched a new deal for junior doctors on 12 June aimed at reducing their hours of work and improving their living and working conditions. This has the full backing of the ministerial group on junior doctors' hours which includes British Medical Association representatives. This group, and its supporting technical group, will continue to meet to monitor progress in implementing the new arrangements. I spoke at the BMA's hospital junior staff committee conference on 15 June.

§ Sir Anthony Durant
Does my hon. Friend agree that that is a welcome new agreement, but that its success depends on the co-operation of the consultants, nurses and ancillary workers and that there will have to be some changes of attitude towards junior hospital doctors, particularly among some senior consultants?

§ Mrs. Bottomley
Indeed, Sir. However, the agreement is a great breakthrough. For 15 months the consultants, junior doctors and the NHS management worked together to hammer out the agreement setting explicit limits on the amount of time that junior doctors should work. It is not good enough that they should be working night and day. It is not good for the junior doctors; it is not good for the patients. The consultants and the royal colleges have had to think carefully about the implementation of the agreement and I am confident that, through the ministerial group, we shall continue to see vital progress.

§ Mr. Eastham
On junior doctors working long hours and the consequences for patients, has not it taken between five and six years to obtain the agreement and is not it true that it is not expected to be fully implemented until the end of 1996 and that even then junior doctors' hours will be reduced to only a 60-hour week? Will the Minister give us a guarantee that there will be no change of mind and that funding will be available?

§ Mrs. Bottomley
Before taking lectures from the hon. Gentleman, I remind him that when the Labour party was in government junior doctors worked an average of 91 hours a week. That is now down to about 81 hours. There is, of course, a difference between contracted hours of duty on call and actual working hours. We make it clear that the maximum amount of time on shift working should be 60 hours immediately and 56 hours by the end of 1994.
If the hon. Gentleman wants more details, he should go to the regional conference in Manchester on 25 July, one of nine regional conferences, where the guidance will be spelt out and those who have only a partial understanding of the agreement will have the opportunity to understand the full significance of the breakthrough.

§ Mr. Moss
I warmly congratulate my hon. Friend on her expert handling of the successful negotiations on junior hospital doctors' conditions of service. This is a major step forward—a view endorsed by the BMA in its recent letter to me. However, bearing in mind the fact that some 50 per cent. of medical students are women, what special steps, if any, does she propose to take to help women junior hospital doctors in particular?

§ Mrs. Bottomley
I pay tribute to all the junior doctors' leaders who worked so hard to secure the agreement. It is another example of practical working together, quite distinct from the rhetoric of adversity and conflict peddled by the Opposition, and building up solid achievements and making progress. My hon. Friend is right that half medical students are women and we are concerned about losing so many of them. There are growing numbers of women general practitioners and doctors. As a practical step forward we have quadrupled the number of part-time registrar posts and developed further initiatives to secure their future so that they can serve the health service on the basis of their training.

§ Mr. Nellist
The Minister will be aware of the case on which I have corresponded with her and the Secretary of State and which I raised with the Prime Minister about three weeks ago of a young junior hospital doctor who worked almost 120 hours during his first week at a hospital and who, at the end of those seven days, collapsed and died. Given that the agreement of which the Minister has spoken this afternoon means that in five years' time, in 1997, it will still be possible for junior hospital doctors to work 72 hours a week, is not that still too little of an agreement to stop the stress and strain on the young doctors replicating that experience, thus risking another death in the next five years?

§ Mrs. Bottomley
I agree that being a junior doctor is much more stressful than it used to be. Modern medicine is much more complex and detailed. Ensuring that juniors are better supported, a better pastoral system, and improved working conditions are all part and parcel of the agreement. It is important to ensure also that junior doctors are properly supervised and that their working arrangements are adequately considered. The 72-hour maximum applies to doctors on duty, but those working consistently on a shift system would work a maximum of 56 hours. To ensure that progress is achieved, we not only established regional working parties but provided 200 extra consultants this year and an additional 50 staff grades. We have backed the agreement with new resources.