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BMA action on free accommodation for foundation house officers

July 2008

In July 2007, the requirement for pre-registration doctors to be resident at the hospital was removed from the Medical Act 1983. This means that there is no longer a statutory requirement for pre-registration doctors (first year foundation house officers (FHO1s) to be resident, which in turn means that hospital accommodation no longer needs to be provided without charge to FHO1s. In August 2007 NHS Employers wrote to trusts to encourage them to continue to provide free accommodation to FHO1s for 2007/08. However, from August 2008 most trusts will not provide accommodation for these doctors without charge.

What has the JDC done to date about this?
The Junior Doctors Committee put evidence to the Review Body on Doctors and Dentists Remuneration (DDRB) for a significant increase in salary for pre-registration doctors – read the BMA evidence now. This builds on preparatory work that the JDC had done during 2006 to alert the DDRB to the possibility that free accommodation would be lost. The JDC argued that pre-registration doctors’ salary has traditionally always been kept at a lower rate because of the benefit such doctors received in free accommodation. This is a fact that is widely accepted by the Department of Health and the Review Body itself. Now that FHO1s will no longer receive free accommodation, their salaries should be increased accordingly. The JDC made this point again recently during the BMA’s oral evidence session to the DDRB and the committee set out all the arguments in a further written statement to the Review Body to ensure members of the board were in no doubt of the importance of this issue - the letter is available to download and read in PDF format here

The DDRB reported in April. The government announced that it was accepting in full the recommendations of the DDRB (Doctors' and Dentists' Review Body)

• Hospital doctors will receive a below inflation pay rise of 2.2%

• The average increase in resources for GP practices is estimated to be 0.2%, with most practices getting nothing and around 10% getting up to 2.7%

• First year junior doctors will not be compensated for the loss of their entitlement to free accommodation

Read the BMA response and the full report here.

More recently we have written to the NHS Employers asking them to negotiate with us about this but unfortunately we have had no positive response to date. We will also be raising the issue with Ministers in a letter.

BMA position
The BMA has always opposed any moves to remove the entitlement to free accommodation and is incensed that the government has taken away a contractual benefit without negotiating with us.

The move to remove the right to free accommodation without any meaningful negotiation with junior doctors, and the refusal of the DDRB to acknowledge its removal with a pay uplift, has been met with anger and concern from medical students and junior doctors.

This comes at a time when student debt is at its highest level and junior doctors’ salaries are shrinking.

We strongly believe that the removal of free accommodation is completely detrimental to the Government’s drive to encourage low income groups into the medical profession. Society is best served by a medical workforce that is representative of, and as diverse as, society itself. The increasing levels of debt among medical students – increased further by the removal of free accommodation – will mean that only those who can afford it will be able to train to become a doctor.

Campaign
The Medical Students Committee and the Junior Doctors Committee also organised a series of protests during May – July 2008 about the loss of free accommodation. For further information please go to www.bma.org.uk/accommodationcampaign

Further background
It has been implied by government that the BMA agreed to the removal of free accommodation for FHO1s. This is categorically not the case. The JDC has always opposed any moves to remove the entitlement to free accommodation. However, the committee was involved in discussions, years ago, concerning the future of the accommodation provision but the matter was left unresolved. The JDC has written to ministers to complain about the misleading information being issued by the Department of Health.

During 2004 the JDC met the Department of Health on a number of occasions at regular meetings of the Joint Negotiating Committee (Juniors) and discussed, amongst many other issues, the future of free accommodation for pre-registration doctors and the Medical Act’s requirement for such doctors to be resident. Throughout these meetings it was clear that both parties were keen to ensure that free accommodation continued to be available to those doctors who required it. Discussion focused on safeguarding the right to free accommodation by enshrining its provision in the terms and conditions of service for pre-registration doctors (see extract of minutes below).

Extract from the minutes of the Joint Negotiating Committee (Juniors) meeting of 21 March 2005
"JDC stated that it was their view that all PRHOs should be offered accommodation and they had in a previous meeting provided a form of words for the TCS which gave trusts the option to offer the accommodation to other potential residents if a PRHO chose not to accept it.

[NHS Employers] stated that there would be a 4 countries meeting to discuss this issue.

JDC stated that it was their view that PRHOs should be entitled to free accommodation and if this was not the case then they would look to get an increase to the PRHO salary which might have a knock on effect to SHO and SpR salaries."

Discussions were complicated by the four health departments holding differing views on the provision of free accommodation and the matter was dropped from negotiating agendas in early 2005 without agreement on a way forward being reached. However, the BMA maintained its position that PRHOs should continue to be offered free accommodation and the JDC understood that the matter was now closed and no changes would be made.

It was therefore incredibly disappointing to find out in 2006 that the amended Medical Act had dropped the residence requirement. The consultation process that the Department of Health led regarding the amending of the Act made no mention of the removal of the residency requirement for FHO1s and no prior discussions were held with the BMA regarding this issue. The JDC is incensed that the government effectively removed a contractual benefit from pre-registration doctors without negotiation with the BMA.