Junior doctors cannot continue to prop up a crumbling system

As your new chair elect of the BMA’s Scottish Junior Doctors Committee – due to take over at the first committee meeting of the year next Wednesday, October 5 – the magnitude of the responsibility with which I’ve been entrusted isn’t lost on me. Staff morale is at rock bottom. Staff retention is at a tipping point. We have been on the receiving end of a derisory real terms pay cut yet again. Undervalued, overworked, underpaid.

Alongside the rest of the population, doctors are staring down the barrel of a cost-of-living crisis. Meanwhile we’re being paid a fraction of what we’re worth, and of what our equivalents were earning just over a decade ago. This year alone we were slapped with a greater than 7% (in line with RPI inflation as it currently stands at 12.3%) real terms pay cut, or the equivalent to working 3 weeks of the year for free!

Make no mistake: if our real terms pay erosion is not fully reversed then the Scottish government is setting itself on a collision course with our profession. Seventy percent of surveyed Scottish juniors were more likely to leave the NHS in Scotland off the back of poor pay awards.  We’ve all worked shifts holding multiple bleeps or with reduced staffing or have been asked to work in a way we aren’t totally comfortable with. You and I cannot continue to prop up a crumbling system at our own expense, beaten with the mantra of individual resilience to compensate for a system that’s had all of its resilience cut from within it. No wonder people are looking elsewhere.

Whilst we’re perpetually understaffed the cartel of junior doctor “nationally agreed” locum rates – which the BMA categorically does not recognise – means that shifts go unfilled as they’re just not financially worthwhile for our members. Fixing our extra-contractual remuneration is not just about empowering us to negotiate our worth, it’s about allowing us to support the health service we cherish, but on our own terms.

So next week I will formally take over as chair of SJDC – and the committee will meet to discuss a whole array of issues. New representatives have been elected to the committee from all regions of Scotland to represent you, with some of our local LNCJDS bodies having huge increases in engagement this year. They will relay their views and ensure your voices guide the committee as we plan our next steps, but a key priority for myself as chair will be an open discussion on pay restoration and how we can win the better pay for juniors we all agree is needed.

In my view, and the majority of those we surveyed, we certainly can’t rely on a broken DDRB to safeguard us from being used as a political football. We’ve diligently engaged year after year, only to be rewarded with yet more cuts, or to have their more reasonable recommendations ignored by governments. Again, I’m looking forward to committee discussion on this, but I want junior doctors in Scotland to lead the way in reforming the DDRB and to return it to its founding principles so that it truly bases its awards on changes in the cost of living, the incomes of other similar professions, and the quality and quantity of recruitment. And for that to happen I am willing to consider all options, including cutting ties with it until it works in our interest again, as consultants and juniors in England have. Ultimately that will be a decision that we take as a committee – and I commit to being transparent and keeping you up to date on where the discussions take us.

Since the pandemic thousands of lauded key workers across all industries are realising the real value of their indispensable roles and are organising through their trade unions to win what they’ve long been overdue. Doctors are no different. In England the Westminster government is sitting on its hands, sleepwalking into an industrial dispute it could easily avoid. I stand in total solidarity with UK JDC and whatever action they are forced to take with regards to winning their own pay restoration, and in Scotland we will learn from what they achieve, support them every step of the way, and continue to prepare for all eventualities.

This summer more than 90% of surveyed Scottish junior doctors said they would be willing to take industrial action, more than any other Scottish branch of practice. Is that a surprise when 93% of us felt that our pay award didn’t recognise our contribution to the NHS? The mood is shifting, and the discontent felt by SJDC reflects that.

As we move forward on this agenda, and after our discussion at SJDC, we’ll be in touch with material to arm you with simple explainers about your basic rights so that you can tackle late rotas, missed breaks and low locum rates at source. We’ll be reaching out with ways to start conversations about organising and about how to make a difference locally. But the very essence of the trade union movement is collective power, so we will simultaneously be using our resources, networks and leverage to stamp out bad practice in the long run and at national level.

An example of how SJDC work for you at the highest national level is that we have agreed a meeting to discuss junior doctor pay with the Cabinet Secretary for Health, Humza Yousaf. We will be unequivocal that we deserve better and that meaningful commitments to reversing our real terms pay cuts are the only way to avoid a deepening staffing crisis and further measures from the BMA. Week after week, from Borders to Highlands, we’re already winning on behalf of our members, not to mention the work that our fantastic staff teams do behind the scenes. Now is the time to join, or re-join, the BMA and to be a part of those wins.

But finally, I want to offer my personal thanks to our outgoing chair Lailah Peel for the enormous amount of hard work and commitment she has given this committee, and junior doctors across Scotland, over the past year. She has led on tangible wins for Scottish juniors this year, such as the new limits on long says in a week, all whilst working in an A&E environment failed by Government and experiencing some of the worst waiting times on record. Thank you, and we are all excited to have an experienced advocate for junior doctors take on the role of deputy chair of Scottish Council.

Chris Smith (he/him), Incoming SJDC Chair

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