Browse content similar to 19/05/2016. Check below for episodes and series from the same categories and more!
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granted to academies in this country. There are many schools that | :00:00. | :00:00. | |
are taking advantage of that particular freedom. Statement, the | :00:00. | :00:10. | |
Secretary of State for Health. Secretary Jeremy Hunt. | :00:11. | :00:13. | |
Thank you. For the last three years there have been repeated attempts to | :00:14. | :00:20. | |
reform the junior doctor's contract to support better patient care seven | :00:21. | :00:27. | |
days a week, culminating in a dispute which has lasted over 10 | :00:28. | :00:31. | |
months after ten days of discussion under the au pishs of ACAS, the | :00:32. | :00:37. | |
dispute was resolved yesterday with an historic agreement between the | :00:38. | :00:42. | |
Government, NHS employers, acting on behalf of the employers of doctors | :00:43. | :00:47. | |
and the BMA which will modernise the contract making it better for | :00:48. | :00:50. | |
doctors and patients. The new contract meets all the Government's | :00:51. | :00:54. | |
red lines for delivering a seven-day NHS and remains within the existing | :00:55. | :01:03. | |
pay envelope. We will publish an equallied analysis alongside a | :01:04. | :01:05. | |
renewed contract. It will be put to a ballot of the BMA membership next | :01:06. | :01:10. | |
month with the support of the leader, the chair of the committee. | :01:11. | :01:15. | |
Mr Speaker, I would first of all like to express my thanks to the BMA | :01:16. | :01:21. | |
for the leadership they have shown in returning to talks, negotiating | :01:22. | :01:25. | |
in good faith and making an agreement possible. I would like to | :01:26. | :01:32. | |
put on record my thanks to Sir Barber for his excellent stewardship | :01:33. | :01:41. | |
and to Sir Dalton for his wisdom and insight. | :01:42. | :01:47. | |
The agreement will facilitate the biggest changes to the junior | :01:48. | :01:52. | |
doctors' contract since 1999. It will allow the Government to delive | :01:53. | :01:59. | |
a seven-day NHS, improve patient safety, support productivity | :02:00. | :02:03. | |
improvements and impoveing the morale of junior doctors with a | :02:04. | :02:06. | |
modern contract fit for a modern health service. The contract, | :02:07. | :02:11. | |
inherited by this Government, had a number of features badly in need of | :02:12. | :02:15. | |
reform, including low levels of basic pay as a proportion of total | :02:16. | :02:22. | |
income, making doctors rely on unpredict Kabul supplements to boost | :02:23. | :02:28. | |
their income, automatic annual pay rises even when people take | :02:29. | :02:31. | |
prolonged periods of leave from the NHS. An unfair banded system which | :02:32. | :02:37. | |
triggers premium rates to every team member, even if only one person has | :02:38. | :02:43. | |
worked the extra hours. High premium rates for weekend work which make it | :02:44. | :02:47. | |
difficult tos are ter staff in line with patient need and risks to | :02:48. | :02:51. | |
patient safety with doctors sometimes required to work seven | :02:52. | :02:55. | |
full days or seven full nights in a row, without proper rest periods. | :02:56. | :02:59. | |
This Government has always been determined that our NHS should offer | :03:00. | :03:04. | |
the safest, highest quality of care possible, which means a consistent | :03:05. | :03:07. | |
standard of care for patients admitted across all seven days of | :03:08. | :03:11. | |
the week. So, the new contract agreed yesterday makes the biggest | :03:12. | :03:16. | |
set of changes to the junior doctor's contract forren 17 years, | :03:17. | :03:21. | |
including establishing the principal that any doctor who works less than | :03:22. | :03:25. | |
an average of one weekend day per month, Saturday or Sunday, should | :03:26. | :03:31. | |
receive no additional premium pay, compensated by an increase of basic | :03:32. | :03:38. | |
pay between 10-11%. Reducing the marginal cost of employing | :03:39. | :03:41. | |
additional doctors at the weekend by a third. Supporting all hospitals to | :03:42. | :03:48. | |
meet the clinical standard, by establishing a new role for | :03:49. | :03:53. | |
experienced junior doctors, a senior clinical decision makers, able to | :03:54. | :03:57. | |
make expert assessments of vulnerable patients who may be | :03:58. | :04:01. | |
admitted or staying in hospitals over weekends and removing t | :04:02. | :04:05. | |
disincentive tos are ter sufficient number of doctors at the weekend by | :04:06. | :04:10. | |
replacing a banding system with a fairer system which values week | :04:11. | :04:17. | |
yeend work by paying social hours -- unsocial hours worked with more pay | :04:18. | :04:21. | |
to those who worked the most. The Government recognises that safer | :04:22. | :04:25. | |
care for patients is more likely to be provided by well-motivated | :04:26. | :04:27. | |
doctors who have sufficient rest between shifts and work in a | :04:28. | :04:32. | |
family-friendly system. So, the new contract and ACAS agreement will | :04:33. | :04:36. | |
improve the well being of our critical junior doctor workforce by | :04:37. | :04:41. | |
reducing the maximum number of hours a doctor can be asked to work in a | :04:42. | :04:46. | |
week from 91-72. Reducing the number of nights a doctor can be asked to | :04:47. | :04:51. | |
work in a row to four. And reducing the number of long days a doctor can | :04:52. | :04:56. | |
be asked to work to five. Introducing a new post, guardian of | :04:57. | :05:00. | |
safe working in every trust to guard against doctors being asked to work | :05:01. | :05:06. | |
excessive hours. Introducing a new catch-up programme for doctors who | :05:07. | :05:10. | |
take community leave or other time off for caring responsibilities. | :05:11. | :05:16. | |
Establishing a review to see how best to allow couples to train in | :05:17. | :05:20. | |
the same areand a offer training placements for those with caring | :05:21. | :05:23. | |
responsibilities close to their home. Giving pay protection to | :05:24. | :05:29. | |
doctors who switch specialities and establishing a review to inform a | :05:30. | :05:33. | |
new requirement on trusts to consider caring and other family | :05:34. | :05:36. | |
responsibilities when designing rotas. Taken together, these changes | :05:37. | :05:42. | |
show the Government's commitment to safe care for patients and the value | :05:43. | :05:48. | |
we attach to the role of junior doctors. Whilst they do not remove | :05:49. | :05:54. | |
every bug bear or frustration, they will significantly improve | :05:55. | :05:56. | |
flexibility and work life balance for doctor, leading, we hope, to | :05:57. | :06:01. | |
improved retention rates, higher morale and better care for patients. | :06:02. | :06:07. | |
But whatever the progress made with today's landmark changes it will | :06:08. | :06:11. | |
always be a matter of great regret it was necessary to go through such | :06:12. | :06:14. | |
disruptive industrial action to get there. | :06:15. | :06:19. | |
We may welcome the destination, but no-one could have wanted the | :06:20. | :06:23. | |
journey. Today, I say to all junior doctors, whatever our disagreements | :06:24. | :06:27. | |
about the contract may have been, the Government has heard and | :06:28. | :06:31. | |
understood the wider frustrations that you feel about the way you are | :06:32. | :06:37. | |
valued and treated in the NHS. Our priority will always be the safety | :06:38. | :06:43. | |
of patients, but we also recognise that to deliver high-quality care we | :06:44. | :06:48. | |
need a well-motivated and happy junior doctor workforce, putting a | :06:49. | :06:51. | |
new modern contract in place is not the end of the story. We will | :06:52. | :06:55. | |
continue to engage constructively with you to try and resolve | :06:56. | :07:01. | |
