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Hunt's approach to junior doctor contract has been 'Stalinistic', says former leader

Health secretary Jeremy Hunt's approach to the new junior doctor contract negotiations was 'Stalinistic', former BMA Junior Doctor Committee chair Dr Johann Malawana has said. 

Mr Hunt had said last year in a speech that the pressure health secretaries come under can lead them to 'discover their inner Stalin' but the Government's approach to measuring quality meant 'a health secretary can relax a little'.

But Dr Malawana, who led junior doctors in a revolt against an imposed new contract during the course of the past year, posted an open letter on Facebook saying these comments were a 'kick in the teeth' considering what followed, culminating in a contract imposition this month.

It is Dr Malawana's first major criticism of the health secretary since he stepped down from his post earlier this month after junior doctors rejected the contract that was agreed between the BMA negotiators and the Government. 

Mr Hunt later announced he would impose the contract regardless.

Dr Malawana's strongly worded letter states: 'Perhaps the biggest kick in our collective teeth was how you described being a more relaxed health secretary that was not going to take a Stalinistic approach.

'Then being seen more like Stalin than any other politician by our generation of doctors, you decided to go far beyond anything we can have imagined.'

Dr Malawana further suggests the media had been geared against junior doctors taking part in the protests.

He tells Mr Hunt: '[You] attacked us not only collectively, but had your friends in the media come after doctors individually if they deemed to speak out against you. You had your staff brief journalists against doctors as if they were the enemy of the state.

'The use of the collective force of Government and the media against a young generation of doctors simply standing up for themselves to protect themselves from your attacks, was beyond appalling.

'Stalin would have been proud.'

Dr Malawana also writes in the letter that the Government has ‘starved’ the NHS of funding while blaming doctors for ‘avoidable deaths’, when the 'fault... lies at the door of Richmond House and the Treasury' – with Mr Hunt 'helping to dismantle and destroy' the NHS.

The letter says: 'You wonder why mistakes happen. Look in the mirror and ask yourself what you can do to stop them.'

Commenting on the letter, Dr Malawana told Pulse: 'The "Stalinistic" comment was taken as a direct quote from his King's Fund speech in July last year... I basically just went through the speech and covered most of the points he covered a year later in light of events.'

The Department of Health declined to comment.

The letter, published by Dr Malawana via Facebook on 16 July, comes after Mr Hunt was retained in the health secretary role by new Prime Minister Theresa May on Thursday last week. Following the appointment, Mr Hunt said he was 'thrilled to be back in the best job in Government'.

Mr Hunt's speech at the King's Fund last July – when he set out his 25-year vision for the NHS – was published in full on Pulse the time. He said at the event that he had 'yet to meet' any doctor who didn't support the Government's seven-day NHS plans.

Readers' comments (13)

  • Full text please?

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  • Dear Anonymous - the link to Dr Malawana's letter to Mr Hunt -

    https://www.facebook.com/johann.malawana/posts/10154362320744772

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  • From Junior Doctors Contract Facebook Forum:


    The Right Honourable Jeremy Hunt
    Secretary of State for Health
    Richmond House
    London

    Dear Jeremy

    A year ago you delivered, probably the most pivotal speech in your political career. You wanted to portray yourself as a great reforming politician. It was interesting how you started your speech, highlighting the funding gap that had opened up, a funding gap caused by the decisions this government has made to starve the NHS of funding. You triumphantly talked about the £8billion in funding your government committed, however you didn’t mention that that £8billion was because you refused to fund the other £22billion the NHS needed. The prime minister you were loyal to then, said and did anything to grasp onto power, including sacrificing the futures of the next generation with a gamble on an EU referendum that only gave him one further year with the power you all craved. That same Prime Minister made it clear that the NHS had to “get real” in how much your government would put into an NHS you didn’t really see the value off. An NHS you tried to block the celebration off in 2012 at the Olympics. Perhaps that was the real indicator of the things to come.

    Trying to claim credit in your speech for your party for the formation of the NHS, that you are helping to dismantle and destroy was probably quite a kick in the teeth for the beginning of a speech, but that wasn’t the last boot you were going to put in. You described the job of a Secretary of State for Health as dealing with crises, it’s a pity you didn’t think about the crisis you were about to create with the rhetoric you were about to deliver. You talked about Mid Staffs betraying what the NHS stood for, betraying the frontline staff. But you have continuously decided to beat the frontline NHS staff up again and again under the auspices of reformation. Why is it you think it is ok that the NHS is starved of funding to the point where only 6.6% of GDP is spent and is creaking under the pressures of a population in desperate need of healthcare. Your government has distributed ever more money to your core supporters. Your government have sacrificed the next generation to garner the votes of the last. Your government have pandered to racists and bigots in order to grasp power and turn the population against one another. Your government has rewarded greed and avarice, making sure that you can justify starving the resource from frontline services so that now the NHS is so underfunded, you’re driving away the staff that catch the sick when they fall, look after the dying in their last days, look after the most vulnerable in society. What did you do, you blamed those very staff, you attacked them and belittled them. You described how you would like to devolve power, yet the hypocrisy of continually forcing the NHS to do something it simply did not want to do, to impose on the next generation of young staff. To force them, not work with them. To attack them, not care for them. To blame them for your failures and that of your colleagues, and portray them as the problem. To tell them to “get real” as some badge to be proud off when you portray yourself as standing up to a trade union you accused of being out of touch. Yet a trade union if anything that has always been conservative and tried its best to actually highlight to you again and again what you are doing to the frontline staff you claim to cherish, and yet every single act seems to demonstrate your total lack of care for.

