Hunt to impose new contract on junior doctors

11 Feb 16

The government is to impose new contract terms on junior doctors after concluding it would not be able to reach agreement with the British Medical Association.

In a statement to MPs today, health secretary Jeremy Hunt said the government had tried for three years to reach an agreement in the long-running dispute over changes, which are intended to improve the availability of staff at evenings and weekends.

However, he stated the doctors’ union, which called two days of industrial action in the dispute, was “unwilling” to discuss changes. Therefore Hunt would introduce the new terms unilaterally, after being urged to do so by Sir David Dalton, who led negotiations for the government.

The health secretary said this was needed to tackle what he called the “weekend effect” of poorer outcomes in hospitals.

“In such a situation any government must do what is right for both patients and doctors. We have now had eight independent studies in the last five years identifying higher mortality rates at weekends as a key challenge to be addressed. Today we are taking one important step necessary to make this possible.”

However, the new terms would also include a higher increase in basic pay than previously set out. It had initially been calculated that changes to reclassify more working hours as plain time would mean that junior doctor basic pay could rise by 11% under new terms. Updated modelling of the impact of the reform had showed that there was room within the pay settlement for an 13.5% increase in basic salary, Hunt told MPs.

“Three-quarters of doctors will see a take home pay rise and no trainee working within contracted hours will have their pay cut.”

The BMA maintains that doctors would be paid less for working unsocial hours than they are under the current contract, with those working in specialties with a high proportion of weekend and evening working, such as emergency medicine, affected disproportionately.

The union is also concerned that financial penalties faced by NHS providers for overworking doctors would be removed in the new contract.

Hunt said a new guardian role would be introduced within every hospital trust, with authority to impose fines for breaches of agreed working hours.

He acknowledged the process had generated considerable dismay among junior doctors, but said he believed the new contract was “one that in time can command the confidence of both the workforce and their employers”.

He added: “We have committed an extra £10bn to the NHS this parliament, but with that extra funding must come reform to deliver safer services across all 7 days.

“That is not just about changing doctors’ contracts: we will also need better weekend support services such as physiotherapy, pharmacy and diagnostic scans; better seven-day social care services to facilitate weekend discharging; and better primary care access to help tackle avoidable weekend admissions. Today we are taking a decisive step forward to help deliver our manifesto commitment.”

Responding to Hunt, Dr Johann Malawana, the BMA’s junior doctor committee chair, said the decision to impose the contract was “a sign of total failure on the government’s part”.

Junior doctors “cannot and will not accept a contract that is bad for the future of patient care, the profession and the NHS as a whole, and we will consider all options open to us”, he said.

“Junior doctors already work around the clock, seven days a week and they do so under their existing contract. If the government wants more seven-day services then, quite simply, it needs more doctors, nurses and diagnostic staff, and the extra investment needed to deliver it.

“This is clearly a political fight for the government rather than an attempt to come to a reasonable solution for all junior doctors. If it succeeds with its bullying approach of imposing a contract on junior doctors that has been roundly rejected by the profession it will no doubt seek to do the same for other NHS staff.”

In response to the decision, NHS Employers’ chief executive Danny Mortimer said he was “saddened and hugely frustrated that an agreed deal has not been reached with the BMA”.

He added: “The NHS needs certainty on this contract and a continuation of a dispute would be harmful to patients, and the NHS. Over the last four years significant progress has been made to address concerns around safe working. I believe the new offer is fair and safe for doctors, and patients.

“Junior doctors are an important part of the NHS’s future so listening directly to their views must now be a priority as we move forward, and employers will accept the part they must play in this process.”

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