outstanding issues, as we proceed on our journey to tackle head on the | :07:02. | :07:05. | |
journey the NHS faces and make it the highest quality health care | :07:06. | :07:10. | |
system in where in the world. Today's agreement shows we can make | :07:11. | :07:14. | |
common cause on that journey w a contract better for patients, for | :07:15. | :07:19. | |
doctors and better for the NHS and I commend it to the House. | :07:20. | :07:28. | |
I want to start by putting on record our thanks to Sir Brendan Barber and | :07:29. | :07:35. | |
the cars for the role they've played in fighting agreements between the | :07:36. | :07:41. | |
two sides in this dispute. -- finding agreement. I want a good | :07:42. | :07:44. | |
pitch to the Academy of red medical Royal colleges who proposed these | :07:45. | :07:49. | |
further talks and encourage the Government and the BMA to pause and | :07:50. | :07:54. | |
think about patients. I have not been shy in telling the house | :07:55. | :07:59. | |
secretary what I think about his handling of this dispute. That today | :08:00. | :08:03. | |
is not the day to repeat those criticisms. I am pleased and | :08:04. | :08:10. | |
relieved that an agreement has been reached, but I am sad that it took | :08:11. | :08:15. | |
an all-out strike of junior doctors to get the Government back to the | :08:16. | :08:22. | |
table. What is now clear, if it wasn't already, is that a negotiated | :08:23. | :08:28. | |
agreement was possible all along. So I have to ask the house secretary: | :08:29. | :08:33. | |
Why couldn't this deal had been struck in February? Why did he allow | :08:34. | :08:40. | |
his pride back then to come before sensible compromise and constructive | :08:41. | :08:46. | |
talks? When he stands up, he might try to blame the BMA for the | :08:47. | :08:51. | |
negotiations breaking down, but he failed to say what options he was | :08:52. | :08:58. | |
prepared to consider in order to ensure that the junior doctors who | :08:59. | :09:04. | |
work the most unsociable hours are fairly awarded. It was a computer | :09:05. | :09:12. | |
says no attitude and that is no way to run the NHS. Why did he ignore my | :09:13. | :09:17. | |
letter to him on the 7th of February on which I asked him to make an | :09:18. | :09:21. | |
explicit and public commitment to further concessions on the issue of | :09:22. | :09:26. | |
unsociable hours. I was clear that if he had done that then I was | :09:27. | :09:31. | |
having courage to BMA to return to talks. Why did he instead insist | :09:32. | :09:40. | |
upon trying to bulldoze and impose the contract through when virtue | :09:41. | :09:43. | |
everyone told him not to and the consequences of doing so were | :09:44. | :09:48. | |
obvious fraud to see, protracted industrial action, destroyed morale | :09:49. | :09:53. | |
and eight complete Britain in trust. -- for all to see. Can it house | :09:54. | :09:59. | |
secretary say more about the changes agreed that can undo the | :10:00. | :10:04. | |
discriminate effects on women of the last contract he published? Does he | :10:05. | :10:09. | |
now accept the previous contract discriminated against women? Will he | :10:10. | :10:16. | |
be clear for the record that he note two now understands that this was | :10:17. | :10:21. | |
never just about pay, can he confirm the concessions have been made not | :10:22. | :10:26. | |
only in respect of the mechanism for enforcing hours worked and breaks | :10:27. | :10:31. | |
taken, but also in ensuring that those specialities with the biggest | :10:32. | :10:34. | |
recruitment problems have decent incentives built into the contract. | :10:35. | :10:40. | |
Moving on to what happens next, can he tell us what he will do if junior | :10:41. | :10:48. | |
doctors vote against this offer? Will he still impose a contract? And | :10:49. | :10:55. | |
which version of the contract will he impose? His preferred version or | :10:56. | :11:02. | |
this compromise one? Can he say whether the possibility of losing a | :11:03. | :11:08. | |
case in the High Court about his power to impose a contract had | :11:09. | :11:12. | |
anything to do with his recently discovered eagerness to return to | :11:13. | :11:19. | |
talks? We all know it High Court told him he had acted above the law | :11:20. | :11:24. | |
when he tried to take the axe to my local hospital, so I can understand | :11:25. | :11:28. | |
why he does not want that embarrassment again, and finally, | :11:29. | :11:35. | |
can I caution him on his use of language both in this chamber and on | :11:36. | :11:43. | |
the media. His loose words and implied criticism of junior doctors | :11:44. | :11:49. | |
is partly the reason why this has ended up being such an almighty | :11:50. | :11:56. | |
mess. Can I suggest a degree of humility on the part of the | :11:57. | :11:59. | |
secretary of the state wouldn't go amiss. And can I encourage a period | :12:00. | :12:05. | |
of radio silence from him to allow junior doctors to consider the new | :12:06. | :12:11. | |
contract with a clear mind and without his spin echoing in their | :12:12. | :12:19. | |
ears? Let me remind the house secretary that he still needs to get | :12:20. | :12:24. | |
a majority of junior doctors to vote for this contract for this dispute | :12:25. | :12:31. | |
to be finally over. Mr Speaker, I hope with all my heart that the | :12:32. | :12:38. | |
agreement yesterday may offer a way forward. Junior doctors will want to | :12:39. | :12:41. | |
consider it, trust needs to be repaired and that will take time. I | :12:42. | :12:48. | |
hope for the sake of everyone patients and doctors that we might | :12:49. | :12:54. | |
see an end to this very sorry episode in NHS history. Mr Speaker, | :12:55. | :13:05. | |
she is wrong today as she has been wrong throughout this dispute. She | :13:06. | :13:12. | |
spent a lot of time in the last ten months criticising the way the | :13:13. | :13:15. | |
Government has sought to change this contract. What she did not dwell on | :13:16. | :13:21. | |
was why it needed to be change in the first place, namely the four | :13:22. | :13:25. | |
flawed contract put in place in 1999, we have major screamers with | :13:26. | :13:30. | |
the BMA but once we agree on was Labour's contract was not fit for | :13:31. | :13:35. | |
purpose. -- many disagreements. Could size and the contract right is | :13:36. | :13:40. | |
like could sizing the mechanic making the car you just crashed and | :13:41. | :13:47. | |
it's time she polished the contract changes -- acknowledged the contract | :13:48. | :13:50. | |
changes have led to the number of the five day care problems were | :13:51. | :13:52. | |
trying to sort out. She was also wrong to say that an all-out strike | :13:53. | :13:58. | |
was necessary to resolve this dispute. The reason that the talks | :13:59. | :14:04. | |
were not in the last ten days, the meaningful talks that we had, is | :14:05. | :14:10. | |
because the BMA changed its position and agreed great goal sheet is | :14:11. | :14:14. | |
wrecked to negotiate an weekend pay. She told the house four times before | :14:15. | :14:19. | |
that change of heart that we should not impose a new contract. What | :14:20. | :14:23. | |
would have happened if we have followed her advice? Quite simply | :14:24. | :14:27. | |
today we would not have had the biggest single step towards a | :14:28. | :14:32. | |
seven-day NHS for a generation. The biggest reforms Don social hours for | :14:33. | :14:38. | |
17 years, with the extra cost of employing a doctor at the weekend is | :14:39. | :14:42. | |
going down by one third. We would not have had the reductions in | :14:43. | :14:46. | |
maximum working hours or many other changes that improve the safety for | :14:47. | :14:50. | |
patients and quality of life for doctors. She was wrong to say that | :14:51. | :14:57. | |
the previous contract was discriminatory against women, it | :14:58. | :15:00. | |
removes discrimination, but does that mean there are a lot of things | :15:01. | :15:06. | |
