A row over whether Saturdays should become part of NHS junior doctors’ normal working week is threatening efforts to resolve the long-running dispute, despite next week’s strike being called off.
The divide between the sides currently involved in talks over the issue is so wide that those involved fear it may scupper any chance of a deal.
Although junior doctors have suspended their 48-hour walkout that was due to start next Tuesday at 8am, negotiations are reaching a critical point with the issue of Saturday working hampering all sides’ desire to reach an agreement.
“Saturday is a huge, huge problem,” said one source close to the negotiations between the British Medical Association and NHS Employers and the department of health, which resume today.
Both see it as a red line on which they cannot compromise, the source added, despite progress on other fronts.
Jeremy Hunt, the health secretary, is insisting that England’s 45,000 junior doctors accept working on Saturdays as part of his plans to bring in a more fully functioning seven-day NHS. But the BMA, the doctors’ union, is refusing to countenance such a radical change to trainee doctors’ working patterns.
The standard working week for junior hospital doctors - all those below the level of consultant - is 7am to 7pm, Monday to Friday. They receive overtime for working outside those hours. But Hunt wants to extend their normal week to 10pm on weeknights and to also include Saturdays up to 7pm and has offered an 11% rise on basic pay if they agree.
“Jeremy Hunt doesn’t want to give in on that. He doesn’t want to give an inch, because of his seven-day NHS pledge. And the BMA are absolutely adamant that Saturday shouldn’t count as normal working,” said the source.
David Dalton, the hospital boss Hunt has brought in to lead negotiations for the NHS, plans to table some new ideas to break the logjam over the issue when the talks resume in London under the auspices of the Advisory, Conciliation and Arbitration Service (Acas).
He is understood to be looking at several proposals, including only Saturday mornings becoming part of junior doctors’ “plain time” - the hours for which they receive only basic pay for working.
He is also examining whether paying trainee medics premium rates for working anything other than an occasional Saturday might be acceptable.
Dalton, the boss of Salford Royal NHS Foundation Trust, has been consulting senior hospital bosses about how to find common ground between the two sides.
“He’s trying to find a formula to sort this. He wants both sides to come to some sort of understanding (on Saturdays) and to compromise, so that no one would get a 100% win,” one ally said. “The key thing he needs is everybody involved to be flexible.”
Hospitals faced with cancelling operations and outpatient clinics for a second time after last week’s first walkout by junior doctors were relieved that the BMA decided to postpone next week’s two-day stoppage. The union hopes that will provide an atmosphere for constructive talks without a strike looming.