    Jeremy, you talk about avoidable deaths, never events. Like you are somehow above these things. Like the staff that suffer the emotional turmoil and consequences of having to live through them are the ones to blame. Why does this happen. The fault does not lie with a young nurse trying desperately to look after a ward of patients, or a surgeon desperately trying to get through another stuffed list with a manager breathing down their neck to hit a target. The fault once again lies at the door of Richmond House and the Treasury. You starve the system of resource and you force corners to be cut. You then put ever more pressure on the system to deliver. You wonder why mistakes happen. Look in the mirror and ask yourself what you can do to stop them.

    You talked back then about intelligent transparency. What did you do about trainee doctors that try and reflect on their practice and then have those reflections used against them in disciplinary situations. What kind of no blame culture encourages a doctor to reflect on their mistakes and then use those reflections to attack them and threaten their career?

    Perhaps the biggest kick in our collective teeth was how you described being a more relaxed health secretary that was not going to take a stalinistic approach. Then being seen more like Stalin than any other politician by our generation of doctors, you decided to go far beyond anything we can have imagined. Attacked us not only collectively, but had your friends in the media come after doctors individually if they deemed to speak out against you. You had your staff brief journalists against doctors as if they were the enemy of the state. The use of the collective force of government and the media against a young generation of doctors simply standing up for themselves to protect themselves from your attacks, was beyond appalling. Stalin would have been proud.

    This speech was a great insight into how you run your department. You announced a series of jobs for the boys. What we learnt later in the year was that those boys were then wheeled out to question the professionalism of their junior colleagues. We are all glad that this is the medical leadership you envisage. You have single handedly taught us what kind of medical leadership we never ever want to see in our profession, in our NHS, frankly in our country. Luckily you continue to ensure that those most loyal to you are rewarded with lucrative jobs running organisations in medicine and healthcare that can ensure the profession is kept to heel. We are all glad to hear the GMC will now be fully integrated into Richmond House. Perhaps you would kindly ask the first efficiency saving to be getting rid of all the extra buildings and simply just move the offices into Richmond House, at least then we maybe able to save some money on our fees.

    A year ago you tried to drive a wedge through the profession and its BMA. You told us to “get real’ and we are not remotely in touch with our members. Lets be clear. Our members absolutely cannot stand what you are doing to the NHS. They cannot stand the idea of agreeing to anything you will laud over them as a victory. They hate any idea that they will be complicit with you and with your government. There is little the BMA or any organisation can do to get passed this absolute truth.

    So dear Jeremy, you managed to cling to the keys of Richmond House, despite Dave not managing to cling to the keys of no10. He sacrificed this country for one more year of power. Now that you are back hiding away on the fourth floor of Richmond house, what are you going to sacrifice? Please don’t let it be even more NHS staff. Please don’t let it be what little goodwill we had left, please don’t let it be anything but your pride. Swallow it and stop antagonising every doctor, nurse, midwife, porter, cleaner, secretary and a million other workers in the NHS that work their socks of for the population of this country. By the way, many of them aren’t British, just like me they were born elsewhere. And no, we aren’t interested in benefits.

    Best wishes

    Just another foreign doctor

    The Speech:

    http://www.kingsfund.org.uk/…/jeremy-hunt-sets-out-his-25-y…

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  • Got to admire the consistancy though.

    Takes a real class act to manage to antagonise/alienate/vilify the entire NHS workforce.

    In cycling terms "chapeau"

    PS pensions beware??

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  • This comment has been moderated.

  • Mr Mephisto

    Mr Hunts pogrom against the junior doctors has resulted in major recruitment and retention issues. His actions will have in no way improved patient safety or patient care and will have had exactly the opposite effect. The chickens will come home to roost in August when hospital trusts across the country wake up to the fact that they don’t have enough junior doctors to cover their daytime duties never mind night-time, weekend, or holiday periods. The remaining junior doctors will buckle under unmanageable workload in under staffed rotas and the wheels will well and truly come off.

    Jeremy Hunts political legacy will not be the premiership that he so much desired but as the man that broke the NHS

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  • I cam only describe hunt as a liar

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  • BEAUTIFUL letter Johann !!! I agree with every word so eloquently put ! BUT, what happened to the intended judicial review from Crown Justice ??? Surely our sincerely given donations were not just lining the pockets of opportunistic lawyers ?

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  • John Glasspool

    Words- not action. Hunt won't give a tinker's cuss.

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  • Vinci Ho

    At least , Lord Vader was honourable enough(one might say he had no f*****g choice) to metaphorically take his own (political) life in front of the public promptly and immediately like a Japanese samurai . Ozzy really had no leg to stand in the cabinet . Our 'wrong dishonourable' Agent switched right away to openly support a then Home Secretary whom he never thought could be the PM a few weeks ago. So much loyalty to your besie mate but he loves the job,wow! You wonder what is going through the deep consciousness of Auntie M : a snake is a snake.......

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  • A foundation doctor who is leaving on sabbatical, told me today that 75% of his colleagues are not progressing into training posts because of the state of the NHS. August will be interesting

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