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Hunt set to impose contract on junior doctors after BMA rejects ‘final offer’

Health secretary Jeremy Hunt is set to impose a contract on junior doctors after failing to offer the BMA adequate concessions on weekend working. 

After yesterday’s strike, Salford Trust chief executive Sir David Dalton – who was drafted in to broker a deal – wrote to Mr Hunt to say: ’Everyone’s first preference has always been for a negotiated outcome. Unfortunately this no longer seems possible.’

It follows a ‘final offer’ made to the BMA, which agreed to pay premium rates to all junior doctors who worked 1 in 4 weekends or more for all Saturdays they worked.

But the BMA rejected the offer, stating that it had made its line clear, and wanted to redistribute much of the 11% increase to basic pay to more adequately remunerate Saturday working.

As a result, it looks likely that a contract will be imposed on junior doctors.

Sir David’s letter said: ’Following consultation with chief executives and other leaders in the service, it is clear that the NHS needs certainty on this contract and that a continuation of a dispute, with a stalemate and without any clear ending, would be harmful to service continuity, with adverse consequences to patients.

’On this basis I therefore advise the Government to do whatever it deems necessary to end uncertainty for the service and to make sure that a new contract is in place which is as close as possible to the final position put forward to the BMA yesterday.’ 

Mr Hunt yesterday said he ’hopes it doesn’t get to’ a potential contract imposition on junior doctors, but warned that there ‘has to be a resolution’ to the row over whether Saturday working should be classed as unsocial hours.

Speaking to the BBC, Mr Hunt claimed that the turnout to today’s strike was lower than the 12 January strike with 43% of junior doctors reporting for shift compared with 39% last time – although both figures including juniors working on emergency care who would never be part of the strike.

Currently weekends and hours worked between 7pm and 7am attract an ’unsocial’ hours payment, which Mr Hunt says disincentivises trusts from rotating senior clinicians.

But the BMA have raised concerns about protections to prevent junior doctors being overworked, and say the proposals could amount to a pay cut for doctors working the longest hours.

The industrial action was sparked when the Department of Health said they would impose their junior doctors contract after negotiations broke down last year.

But Mr Hunt failed to rule out another potential imposition of the contract. When asked if the Government would impose a contract, Mr Hunt said: ‘I really hope it doesn’t get to that, in the end we do have to have resolution to this – as a lot of people inside the NHS are now beginning to say. 

He added: ’[The DH proposals] will mean we can offer better care for patients, and surely that’s something we should be talking about. Not taking this very damaging industrial action.’

The Independent this week reported that Mr Hunt had personally vetoed a cost-neutral settlement on Saturday pay agreed by the BMA and NHS Employers.

When this was put to him, Mr Hunt said: ‘There’s been no rejection of any proposals or plans that would deal with this weekend effect that is of such concern to patients and the public.’

More than half of the 26,000 junior doctors who would typically be working yesterday are participating in industrial action.

Senior doctors have been covering rotas for their junior colleagues and NHS England reports that 72% of the total hospital trust workforce including doctors and consultants are in work.

It estimates that almost 3,000 procedures have been cancelled as a result of the industrial action – 1,150 inpatient and 1,734 day cases.

Dr Anne Rainsberry, national incident director for NHS England, said: ‘It is deeply regrettable that this strike has disrupted care for thousands of patients at the most pressurised time of year and we apologise to anyone affected. It’s a tough day but the NHS is pulling out all the stops, with senior doctors and nurses often stepping in to provide cover.’

Read how the end of the negotiations unfolded here