that we can do to support women who work as junior doctors? There are, | :15:07. | :15:13. | |
and that is why the new Deal announced yesterday has an important | :15:14. | :15:16. | |
and new character clause for women who take time off from maternity | :15:17. | :15:19. | |
leave him they can get back to the position they would have been in if | :15:20. | :15:22. | |
they had not had to take time off to have children. And she asked what | :15:23. | :15:30. | |
happens if the ballot goes the wrong way. What she failed to do was to | :15:31. | :15:34. | |
say whether she was encouraging junior doctors to vote for that | :15:35. | :15:41. | |
ballot, and I say to her that on the 28th of October she has told this | :15:42. | :15:46. | |
house that she supported the principle of seven-day services, but | :15:47. | :15:51. | |
as Tony Blair once said, you cannot will the end without willing the | :15:52. | :15:55. | |
means, and in this dispute shows refused to say that she was spot -- | :15:56. | :16:00. | |
supports the withdrawal of emergency care if you report -- supports | :16:01. | :16:04. | |
contentious changes to reform we can premium pay and now she won't even | :16:05. | :16:08. | |
say doctors should vote for the new agreement. Leadership is facing up | :16:09. | :16:13. | |
to difficult decisions, not ducking them. I say to her this Government | :16:14. | :16:17. | |
is prepared to take difficult decisions and fight battles that | :16:18. | :16:21. | |
improve quality and safety of care in | :16:22. | :16:21. | |
fight them that is fine, but she shouldn't stand dispatch box and | :16:22. | :16:29. | |
claim Labour stands up for NHS patients. If she doesn't want to | :16:30. | :16:33. | |
listen to me perhaps she should listen to former Labour Minister Tom | :16:34. | :16:37. | |
Harris, who said strategically Labour should be on the side of the | :16:38. | :16:42. | |
patients and we aren't. If Labour isn't, the Conservatives are! Mr | :16:43. | :16:52. | |
Speaker, could I add my congratulations on both sides for | :16:53. | :16:56. | |
turning to constructive negotiations and far reaching an agreement and I | :16:57. | :16:59. | |
would like to pay particular tribute to Professor Sue Bailey in the | :17:00. | :17:03. | |
Academy of Medical Royal Colleges for their role in bringing both | :17:04. | :17:07. | |
sides together. I welcome the particular focus on all the other | :17:08. | :17:12. | |
aspects that are blighting the lives of junior doctors alongside | :17:13. | :17:16. | |
negotiations around weekend pay and recognising we need to focus on | :17:17. | :17:20. | |
those specialties which is hard to recruit two and those of junior | :17:21. | :17:23. | |
doctors who are working the longest hours of folks of patient safety. | :17:24. | :17:29. | |
We're not out of the woods yet, we need junior doctors to vote for this | :17:30. | :17:35. | |
in a referendum. And could I add my voice to the voices of the Leader of | :17:36. | :17:40. | |
the Opposition spokesman of health to say that I think what is needed | :17:41. | :17:46. | |
now is a period of calm reflection and to build relationships with | :17:47. | :17:48. | |
junior doctors going into the future. I wonder if this act of | :17:49. | :17:53. | |
state could comment on his plans for building a relationship with our | :17:54. | :17:58. | |
core workforce? Firstly I would like to very much agree with the | :17:59. | :18:03. | |
honourable lady in her thanks to Professor Dame Sue Bailey and the | :18:04. | :18:06. | |
leadership the Academy of Medical Royal Colleges has shown in making | :18:07. | :18:12. | |
the initiative that in the end made this detox possible and the | :18:13. | :18:15. | |
agreement is possible and I know it's been a difficult and | :18:16. | :18:18. | |
challenging time for the Royal colleges but I think Professor | :18:19. | :18:20. | |
Bailey showed real leadership in turn should have and I also very | :18:21. | :18:25. | |
much agree with her about the need to sort out some of the issues that | :18:26. | :18:29. | |
have been frustrations for junior doctors, not just in the last few | :18:30. | :18:33. | |
years, but going back decades in terms of the way their training work | :18:34. | :18:39. | |
and in terms of the flexibility of the system of six-month rotations | :18:40. | :18:43. | |
that they work in actually operates and this is an opportunity to look | :18:44. | :18:46. | |
at those wider issues, think we have started looking at some of them | :18:47. | :18:50. | |
yesterday and think there is more we can do and I think it is very | :18:51. | :18:55. | |
important that this is seen not as one side winning and the other side | :18:56. | :18:59. | |
losing, but as a win-win. But the last ten days it showed is that if | :19:00. | :19:05. | |
you sit around the table you commit real progress in a better deal for | :19:06. | :19:09. | |
patients and doctors and that is the spirit we want to go forward. I | :19:10. | :19:22. | |
absolutely welcome this agreement and I pay tribute to the Royal | :19:23. | :19:27. | |
Academy of Royal colleges for bringing this about. I do wish there | :19:28. | :19:32. | |
had been some response to the latter that we sent before the all out | :19:33. | :19:37. | |
strike. Simic letter. That was the attempt we were trying to make to | :19:38. | :19:42. | |
create a space that both sites could step into Britain that we got to it | :19:43. | :19:45. | |
now. I welcome the recognition the quality issues to us and many junior | :19:46. | :19:51. | |
doctors appear to be dismissed in the impact assessment, the idea of | :19:52. | :19:56. | |
flexible training champions in each trust, I myself was a flexible | :19:57. | :20:01. | |
training senior surgeon, the first one in Scotland at the time, and I | :20:02. | :20:04. | |
think that is really important. The idea was celebrated -- of | :20:05. | :20:09. | |
accelerated training that one concern I have is the issue of | :20:10. | :20:15. | |
childcare, if women, junior doctors, will be working longer shifts and | :20:16. | :20:19. | |
more anti-social shifts, I remember myself when I had to fork out for | :20:20. | :20:24. | |
childcare, I would like to know, will the NHS respond to that? Is | :20:25. | :20:30. | |
that in question are as -- crash hours or support? I welcome the | :20:31. | :20:34. | |
hours Guardian will also be linked to the Director of medical education | :20:35. | :20:39. | |
and they will be an elected junior doctors for. That was one of their | :20:40. | :20:42. | |
concerns that they would have no voice in relation to the Guardian. I | :20:43. | :20:47. | |
also welcome the idea of using modern technology in rota creation. | :20:48. | :20:53. | |
At the moment rodders are sheets of paper and often no one looks at the | :20:54. | :20:57. | |
shoulder of one closer to the next and people can end up with very long | :20:58. | :21:03. | |
periods on call. I do welcome that but one concern that remains is the | :21:04. | :21:08. | |
issue of rota gaps, we actually don't have enough junior doctors and | :21:09. | :21:12. | |
we don't have enough junior doctors in the most acute specialties. I | :21:13. | :21:18. | |
would ask, how is the Secretary of State planning to re-establish a | :21:19. | :21:22. | |
relationship? How will he recruit people to fill that gap? Because | :21:23. | :21:27. | |
that was actually the coffee of junior doctors, lack of doctors | :21:28. | :21:32. | |
simply being spread further. How will we recruit and retain after all | :21:33. | :21:37. | |
of the painful clash that has been going on for the last year? I | :21:38. | :21:43. | |
welcome the tone of her comments, which I might say could have been | :21:44. | :21:47. | |
the tone we might have wanted from the Shadow Health Secretary. Let me | :21:48. | :21:53. | |
address constructively her comments as she made them constructively to | :21:54. | :21:56. | |
me that she is right about flexible training, we have to recognise that | :21:57. | :22:01. | |
