The BMA said it was pressing ahead with the ballot despite Hunt’s offer, which included an 11% increase to basic pay as part of a new junior doctor contract intended to improve NHS provision at evenings and weekends.
In a statement yesterday, Hunt said the change would end some currently unsafe working hours. However, some doctors have warned they could lose out under the new deal as evening and weekend work would be classified as normal working time.
Hunt said the new contract would build upon “cast-iron guarantees” that the junior doctors pay bill would not cut and that average earnings would be maintained.
“The proposals offer an 11% increase to basic pay, with further increases linked to progressing through training and taking on roles with greater responsibility – instead of being based on time served,” he added.
Under the plans, no junior will be required to work more than a weekly average of 48 hours without consent and those who opt out of the European Working Time Directive limit will not be able to work more than 56 hours.
The deal would introduce a new 13-hour cap on shifts and limit shift patterns to no more than 5 consecutive long days or 4 consecutive nights, down from current levels of 12 and 7 respectively.
Hunt said that under the plans, no junior doctor working legal hours would receive a pay cut. The exception will be those receiving up to a 100% salary boost as compensation for working unsafe hours who will no longer be required to work such rotas.
BMA junior doctors committee chair Johann Malawana said the offer had been “put out under the cover of darkness” and offered nothing new compared to previous offers.
“So the first ever juniors-only ballot for industrial action will open,” he stated. “The uniqueness underlines the severity of the situation in which we currently find ourselves – the situation that the government has forced us into.”
Among what he called the “fundamental flaws” in the latest offer was the lack of recognition of unsocial hours as premium time, as the proposed new contract would still reduce the number of hours that are classed as unsocial hours by re-classifying weekday evenings and Saturdays as plain time.
Doctors would still be paid less for working unsocial hours than they are under the current contract, the BMA said, with those working in specialties such as emergency medicine, which have a high proportion of weekend and evening working, disproportionately affected.
The financial penalties faced by NHS providers for overworking doctors would be removed in the new contract, the association said, and replaced by an inspection regime led by the Care Quality Commission.
It was not clear how this would achieve the required controls on hours, the BMA said.
Junior doctors in England will be asked two questions in the ballot: whether they are prepared to take part in a strike; and whether they are prepared to take industrial action short of a strike.
