Revised contracts ‘not substantially different’ to original proposals that sparked row

Strike action by junior doctors is back on after talks between the British Medical Association (BMA) and NHS Employers failed to reach an agreement.

Three days of industrial action, due to begin on 1 December 2015, were called off but have now been reinstated, with the first day of strikes on 12 January.

The negotiations to create new contracts for junior doctors has been ongoing for two years after the government asked the Doctors' and Dentists' Pay Review Body (DDRB) to provide recommendations for a new contract due to take effect in August.

The BMA, which has been in talks with ACAS and NHS Employers - the body which acts on behalf of NHS employers - said the latest revised contract is “not substantially different to the recommendations from the DDRB, and leaves many key concerns about safety and fairness unrecognised”.

The basis for the current round of negotiations was the government's offer from November, including an 11 per cent rise in basic pay for junior doctors. This is offset by plans to cut the number of hours for which junior doctors can claim extra pay for unsocial hours.

Currently, 7pm to 7am Monday to Friday and the whole of Saturday and Sunday attract a premium rate of pay. Under the proposed changes, a higher rate would run from 10pm to 7am Monday to Friday, and from 7pm on Saturday evenings.

A BMA spokesman said the key sticking points were around pay for unsocial hours and concerns about patient safety if trusts were not prevented from allowing junior doctors to work dangerously long hours.

"What the government is asking junior doctors to do is work late into the night, at weekends and early in the morning without additional pay supplement for that. From our perspective, we think it is perfectly reasonable that if you are working early morning shifts and Saturday and Sunday that you get additional pay to acknowledge that," he said.

He added that the current proposals did not address concerns around trusts being able to force junior doctors to work long hours. "At the moment, if trusts force doctors or do something wrong in this area then they are financially penalised but we are not convinced that what the government is proposing as an alternative is tough enough to stop this happening in the future."

In a letter to Jeremy Hunt, secretary of state for health, Daniel Mortimer, chief executive at NHS Employers, outlined the stage talks with the BMA had reached and said he believed there had been proposed or agreed progress on everything except pay.

"The key point of difference relates to the BMA proposal - which they have to date refused to compromise on - that the same rate of unsocial hours are paid to staff working across the weekends and at night. Further, they argue that the present 1999 definition of unsocial hours pay as any outside 7am to 7pm is maintained," he wrote.

The BMA spokesman said it would continue with discussions."We want to try and find a resolution to this problem but at the moment the government is being pretty intransigent," he said. Strike action is currently scheduled for 12 January for 24 hours and 26 January for 48 hours, where junior doctors will provide emergency care only, and 10 February, which will see a full withdrawal of junior doctors' labour.