we have a junior doctor workforce that is now majority female, that | :22:02. | :22:08. | |
has a number of family and caring pressures that need to be taken | :22:09. | :22:12. | |
account of and we need to do this for the NHS as well as because it is | :22:13. | :22:14. | |
the right thing to do. I think we have to look at | :22:15. | :22:26. | |
particularly the east Responsibilities of doctors with | :22:27. | :22:29. | |
young children and one of the things we anoinsed yesterday was an | :22:30. | :22:36. | |
obligation on trusts to take account of caring responsibilities. If you | :22:37. | :22:42. | |
have a doctor who wants to work less time during school holiday ands more | :22:43. | :22:46. | |
and during term time. The needs of patients have to come first. It | :22:47. | :22:51. | |
could be something which could be taken account of, in the way that | :22:52. | :22:55. | |
many other industries which operate 24/7 do. She's right to say that | :22:56. | :22:59. | |
modern technology is key for this. If you are an air steward working | :23:00. | :23:07. | |
for basmt, you can go on to an electronic system yourself and | :23:08. | :23:11. | |
choose the hours you wish to work. We have seen a lot of low come work | :23:12. | :23:19. | |
which is partly driven because they offer the flexibilities that people | :23:20. | :23:22. | |
need. These are important changes and we intend to take them forward. | :23:23. | :23:28. | |
May I tell my Right Honourable friend that the actions of him and | :23:29. | :23:33. | |
his department and the BMA in reaching an agreement will be warmly | :23:34. | :23:37. | |
welcomed, but will be met with a sigh of relief. Will he accept that | :23:38. | :23:43. | |
the fact that the BMA were prepared to think again on crucial issues | :23:44. | :23:48. | |
like overtime at weekends, should not be seen as a sign of weakness, | :23:49. | :23:54. | |
but of maturity in working the Government to ensure a seven-day NHS | :23:55. | :24:00. | |
that is for the benefit of patients and patient safety? I agree with | :24:01. | :24:08. | |
that wise comment, as befits someone who is in fact experienced and | :24:09. | :24:12. | |
working in the Department of Health. You always get further if you sit | :24:13. | :24:16. | |
around the table and talk about these issues and it is much better | :24:17. | :24:21. | |
when you have a Government that is determined to improve the quality | :24:22. | :24:25. | |
and safety of care for patients, it is also better to recognise that if | :24:26. | :24:30. | |
the Government is successful that will also be better for the morale | :24:31. | :24:35. | |
of doctors because the happiest, most motivated doctors are working | :24:36. | :24:38. | |
in the hospitals which are giving the best care for patients. That is | :24:39. | :24:47. | |
why it is a win win. It was the refusal for many wreers of the BMA | :24:48. | :24:51. | |
to discuss the issue that my Right Honourable friend referred to meant | :24:52. | :24:56. | |
we did reach a deadlock. It was the fact this Government was willing to | :24:57. | :24:59. | |
proceed with important reforms on our own f we had to, which meant in | :25:00. | :25:05. | |
the end everyone came together and got a sensible negotiation. Everyone | :25:06. | :25:08. | |
would have wished we did haven't to go on the journey we did to get | :25:09. | :25:12. | |
there. Now we have got there it is the time for being constructive on | :25:13. | :25:16. | |
all sides. Can I thank the minister and the BMA for coming to an | :25:17. | :25:21. | |
agreement. It is a win win for everyone. Talk dialogue does bring | :25:22. | :25:26. | |
results. It happened in Northern Ireland and in the conclusion of | :25:27. | :25:31. | |
this process as well. 45,000 junior doctor BMA members will now be asked | :25:32. | :25:35. | |
to vote in this and a date has been reached. We've had eight days of | :25:36. | :25:42. | |
strikes since January. A cancellation of who,000 planned | :25:43. | :25:46. | |
operations -- 40,000 planned operations what will be done to | :25:47. | :25:53. | |
catch up with those cancelrationlations? We are in | :25:54. | :26:04. | |
constant touch with the devolved regions to make sure they know of | :26:05. | :26:08. | |
the changes we are making and to share any learn from the pro-ess | :26:09. | :26:12. | |
ises we have been through. We -- processes we have been through. We | :26:13. | :26:16. | |
are across the country now doing everything we can to catch one the | :26:17. | :26:21. | |
back log of all the things which have been affected by the industrial | :26:22. | :26:27. | |
relations dispute. Trust will always priority the areas where clinical | :26:28. | :26:31. | |
need is the greatest. I know that work is on going across the country. | :26:32. | :26:36. | |
Thank you, Mr Speaker. I very much welcome the agreement that has been | :26:37. | :26:44. | |
reached. We know that the Secretary of State recognises the important of | :26:45. | :26:48. | |
having a happy and well-motivated workforce and this contract | :26:49. | :26:52. | |
addresses many of the causes of unhappiness for junior doctors. It | :26:53. | :26:57. | |
is particularly good to see addressing the problems of couples | :26:58. | :27:00. | |
who are both junior doctors. There is more to do, has been | :27:01. | :27:05. | |
acknowledged, especially on the reasons why junior doctors feel | :27:06. | :27:10. | |
unsupported and not valued by their employers. My honourable friend | :27:11. | :27:16. | |
commissioned a report and a review from Sue Bailey, underlining the | :27:17. | :27:20. | |
problems of junior doctors in training. Can he advise us whether | :27:21. | :27:27. | |
this review will proceed? The request from the BMA was to find a | :27:28. | :27:31. | |
way of proceeding with that very important work and we will do it | :27:32. | :27:36. | |
with the input of Professor Bailey because she has an important | :27:37. | :27:39. | |
contribution to make. She is right to say that as well as the issue of | :27:40. | :27:44. | |
more flexible working for people with family commitments, the big | :27:45. | :27:48. | |
issue for many junior doctors is the way the training process happens. In | :27:49. | :27:52. | |
particular the way that continuity of training has been undermined by | :27:53. | :27:57. | |
the new shift system, which we need for reasons of patient safety. That | :27:58. | :28:02. | |
often means that you can have a different consultant giving advice | :28:03. | :28:06. | |
on different aspects of care from day-to-day. That is frustrating. We | :28:07. | :28:11. | |
will look at all those issues with Professor Bailey, with health | :28:12. | :28:13. | |
education England and with the BMA to see if we can find a better way | :28:14. | :28:19. | |
forward. Will the Secretary of State be aware | :28:20. | :28:26. | |
that even my constituents struggling the possible closure of the A in | :28:27. | :28:32. | |
Huddersfield will otherwise welcome and say thank you to everyone who | :28:33. | :28:36. | |
has brought this about. Including, I have to say, the leaders of the | :28:37. | :28:40. | |
opposition parties, our spokeses people who have done so much to help | :28:41. | :28:47. | |
a positive spirit? Will he just not glout about that or keep that period | :28:48. | :28:51. | |
of silence because out there, this is part of the phenomenon of the | :28:52. | :28:57. | |
deep unhappiness about the NHS and problems will arise again because so | :28:58. | :29:04. | |
many people work in the NHS service, know it has been privatised by the | :29:05. | :29:08. | |
back door, know that the clinical commissioning system is not working | :29:09. | :29:12. | |
and that problems will come back again and again unless he confronts | :29:13. | :29:17. | |
that. Weshlings it would have been a | :29:18. | :29:23. | |
constructive contribution to this morning's debate if he had not | :29:24. | :29:27. | |
started to descend into totally false slurs about this Government's | :29:28. | :29:31. | |
