New NHS Doctor Contracts: What does this mean for the industry?

The streets of London and Belfast, among other areas, have recently been flooded by junior doctors who are protesting the planned changes to their contracts. If it falls through, the proposal will completely re-define anti-social hours.

As it currently stands, junior doctors work a basic 40 hour week, working from 7 to 7 on weekdays. Depending on how they fit into a set banding system, they earn more for working outside of these basic hours, and trainee GPs are paid a supplement.

This system has been in place for several years, but recently there have been various proposals made by the government intended to get rid of both the GP supplement and the banding system, and replace it with new contracts based on work schedules, reporting exceptions and reviews. One of the proposals redefined Saturdays as normal working hours.

With the new proposals implemented, pay progression will be based on the level of job responsibility, so a specialist doctor moving from his or her third to fourth year will no longer receive a pay rise. While some MPs support the proposed changes, many have fears of how this will affect doctors’ choices to progress in their careers. Some speakers on the side of the British Medical Association argue that the pay changes completely ignore the wide variety of responsibilities that doctors have at various stages in their early career.

For those involved in the public health sector, these proposals have a few important and potentially damaging consequences. Being a practising doctor is a highly stressful position, and some have argued that by removing the current banding system and introducing more “normal working hours” to the week, the government is taking away safeguards on existing, safer working hours. Under the new system, it will be a distinct possibility for junior doctors to work 72-hour weeks.

The new proposals also state that after taking a career break, for further academic pursuits or otherwise, junior doctors will not receive a pay increment when they come back to work. Because the governments of Wales and Scotland have decided to leave junior doctor contracts as they are, many medical professionals are predicting a mass exodus of doctors from England, as well as a large proportion quitting medicine altogether. All in all, the proposals are predicted to be highly detrimental to doctors’ work-life balance, earnings, and most importantly the safety of their patients.

Aside from leaving the country, a popular escape route for junior doctors currently working for the NHS is going into cosmetic medicine. Because this branch exists primarily in the private sector, doctors working exclusively as cosmetic practitioners will be saved from any pay cuts. If leaving the NHS seems like a given, doctors may choose to set up their own limited companies, where it’s possible to turn an hourly profit of £200. With more experience, they can also gain positions in private medical firms, which will offer them the stability and security of full-time employment. Studies have found that out of all the professions making up the cosmetic sector, doctors are generally the most trusted to carry out aesthetic procedures.

Working hours will still be as flexible as required, with many doctors choosing to work just a single afternoon in a weekend. Following their F2 year, an increasing proportion of doctors will look into cosmetic medicine as a possible career path.

If a newly qualified doctor chooses to go into this niche, they’re likely to start off at one of their local cosmetic clinics or spas. The demand for aesthetic treatments is increasing as it becomes more accessible to more people, and because of this spas and other such health centres are on the hunt for proven, competent practitioners for aesthetic treatments involving injections.

Any junior doctors considering going into aesthetic medicine should start taking steps immediately in preparation for the proposals following through. Supervision in the doctor’s initial practice will be essential due to the 2015 GMC draft guidelines.

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