Junior doctors afraid to complain about hours and pay, tribunal told

compliant, the head of a British Medical Association committee told an

industrial tribunal in Glasgow yesterday.

Dr Peter Bennie, chair of the committee of Scottish junior doctors,

was giving evidence on the first day of a test case hearing into claims

by 12 young doctors backed by the BMA.

They say they were wrongly classified in their contracts by their then

employer, the Royal Alexandra Hospital in Paisley, and are owed

potentially thousands of pounds in unpaid overtime.

Should their complaints be upheld, NHS trusts across Scotland could

face similar actions costing perhaps millions.

The tribunal agreed to hear the cases of four, Dr Bruce Elliot, Dr

Rory Melville, Dr Claire Murray, and Dr Valerie Dudgeon over the four

days set aside this week. The remaining eight cases will be held over.

Dr Bennie told the tribunal that junior doctors who completed two

six-month attachments -- one surgical, one medical -- before progressing

to the grade of senior house officer, frequently received their

contracts of employment setting down their formal terms and conditions

three to four months after starting work.

These arrangements, he said, often bore little resemblance to the work

actually undertaken. There existed powerful pressures on doctors in

their first professional positions to accept the situation and keep

quiet.

''Most junior doctors are quite wary of taking any action about their

terms and conditions, usually for fear that they may be identified as

troublemakers and their career prospects damaged as a result,'' said Dr

Bennie, a senior registrar in psychiatry.

Public concern and a widespread professional acknowledgment of the

potential dangers of working junior doctors too hard had led to the

agreement in 1992 of a new deal limiting their hours of service.

Under this deal, an upper limit was set on mandatory overtime above a

40-hour week of between 16 hours if a full shift was worked and 32 hours

if on call, with a third category of a partial shift created, set at 24

additional hours.

The agreement also set the proviso that doctors on call should be

resting for a substantial period of the duty. ''If a doctor is worked

intensely for 72 hours instead of 56 it is clearly outwith the terms of

agreement,'' said Dr Bennie.

Pay rates were also laid down whereby doctors received 50% of their

basic hourly wage for hours spent on call, 70% of basic for every hour

worked on a partial shift, and the full basic rate paid for every hour

on a full shift.

''A hospital will do its utmost to classify a job as an on call rota

position wherever possible,'' Dr Bennie said. ''That means they can work

junior doctors for the full 72 hours and only have to pay them the 50%

overtime rate.''

They were consequently often used as a source of cheap labour, doing

tasks that could be completed by other hospital employees.

He told the tribunal: ''Some are used for clerical tasks because at

only 50% overtime they're cheaper than employing somebody to do the job.

The junior doctors are not in a position usually to be brave enough to

complain.''

The complaints of the 12 doctors involve a six-month period from

August 1993 to the end of January last year, when they were first

employed at the Royal Alexandra.

The group, now mostly senior house officers employed elsewhere,

exhausted the NHS trust's internal grievance procedure before bringing

their case to the industrial tribunal, which continues today.