commitment to our NHS. I say to him, if you support the NHS, if you are | :29:32. | :29:35. | |
passionate about it as this Government is, you put the money in | :29:36. | :29:40. | |
- ?5.5 billion more than his party was promising at the last election | :29:41. | :29:44. | |
and you make the difficult reforms necessary to make sure that NHS care | :29:45. | :29:48. | |
is as good or better than anything which can be provided in the private | :29:49. | :29:52. | |
sector. That is what this Government is doing. We believe in our NHS and | :29:53. | :29:57. | |
we are backing it to give it the best care anywhere in the world. I | :29:58. | :30:01. | |
strongly welcome this important statement and the leadership from | :30:02. | :30:04. | |
the Secretary of State and congratulate all those involved in | :30:05. | :30:08. | |
the discussions. On Tuesday, in Eastly, I spoke with a constituent, | :30:09. | :30:14. | |
a junior doctor and new mum married to a senior nurse at my advice | :30:15. | :30:20. | |
surgery. She's unable to fast track into GP working and future care | :30:21. | :30:26. | |
around her four-month-old baby is part of the concerns she has, and | :30:27. | :30:30. | |
around these negotiations and it weighs heavily on this family, | :30:31. | :30:34. | |
particularly around on-call working. Can I ask that agile working and | :30:35. | :30:39. | |
those family first issues are truly taken into account where there are | :30:40. | :30:42. | |
nurses and doctors trying to bring up families together? | :30:43. | :30:47. | |
My honourable friend gives one example. I think there are thousands | :30:48. | :30:52. | |
of examples of people like that who are totally committed to the NHS, | :30:53. | :30:58. | |
have a bright future and can make a huge contribution to the success of | :30:59. | :31:03. | |
the NHS in doing a good job looking after patients, but also have home | :31:04. | :31:06. | |
responsibilities, which are difficult to fulfil when you have | :31:07. | :31:11. | |
very inflexible Ross tering systems. This is one of -- rostering systems. | :31:12. | :31:19. | |
We will look at how it brings in that flexibility. If we don't do | :31:20. | :31:24. | |
that we will see more and more doctors saying they will work to | :31:25. | :31:30. | |
work as locums or want to work for an agency. That is why we have an | :31:31. | :31:35. | |
urgent need from the perspective of patients and doctors to address that | :31:36. | :31:38. | |
issue. I am interested in the Secretary of | :31:39. | :31:43. | |
State's thoughts about the serious impact on morale that this dispute | :31:44. | :31:48. | |
has had. I was talking to a junior doctor in Sheffield this-the-other | :31:49. | :31:52. | |
day who said priority to -- prior to the dispute he did not look at his | :31:53. | :31:56. | |
contract, he simply got on and did whatever was needed. Does the | :31:57. | :32:01. | |
Secretary of State realise even if this is settled there's been a | :32:02. | :32:06. | |
serious impact on goodwill in the health service which could affect | :32:07. | :32:11. | |
service delivery going forward? I would say to him that if he looks at | :32:12. | :32:18. | |
the latest NHS staff survey we actually see higher staff | :32:19. | :32:20. | |
motivation, better communication and more staff recommending their | :32:21. | :32:23. | |
organisation as a place to work or be treated. I also do accept that | :32:24. | :32:31. | |
when you make big changes to a contract like the junior doctor's | :32:32. | :32:37. | |
contract they can be contentious and have an impact on morale. Morale | :32:38. | :32:41. | |
goes up when doctors are able to give better care for patients and | :32:42. | :32:47. | |
this is what this will require. The Secretary of State I think has done | :32:48. | :32:53. | |
a very good job in explaining today. Look, let's look at this, the BMA | :32:54. | :32:57. | |
caused a problem which should have been resolved a long time ago thasmt | :32:58. | :33:00. | |
decided they would make a political point. That is fair enough. | :33:01. | :33:05. | |
Conversely the opposition should have actually been big enough to | :33:06. | :33:09. | |
say, look, we want to cause political trouble on this. A lot of | :33:10. | :33:15. | |
this has been caused by political shenanigans. The failure of this is | :33:16. | :33:20. | |
the junior doctors themselves have lost prestige throughout the UK | :33:21. | :33:24. | |
because they were used by political pawns as two organisations. Well, I | :33:25. | :33:32. | |
think it is a great tragedy that the dispute unfolded in the way it did. | :33:33. | :33:36. | |
I am sure there are people with different agendas who have not | :33:37. | :33:40. | |
played constructive roles at various points. Given we now have an | :33:41. | :33:46. | |
agreement I want to look forward and say the lesson of the last ten days | :33:47. | :33:51. | |
is when you sit down and negotiate about all the outstanding issues | :33:52. | :33:55. | |
with a Government that is trying to make care better and safer for | :33:56. | :33:59. | |
patients then you get a result which is good for everyone. | :34:00. | :34:02. | |
It is not the time to be claiming victory. This negotiated agreement | :34:03. | :34:07. | |
now has to be put to the members of the British Medical Association. | :34:08. | :34:11. | |
Will the Secretary of State acknowledge that his own refusal to | :34:12. | :34:20. | |
negotiate easts a sister baiteded this crisis? Will he heed my | :34:21. | :34:24. | |
honourable friend, the Shadow Secretary's call for a period of | :34:25. | :34:29. | |
silence in order to avoid antagonising the junior doctors | :34:30. | :34:34. | |
still further? Let 's be absolutely clear there was never a refusal to | :34:35. | :34:38. | |
negotiate on the Government's side. You know, we have now, I think, | :34:39. | :34:43. | |
developed a lot of trust between the Government and the BMA leadership. | :34:44. | :34:48. | |
Until that point, they balloted for industrial action without even | :34:49. | :34:51. | |
sitting down and talking to the Government and they refused to | :34:52. | :34:55. | |
discuss the issue of weekend pay premium, which is the crucial change | :34:56. | :34:59. | |
we needed for a seven-day NHS. It is when they changed their position on | :35:00. | :35:03. | |
those areas that we were able to have constructive talks and that is | :35:04. | :35:08. | |
why they deserve great credit for coming to the table and negotiating | :35:09. | :35:12. | |
on things they did not want to previously. | :35:13. | :35:17. | |
I would like to say thank you to the Secretary of State for bringing hard | :35:18. | :35:21. | |
to bring about this resolution and always putting users of the NHS at | :35:22. | :35:25. | |
the heart of everything he does. Will he join me in urging junior | :35:26. | :35:32. | |
doctors to consider it with an open mind and strip out some of the | :35:33. | :35:36. | |
politics we have heard. And let's consider what is best for patients, | :35:37. | :35:40. | |
for the NHS and then what is best for the junior doctors? She speaks | :35:41. | :35:46. | |
very wisely. All I would say is that I understand in a very contentious | :35:47. | :35:51. | |
industrial relations dispute that junior doctors will not necessarily | :35:52. | :35:54. | |
look to me for advice as to which way they should vote, but it wasn't | :35:55. | :36:00. | |
just me doing this agreement, it was a negotiated agreement and the | :36:01. | :36:03. | |
leader of the junior doctors committee said it is a good | :36:04. | :36:06. | |
agreement, he will support people to support it and he thinks it is a | :36:07. | :36:11. | |
good way forward for doctors and patients T people closest to the | :36:12. | :36:14. | |
detail, to the negotiations think it is the right step forward for junior | :36:15. | :36:18. | |
doctors and that is something I want to take account of. Thank you, Mr | :36:19. | :36:26. | |
