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Letters

Pay rates for junior doctors' additional hours need to be adjusted

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7146.1748 (Published 06 June 1998) Cite this as: BMJ 1998;316:1748
  1. Trevor Pickersgill, Research fellow in neurology,
  2. H G Kynaston, Consultant urologist,
  3. Rhidian Hurle, Senior house officer in orthopaedics and trauma,
  4. Gary Small, Senior house officer in oncology
  1. University Hospital of Wales Healthcare NHS Trust and University of Wales College of Medicine, Cardiff CF4 4XW
  2. Glan Hafren NHS Trust Royal Gwent Hospital, Newport, Gwent NP9 2UB
  3. TP, RH, and GS are junior doctors. RH and TP are members of the Junior Doctors Committee of the BMA.

    EDITOR—Work out of hours (additional duty hours) performed by junior doctors working on call rotas is currently paid at 50% of the standard hourly rate. Many junior doctors find this rate insulting and think that overtime, being compulsory and demanded by a monopoly employer, should be just what it says.

    Pay rates should therefore be at least the same as for a normal working day, for reasons of responsibility, inconvenience, and comparability with pay for work done outside normal working hours in other professions and trades. The annual evidence given by the BMA's Junior Doctors Committee to the pay review body for doctors and dentists has stated this for many years; yet since 1991, when the new deal was agreed,1 there have been no further increases in rates for additional duty hours since the increase from 38% to 50%. Our fellow health professionals who share our commitment out of hours to the NHS have long been amazed that such a pay rate exists. Many do not believe us.

    We have surveyed nurses, patients, and medical students from two different years and assessed each group's knowledge of the current pay rates for junior doctors. Ethical approval for the study was obtained. The participants were handed a brief questionnaire asking their age and sex and how much they thought a preregistration house officer would be paid per hour on Christmas Day 1997, given that they would be earning £7.42 per hour on Christmas Eve, a normal working day. The participants' responses were collected directly thereafter. We obtained 529 replies, of which 523 answered the question on out of hours pay (86 patients, 157 nurses, 168 first year and 118 fourth year medical students; mean (SD) age 29.2 (15.1) years).

    Figure1

    Distribution of estimated hourly pay for additional duty hours of junior doctors by nurses, patients, and medical students

    The figure shows the frequency of replies. One way analysis of variance indicated pairing of the groups, with first year medical students and patients (means £12.34, £13.73 respectively) estimating significantly higher than nurses and fourth year students (£9.37, £9.80) (P<0.001). There was no correlation between the estimate given and either age or sex overall or within any of the groups.

    To our knowledge this is the first study to examine this issue. Only 14 respondents correctly estimated the hourly pay rate at £3.71. Most (510) estimated a pay rate of at least 100%, and a significant minority (155) estimated that preregistration house officers were paid at “double time” or more. If patients, medical students, and nurses believe that junior doctors are paid at these sorts of rates, we believe that this is cogent evidence of public opinion that they should.

    References

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