Yup. Still a [LIFTED] though. Was before he got the health job, will be afterwards.

Hunt's plan is to use this to force 7-day working. Which means there will be more elective admissions over the weekend, which will balance out the statistics. The same number of people admitted as emergency and dying won't specifically change but will be "diluted" in with non-emergency admissions. It will be presented as "proof".

The GMC have started cashing in on this by charging for these letters, which used to be free.

There are a few points of concern with the proposed contract, not all of it to do with money:

Night shifts
Currently this is defined as 7pm to 7am IIRC, and there is a limit to how many you can do in a row without a break. The proposed contract does not recognise work done outside of 11pm to 6am for less than three hours. So I could work from 6pm to 2am (well 1.59am) and this would not be recognised as a night shift, nor would any part of it be recognised as a nightshift.

Spare time
A junior doc can work up to 48 hours in a week (though max limit is 56 hours). They can do extra work out of this eg work in sports medicine or for a charity. Under the proposed contract, if a junior doc wants to do extra work, they must give the NHS trust first refusal.

welcome to my world ...
Escalation
There's a proposal for a new role for someone to monitor working hours for junior docs and escalate if things become unsafe. Sounds great, except while the BMA wants someone independent, NHS England (NHSE) want someone on the hospital's payroll to do the monitoring instead.

Missed breaks
It's inevitable that working as a junior doc means you won't have a chance to have a break. NHSE say doctors have paid breaks and hence if they miss their break, there should be no financial penalty. BMA say there should be one to ensure junior docs get a break during their shift.

Additional hours
Through good will, junior docs often work past their shift time. The BMA feel junior docs should be paid for all work they do and that a penalty for the trust would limit junior docs being exploited. NHSE say they will pay junior docs but only at their normal hourly rate for this "overtime" work.

Non-resident on-call
Historically, the doctor would sleep in the doctor's room at the end of the ward. Hence they were resident on-call. These rooms have since been demolished and converted into managerial offices, and junior docs have to stay at home and be available until called in. NHSE will pay on-call rates for when the doctor is called in but not when they're at home. Instead they offer 5% of basic pay for a doctor to sit at home. The BMA wants this to be bumped up to 5-20% depending on intensity and frequency.

London weighting
London is more expensive to live in and certainly staff are paid more when working in London compared to the same job/role elsewhere in the country. The cost of living in London has gone up but the weighting hasn't increased in the last five years. BMA wants to bring this up to date. NHSE doesn't.

Pay protection
Currently, if a junior doc decides after four years of surgery that they want to change to medicine, paediatrics or any other specialty, the NHS recognises their extra years of experience and add this to their pay ladder. Hence this junior doc would be four pay levels above a colleague just starting say paediatrics and is reflective of their experience. NHSE want to abolish this so your pay drops back to the lowest rung.

http://koshh.org/the-connection-between-the-junior-doctors-contract-and-the-american-corporate-takeover-of-the-nhs

The reality is that more qualified staff are being driven out in preparation for the de-skilling that is always part of healthcare privatisation and corporate takeover.

Small problem with that - you can't 'deskill' the doctors out of the NHS. It's not legal for people other than doctors to do lots of things doctors do.