Speaker. I don't wish to invite the Secretary of State to provoke by | :36:27. | :36:30. | |
presumption. If this changes the shape of services it will have | :36:31. | :36:34. | |
implications for other health professions. Is he prepared to have | :36:35. | :36:40. | |
further conversation that needs to be had there and with counterparts | :36:41. | :36:45. | |
across these nationals to professional education and training? | :36:46. | :36:50. | |
We are of course willing to have those discussions with colleagues in | :36:51. | :36:55. | |
other parts of the UK. But he is right that to have a seven-day | :36:56. | :37:02. | |
service doesn't just involve junior doctors, it involves widespread | :37:03. | :37:05. | |
changes across the service. I would say for nurses, health care | :37:06. | :37:09. | |
assistants, porters, cleaners, others who work in hospitals, they | :37:10. | :37:15. | |
already operate on 24/7 shifts. So the changes necessary to contracts | :37:16. | :37:19. | |
are much less profound than they are to some of the doctors' contracts, | :37:20. | :37:23. | |
which is why it is important that we change not just the junior doctors' | :37:24. | :37:29. | |
contract but the consultants' contracts and the fact we have an | :37:30. | :37:33. | |
agreement bodies well for the consultants' contract, which is the | :37:34. | :37:34. | |
next step. Can I congratulate my honourable | :37:35. | :37:44. | |
friend and all honourable friend the member for switch for his hard work | :37:45. | :37:51. | |
in dealing with the dispute with the BMA. Patients up and down the | :37:52. | :37:57. | |
country, including mine, were somewhat concerned about the | :37:58. | :37:59. | |
cancelled operations but I'm delighted that the deployment will | :38:00. | :38:04. | |
try and make sure this gets caught up with. -- department. One of the | :38:05. | :38:09. | |
things come out of it was that some senior consultants had to end up on | :38:10. | :38:13. | |
the front line for the first time in a long time and can I ask what can | :38:14. | :38:17. | |
be done to make sure this happens on a regular basis so they are getting | :38:18. | :38:20. | |
experience on the front line as well? Think I will dig myself into a | :38:21. | :38:30. | |
deep old answer that directly. I would like to echo his thanks to my | :38:31. | :38:38. | |
honourable friend the member for Ipswich, who has done an outstanding | :38:39. | :38:45. | |
job at every stage throughout this very difficult period and I can | :38:46. | :38:48. | |
certainly say we would not have had yesterday's agreement without his | :38:49. | :38:52. | |
very strong help and support at every stage. I think it's true that | :38:53. | :39:01. | |
there are A departments that have to plan for the withdrawal of | :39:02. | :39:05. | |
emergency care and they found that having consultants more visible to | :39:06. | :39:10. | |
patients had some positive impact and I know studies are going on to | :39:11. | :39:13. | |
see what lessons can be learned going forward. I too welcome the | :39:14. | :39:20. | |
opportunity for a negotiated settlement, but let us take a moment | :39:21. | :39:26. | |
to reflect on one of the fundamental principles of the NHS about | :39:27. | :39:31. | |
providing high quality patient care, and to that end, Woody section of | :39:32. | :39:35. | |
state figures opportunity to offer our heartfelt and sincere apology | :39:36. | :39:39. | |
for the significant and severe distress that has been caused to | :39:40. | :39:43. | |
patients as a result of this prolonged dispute? With the gift | :39:44. | :39:50. | |
greatest of respect it was not my decision to take industrial action, | :39:51. | :39:56. | |
to ballot without him in being prepared to sit around the table and | :39:57. | :40:00. | |
talk to the Government, and with respect to patient safety we seemed | :40:01. | :40:03. | |
about improvements in beige and safety under this Government as we | :40:04. | :40:07. | |
face up to the many problems in care that we inherited, not just miss | :40:08. | :40:15. | |
staffs and many other places that option should welcome the changes | :40:16. | :40:18. | |
we've made in one of those it have a seven-day NHS. Like many colleagues | :40:19. | :40:27. | |
in the house, wrote visit to stick on numerous occasions over the last | :40:28. | :40:31. | |
six months to express concerns of local junior doctors so, | :40:32. | :40:34. | |
congratulate him on reaching this and I hope the new doctors in | :40:35. | :40:37. | |
Wimbledon will wholeheartedly support this deal. Can I say we | :40:38. | :40:40. | |
spoken about the Guardian and the ability of it and its role to | :40:41. | :40:45. | |
safeguard and have safe working hours per patients and doctors. Can | :40:46. | :40:51. | |
have more details about how that should work? I'm happy to do that | :40:52. | :40:54. | |
and I thank him for his correspondence. The principle is | :40:55. | :40:58. | |
that junior doctors want to know that there is someone independent | :40:59. | :41:03. | |
that they can appeal to the think they are being asked to work hours | :41:04. | :41:08. | |
that are unsafe the spin they cannot work -- after patients how they | :41:09. | :41:11. | |
wanted because they're physically or mentally too exhausted. That is | :41:12. | :41:15. | |
something we would all want to make possible but it means they need to | :41:16. | :41:22. | |
have someone who is the -- is not their line manager, someone | :41:23. | :41:25. | |
independent and separate. One of the areas we made the most progress in | :41:26. | :41:30. | |
the last few months, even before the last ten days, is establishing how | :41:31. | :41:34. | |
these guardians can work in a way that has the of the hospitals the | :41:35. | :41:42. | |
doctors working there. The section of state is right when he says you | :41:43. | :41:45. | |
always get further if you get around the table. I ask him why in response | :41:46. | :41:51. | |
to the cross-party initiative back in February to get everyone around | :41:52. | :41:55. | |
the table didn't he do that and save us all this trouble rather than | :41:56. | :42:00. | |
finding both the contract? The cross-party initiative was in for a | :42:01. | :42:03. | |
new contract, it was to abandon plans for a new contract and just | :42:04. | :42:08. | |
have pilots in a few limited places and if we had followed that advice | :42:09. | :42:11. | |
we would not now today had the biggest changes in junior doctor | :42:12. | :42:17. | |
contracts for 17 years agreed with the BMA, and that was why the call | :42:18. | :42:21. | |
we wanted was to get the agreement yesterday, safer carefully NHS and | :42:22. | :42:26. | |
better deals for doctors. That is what we got and we wouldn't have if | :42:27. | :42:34. | |
we listen to that advice? Can I join in the welcome for the agreement and | :42:35. | :42:39. | |
the persistent and patients that eventually paid off. In previous | :42:40. | :42:43. | |
statements I've raised with the sexual state this problem of married | :42:44. | :42:50. | |
couples, both of whom are doctors, -- secretary of state. If they have | :42:51. | :42:54. | |
roasters that clash, can he say a word about the progress made in this | :42:55. | :42:58. | |
important area of making work more family friendly. I'm happy to do | :42:59. | :43:10. | |
that. Is not easy dissolved because junior doctor at training places | :43:11. | :43:15. | |
operate on six-month locations and are competitive. You get many more | :43:16. | :43:22. | |
up applicants than there are posts available, so we have to find a way | :43:23. | :43:27. | |
of balancing the need to respect family responsibility, something we | :43:28. | :43:30. | |
would all want to do, with the need to have a fair process for the most | :43:31. | :43:34. | |
competitive positions. I think we have not got the balance right to | :43:35. | :43:41. | |
date, so we said cells Dott health education and where we decide people | :43:42. | :43:44. | |
