| Health Secretary Jeremy Hunt has written to 50,000 junior doctors in England outlining plans he says would lead to basic pay increasing by 11%. But he wants to curb other elements including guaranteed pay rises. The British Medical Association said it had not seen the proposals. It is preparing to send ballot papers out on Thursday ahead of possible industrial action in a fraught pay dispute. Mr Hunt says just 1% of NHS junior doctors would lose out under his plans. 'Salaries protected' The health secretary's proposed rise to basic pay would see a new doctors' salary rise from £22,636 to £25,500. But guaranteed annual pay rises are being scrapped and instead pay will be directly linked to progress through dedicated training stages. Other elements of their pay package are also being cut. Mr Hunt now wants the BMA to return to the negotiating table, but the union has refused. Mr Hunt said the changes would mean three-quarters of junior doctors will get pay rises, while most of the rest will see their salaries protected. The government said the doctors who lose out are the ones who work lots of extra hours and therefore are entitled to extra payments. Thousands of doctors have taken to the streets in recent weeks to protest about the contract offer, which they say could put patient safety at risk because of longer hours and lead to pay cuts of up to 15% for some. Analysis The timing of this letter - the day before the ballot opens - is no coincidence. Mr Hunt has provided more detail on the contract plus some concessions in an attempt to get junior doctors to step back from the brink. Union leaders and many others in the medical profession will now spend the next few days poring over the details. The 11% basic pay rise seems attractive, but that is tempered by the plan to end guaranteed annual pay rises and curbing what constitutes anti-social hours. And while the pledge that only 1% of doctors will lose out may seem positive on paper, those in the profession worry that that figure could increase in years to come as the full impact of the changes filters through the system. The ballot closes in two weeks. We won't have to wait long for a verdict on the health secretary's latest salvo in this long-running dispute. The details being sent out by Mr Hunt to medical schools include a concession on what constitutes unsociable hours. The original plan included classing Saturday working from 7am to 10pm as normal hours, but that has now been reduced to 7am to 7pm. Currently the whole weekend is classed as anti-social working and therefore attracts extra payments. The deal is due to come in next August with ministers warning they will impose it if need be. The Care Quality Commission is also being asked to monitor how many hours junior doctors are doing as part of its inspection regime to make sure trusts are not overworking medics. Mr Hunt told BBC Breakfast the deal would be good for doctors and patients. Professor Sir Bruce Keogh, medical director for NHS England, said doctors should consider the terms being offered. 'Varying percentages' "I urge all junior doctors to please pay careful and considered attention to the new contractual offer set out today which if implemented correctly will address the long hours and related safety issues which have been such a cause for concern," he said. Dr Johann Malawana, the BMA's junior doctors leader, told BBC Breakfast: "I haven't actually seen the proposals because it's all been released via the media overnight." He added: "Throughout the last month or so the government has had varying different percentages that they claim that they are going to increase basic pay by. And every time we have seen the detail of this, it's unravelled." Scotland and Wales have said they do not want to introduce the changes, while Northern Ireland has yet to make a decision. |