Junior doctors' row: NHS chiefs speak out over letter

Protests outside the Department of Health's offices in LondonImage source, PA
Image caption,
Protests continued outside the Department of Health's offices in London on Thursday night

Some NHS bosses have distanced themselves from suggestions they backed a new junior doctors contract being imposed, after their names were linked to a letter used to justify the move.

Names of 20 chief executives appeared on a letter from the government's chief negotiator, advising it to do "whatever it deems necessary" to end the row.

On Thursday, Health Secretary Jeremy Hunt said a contract would be imposed.

But 10 of the letter's signatories say they do not support the decision.

Ministers took the decision to impose the contract in England after their mediator, Sir David Dalton, advised them a negotiated outcome "no longer seems possible".

In his letter to Mr Hunt, Sir David said the recommendation "to make sure that a new contract is in place" was supported by "chief executives across the country", and supplied 20 names.

Half of the signatories have since stressed that they did not agree to the contract being forced on medics.

Sir Andrew Cash, head of Sheffield Teaching Hospitals NHS Foundation Trust, said he supported "the improved offer made this week as fair and reasonable", but said: "I do not support imposition."

Meanwhile, Andrew Foster, of Wrightington, Wigan and Leigh NHS Foundation Trust, said: "I have not supported contract imposition. I have supported the view that the offer made is reasonable."

'Unfortunate development'

Responding, Sir David told the Health Service Journal (HSJ) the statement they had agreed to "was confirming that the best and final position was considered fair and reasonable, and that they believed the NHS needed certainty and not continuation of the stalemate".

He continued that if anyone wanted to make an inference from this that they supported imposition, "then that is their inference, [but] that is not what [the signatories] have committed their names to".

"I neither want to say they do or that they don't. There is a variety of opinion on this."

The BBC's health editor Hugh Pym said the debate over whether there was wider support among NHS leaders for the government's stance could turn out "to be a storm in a teacup".

But he said it was an "unfortunate development as ministers embarked upon what may prove to be a long-haul task of finalising and pushing through the contract".

What is the latest contract offer?

Image source, PA
  • The government is offering extra pay after 17:00 on Saturdays
  • But they have offered to top up the pay by 30% for those who work regular Saturdays - defined as at least one in four
  • The BMA wants all day Saturday for everyone to be paid at 50% above the basic rate
  • Agreement has not been reached on on-call allowances, how limits on working hours are to be policed and days off between night shifts
  • The government has offered a basic pay rise of 13.5%
  • The BMA has said it is willing to accept between a 4% and 7% hike in basic pay to cover the weekend pay issue

Want to know more?

'Flawed' contract

Junior doctor leaders have promised to fight on after the government in England announced it would impose a new contract on the profession.

It comes after junior doctors staged a second 24-hour strike over the controversial new contract.

The British Medical Association's junior doctor leader Dr Johann Malawana said it was "flawed" and they had put forward a "fair and affordable" alternative.

Speaking in the House of Commons on Thursday, Mr Hunt said the contract was an "important step" in improving care at weekends.

He said the government's door had "remained open for three years" but the BMA had proved "unwilling" to show flexibility and compromise.

How will imposition work?

Image source, Reuters

In theory, it is pretty easy.

Junior doctors rotate through jobs quickly so within a year of the new contract coming into force in August the majority of the 55,000-strong workforce would be on it. All new doctors graduating from medical school will also go on it.

There are some who are on longer contracts, who will not go on it straight away, while others will have completed their training before it affects them. This group represents about a fifth of the workforce, it is thought.

Between now and the summer hospitals will have to review their rotas and staffing requirements, before sending out offers to junior doctors in May.

But the big unknown is how the British Medical Association and medical workforce will react.

While in the long-term doctors have warned of "brain-drain" with medics heading abroad, to other parts of the UK or into other sectors, such as the drugs industry. This, it seems, is uncharted territory - imposing a whole new contract on doctors like this has never been done before it is believed.