will go on rotation will have a duty to consider family response but is | :43:45. | :43:47. | |
when they make decisions about those locations. I welcome the potential | :43:48. | :43:57. | |
resolution, thank the Government for negotiation at the doctors having | :43:58. | :44:01. | |
the courage to go on strike, which no one does likely to get a better | :44:02. | :44:05. | |
deal for the NHS. I would ask the secretary of state to reflect on | :44:06. | :44:11. | |
this and take further steps to build on his difficult relationship with | :44:12. | :44:15. | |
NHS staff and stop resenting NHS policy and false dichotomy between | :44:16. | :44:17. | |
the interests of patients and interests of NHS staff. If he had | :44:18. | :44:26. | |
listened to what I said, for we said Beasley I don't think that the cost | :44:27. | :44:29. | |
me exists, the false dichotomy as he says in the end what is right for | :44:30. | :44:34. | |
patients is also right doctors, the thing that demoralises doctors and | :44:35. | :44:38. | |
nurses and everyone working in hospitals and different part of the | :44:39. | :44:41. | |
Ayrshires is when they are not able to give the care they want what they | :44:42. | :44:46. | |
think is appropriate to the patients in front of them, which is why we | :44:47. | :44:51. | |
see hospitals that have moved closes towards a seven-day services are | :44:52. | :44:54. | |
also some of hospitals with the highest levels of morale in the NHS. | :44:55. | :44:58. | |
He is right, it's not a false dichotomy and we need to do both | :44:59. | :45:05. | |
together. As the sexual note, my brother and his wife were junior | :45:06. | :45:07. | |
doctors when they made the decision to move over to New Zealand a long | :45:08. | :45:13. | |
while ago. That was because of the long-standing cultural problems in | :45:14. | :45:16. | |
the NHS. They will be pleased indeed about the announcement yesterday | :45:17. | :45:22. | |
around the couples being able to work together in hospitals | :45:23. | :45:25. | |
potentially. I have a question for my mother and it relates around what | :45:26. | :45:33. | |
can you do now in order to encourage them and their friends back into the | :45:34. | :45:42. | |
NHS? Let me say to your mother that I hope the message of this new | :45:43. | :45:47. | |
agreement will go brightly way around the world and any doctors who | :45:48. | :45:53. | |
have moved to New Zealand or Australia are always welcome to come | :45:54. | :45:56. | |
back, and I think the thing that must unite this Government and the | :45:57. | :46:03. | |
good doctors who work in the NHS is our commitment to making NHS care | :46:04. | :46:07. | |
the safest and best in the world, and I think we had a terrible shock | :46:08. | :46:11. | |
with what happened at mid-staffs, but we're using it as an moment of | :46:12. | :46:17. | |
change, decisive change, NHS and were on the way to higher standards | :46:18. | :46:20. | |
of care that are available in many other countries. Mother Howlett is | :46:21. | :46:25. | |
satisfied, or idea we shall hear about it. -- or IDSA. | :46:26. | :46:32. | |
Congratulations Government and everyone on getting this in place, | :46:33. | :46:38. | |
it will have a knock-on effect in Northern Ireland into my | :46:39. | :46:40. | |
constituency, when I went around Antrim area hospitals their concerns | :46:41. | :46:45. | |
the number of doctors and how you get a seven day a week cover from | :46:46. | :46:50. | |
everything else that needs to go on in the health service, which, and | :46:51. | :46:53. | |
how we will deal with that and we will work with parliaments? I do | :46:54. | :47:00. | |
agree, we need more doctors and more nurses and by the end of this | :47:01. | :47:04. | |
parliament will have 1 million more over 70s in England alone and I know | :47:05. | :47:08. | |
the demographic effect in Northern Ireland will be equivalent. Globally | :47:09. | :47:12. | |
we have a shortage of about 7 million doctors, so we need to train | :47:13. | :47:18. | |
more. We are training an extra 11,420 doctors over this parliament | :47:19. | :47:22. | |
as part of the spending review. Because the training is done on the | :47:23. | :47:25. | |
UK wide basis it is something we will need to work closely with all | :47:26. | :47:31. | |
of the devolved regions. I warmly welcome this draft agreement and it | :47:32. | :47:35. | |
will be met with some relief in Cheltenham. Whatever article the | :47:36. | :47:38. | |
health concerns about the behaviour of the BMA in the past, does the | :47:39. | :47:42. | |
Secretary of State agree it should be an admission that this should be | :47:43. | :47:45. | |
part of the beginning of a more constructive future and will you | :47:46. | :47:51. | |
join me in congratulating the BMA negotiations for being able to | :47:52. | :47:53. | |
address constructively issues like Saturday pay. I'm happy to do that, | :47:54. | :48:01. | |
and I recognised it was not easy for them because they are still | :48:02. | :48:03. | |
involving changing the position that had for over three years. The result | :48:04. | :48:09. | |
we got to admit that at the details was actually something that was not | :48:10. | :48:12. | |
difficult for them to sign up to because they could see it really was | :48:13. | :48:16. | |
better for their members as well as better for patients. I think the | :48:17. | :48:20. | |
lesson is that the NHS faces huge challenges and can only be right to | :48:21. | :48:24. | |
deal with these challenges by sitting around the table as | :48:25. | :48:30. | |
negotiating constructively. I also warmly welcomed the news of the | :48:31. | :48:34. | |
agreement and I hope it feeds into a settlement. Can I ask the Secretary | :48:35. | :48:39. | |
of State if it is his intention to create a seven-day NHS, that will | :48:40. | :48:43. | |
require the participation of more than just the junior doctors, will | :48:44. | :48:48. | |
he bring forward a new contract for consultants? Or will he bring | :48:49. | :48:52. | |
forward a new contract for hospital lab walkers or Amazon 's workers or | :48:53. | :48:59. | |
nurses or indeed for catering staff? He is right. A seven-day NHS is not | :49:00. | :49:05. | |
just or even mainly about junior doctors, their important part of the | :49:06. | :49:09. | |
equation but we will need a new contract for consultants and we are | :49:10. | :49:13. | |
having constructive negotiations with consultant about that. For | :49:14. | :49:18. | |
other people working in the NHS, many are already or seven-day | :49:19. | :49:24. | |
contract, so he is right to say that we are going to have to have | :49:25. | :49:29. | |
diagnostic services operating across seven days so junior doctor working | :49:30. | :49:32. | |
at the weekend will be up to get the result back for a diagnostic test | :49:33. | :49:35. | |
the weekend and those are all part of the changes that we will make to | :49:36. | :49:44. | |
make and it is safer for patients. Can I warmly congratulate both sides | :49:45. | :49:48. | |
on reaching this agreement. Our NHS is different at weekends and my | :49:49. | :49:56. | |
honourable friend is right to bring in the four key clinical standards | :49:57. | :50:00. | |
on Sunday and Saturday. Would he agree it's important not simply to | :50:01. | :50:05. | |
rely on mortality data, which are often difficult to interpret in | :50:06. | :50:09. | |
underpinning the case for the seven-day NHS and will he look | :50:10. | :50:11. | |
closely at other metrics based on clinical standards around things | :50:12. | :50:16. | |
like endoscopy and routine lists on Saturday and Sunday and periods of | :50:17. | :50:21. | |
care particularly, which does not feature in any hospital mortality | :50:22. | :50:30. | |
data? He speaks very wisely on medical matters and I particularly | :50:31. | :50:33. | |
agree when he speaks about palette of care, which has got better, but | :50:34. | :50:38. | |
nonetheless there is a long way to go and we had recent evidence that | :50:39. | :50:42. | |
it is particularly in need of improvement where we are not able to | :50:43. | :50:49. | |
offer a seven-day part of support. I welcome this settlement and thank | :50:50. | :50:55. | |
everyone involved for securing it. Many junior doctors remained | :50:56. | :51:00. | |
concerned that as you increase the hours worked over a weekend you | :51:01. | :51:06. | |
inevitably produce cover during the week -- Regis cover unless you buy | :51:07. | :51:09. | |
more junior doctors to bridge that gap. With many rotors of ready on | :51:10. | :51:15. | |
filter does not until around the country during the week how can he | :51:16. | :51:18. | |
guarantee we will not make the situation worse during the week, | :51:19. | :51:26. | |
thereby impacting on patient safety? I understand the concern and the | :51:27. | :51:29. | |
short answer is that we need to increase the NHS workforce, which we | :51:30. | :51:33. | |
are doing and we will see more doctors going into training during | :51:34. | :51:36. | |
the course of this parliament, as were somewhat doctors going into | :51:37. | :51:38. | |
training over the course of the last Parliament. More doctors in the | :51:39. | :51:42. | |
workforce will be an important part of the solution. At the start of the | :51:43. | :51:50. | |
recent negotiations appears that the payment for Saturday working was the | :51:51. | :51:55. | |
main sticking point from the BMA but it appears from this negotiation now | :51:56. | :52:00. | |
that the issue of weekend pay has been resolved, can my honourable | :52:01. | :52:05. | |
friend confirmed that the position now is that this can lead for the | :52:06. | :52:09. | |
doctors that are working extended hours for the weekend will get extra | :52:10. | :52:14. | |
pay and patients can see a seven-day week NHS, which we all want to see? | :52:15. | :52:21. | |
It is much fairer for doctors than the current system. We are giving a | :52:22. | :52:29. | |
pay rise of between 10-11%, for which we are saying people are | :52:30. | :52:32. | |
expected to work one weekend day a month. The doctors who work more | :52:33. | :52:39. | |
than that get more and it goes up T more weekends you work the more | :52:40. | :52:43. | |
extra pay you get. That is one of the reasons the BMA was prepared to | :52:44. | :52:47. | |
sign up to this agree. It does value the people who give up the most | :52:48. | :52:53. | |
weekends. I was contacted by a constituent, | :52:54. | :52:57. | |
who told me how his four-year-old daughter fell through a pane of | :52:58. | :53:04. | |
glass, severely cutting her face. Unfortunate natly this accident -- | :53:05. | :53:08. | |
unfortunately this accident had on a Friday evening because there were | :53:09. | :53:13. | |
insufficient doctors working she could not have on operation until | :53:14. | :53:18. | |
the Monday. That four-year-old girl will now suffer severe facing | :53:19. | :53:23. | |
scarring for the rest of her life. Does my friend agree with me, that | :53:24. | :53:28. | |
is the republic why we need a seven-day NHS. I couldn't have put | :53:29. | :53:32. | |
it better myself. Those are the stories we hear from our | :53:33. | :53:35. | |
constituents, from our families. That is why yesterday was an | :53:36. | :53:39. | |
important step forward in terms of that seven-day agenda. I must | :53:40. | :53:45. | |
confess to being puzzled because the BMA have said all along this strike | :53:46. | :53:48. | |
and dispute was nothing to do with weekend pay and terms. Yet, after | :53:49. | :53:54. | |
discussions, negotiations which were limited simply to weekend pay and | :53:55. | :53:59. | |
terms, the BMA have now come to a deal and advised against strike | :54:00. | :54:05. | |
action. Can we take it despite much huffing and puffing this was about | :54:06. | :54:08. | |
the future of the NHS and the rest of it, at the end of the day it was | :54:09. | :54:14. | |
all about weekend pay and terms? I think he is right that was the big | :54:15. | :54:19. | |
sticking point and their willingness to be flexible and the goshiate on | :54:20. | :54:25. | |
that which made -- and negotiate on that which made it possible. There | :54:26. | :54:30. | |
are many other noncontractual issues in the way that doctors are trained | :54:31. | :54:34. | |
and treated by the NHS. We want to use this as an opportunity to put | :54:35. | :54:40. | |
that right. Can I congratulate on the Secretary of State op putting | :54:41. | :54:46. | |
patients first. Those people who had their operations cancelled during | :54:47. | :54:57. | |
industrial action. Looking at people on the back-burner or poss pope | :54:58. | :55:04. | |
their medical -- or postpone their medical care? That is a view some | :55:05. | :55:09. | |
share. Doctors have obligations now under the Medical Act not to take | :55:10. | :55:15. | |
action which would harm patients and under their responsibilities to the | :55:16. | :55:19. | |
General Medical Council. They have to be aware of those. What I hope is | :55:20. | :55:24. | |
that question does not arise again, we are having constructive | :55:25. | :55:27. | |
discussions with the BMA. It is the way forward and I hope that neither | :55:28. | :55:31. | |
myself or any future Health Secretary has to go through what we | :55:32. | :55:39. | |
have during the last ten months. I explored the tone and content of the | :55:40. | :55:42. | |
remarks today. It will go down as a break through in the NHS. It has | :55:43. | :55:46. | |
been very uncomfortable to have dialogue with constituents who are | :55:47. | :55:50. | |
junior doctors who have felt aggrieved. So, I have particularly | :55:51. | :55:54. | |
welcomed the way he's been able to look at noncontractual issues. I | :55:55. | :55:58. | |
would urge him to look very strongly at the issue of -- the outcome of | :55:59. | :56:04. | |
the Bailey review so he can move forward on morale and the wider | :56:05. | :56:09. | |
issues which have been raised. Well, I just finish by saying I | :56:10. | :56:17. | |
complete aagree with him. It's been a very sad dispute. We recognise | :56:18. | :56:20. | |
that junior doctors are the back bone of the NHS. They work very | :56:21. | :56:24. | |
hard. They often work the most weekends already. I think it is | :56:25. | :56:28. | |
therefore a brilliant step forward that we have an agreement. But the | :56:29. | :56:33. | |
constituents that he talks about and that we all have who work hard for | :56:34. | :56:37. | |
the NHS are the people we want to value. Therefore, dialogue, | :56:38. | :56:44. | |
constructive discussion must be the way forward. | :56:45. | :56:51. | |
THE SPEAKER: In accordance with standing order 122D, I must announce | :56:52. | :56:56. | |
the arrangements for the election of the chair of the Backbench Business | :56:57. | :57:01. | |
Committee for the new session. If there is more than one candidate, | :57:02. | :57:07. | |
the ballot will be held in committee room 16 from 11am to 1. 30pm on | :57:08. | :57:15. | |
Wednesday, 25th May. Nominations must be submitted in the | :57:16. | :57:20. | |
table office between 10am and 5pm. That is on the day before the | :57:21. | :57:23. | |
ballot. That is to say, Tuesday 24th May. In | :57:24. | :57:29. | |
accordance with the standing order, only members who do not belong to a | :57:30. | :57:36. | |
party represented in her Majesty's Government may be candidates in this | :57:37. | :57:40. | |
election. A briefs note with more details | :57:41. | :57:47. | |
about the election will be made available to members and published | :57:48. | :57:55. | |
on the internet. Order. Presentation of bill, Mr Javid. | :57:56. | :58:02. | |
Second reading, what day? Tomorrow. Order, the clerk will proceed to | :58:03. | :58:08. | |
read the orders of the day. Nanss bill, presentation Fy second | :58:09. | :58:15. | |
reading and committal. In accordance with standing order number 80 B and | :58:16. | :58:18. | |
the order | :58:19. | :58:19. |