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All the reaction to the junior doctor contract imposition

Dr Johann Malawana, BMA Junior Doctors Committee chair

The decision to impose a contract is a sign of total failure on the Government’s part. Instead of working with the BMA to reach an agreement that is in the best interests of patients, junior doctors and the NHS as a whole the Government has walked away, rejecting a fair and affordable offer put forward by the BMA. Instead it wants to impose a flawed contract on a generation of junior doctors who have lost all trust in the Health Secretary.

Junior doctors already work around the clock, seven days a week and they do so under their existing contract. If the Government want more seven-day services then, quite simply, it needs more doctors, nurses and diagnostic staff, and the extra investment needed to deliver it. Rather than addressing these issues, the Health Secretary is ploughing ahead with proposals that are fundamentally unfair.

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.

It is notable that the rest of the UK has chosen a different, constructive path on junior doctors’ contracts with only the Health Secretary in England choosing imposition over agreement.

The Government’s shambolic handling of this process from start to finish has totally alienated a generation of junior doctors – the hospital doctors and GPs of the future, and there is a real risk that some will vote with their feet.

Our message to the Government is clear: 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.


Dr Maureen Baker, chair of the RCGP

We are shocked and dismayed at the Government’s decision to impose a contract on our dedicated and committed junior doctors.

Imposing a deal on junior doctors is wrong-headed, will inevitably damage morale across the NHS – and may damage patient care.

We had hoped that ministers would ensure an agreement could be reached in a professional and amicable way, so that the two sides could bridge their differences in a constructive manner.

We would ask whether the Government has carried out a structured and robust risk assessment, along with measures to evaluate the impact of their decision on patient safety.

If it has, we would urge ministers to publish the full results forthwith.

The last few months have been incredibly tough for junior doctors, and have led to the lowest morale across our profession in a generation. Imposing a contract, in its current form, is asking junior doctors – the future of our NHS – to work under conditions in which they neither feel valued nor able to deliver safe patient care.

The imposition of the contract will undoubtedly impair our efforts to recruit thousands of additional doctors into the NHS over the coming years in order to keep the health service sustainable – as many medical students are seeing this turmoil, not liking what they see, and turning away from medicine in the UK altogether.

Doctors choose medicine because they genuinely want to care for their patients and contribute to the health service. It is evident that junior doctors do not think the proposed contract will allow them to do this.

 The College will continue to support our junior doctors.


Heidi Alexander, shadow health secretary

Jeremy Hunt has turned these contract negotiations into a symbolic fight for delivery of seven day services, has led to a situation which has led to a situation unprecedented in my lifetime.

How can it possibly be right for us to be training junior doctors and the consultants of tomorrow, only to be exporting them en masse to the southern hemisphere? The health secretary needs to stop behaving like a recruiting agent for Australian hospitals, and start acting like the secretary of state for our NHS.

What we have heard from the secretary of state today could amount to the biggest gamble with patient safety this house has ever seen. He has failed to win the trust of the very people who keep our hospitals running, and he has failed to convince the public of his grounds for change.

Imposing a contract is a sign of failure, it’s about time the secretary of state realised that.


Katherine Murphy, chief executive, Patients Association

The Government’s decision to impose contract terms on junior doctors is unacceptable.

The health and social care system depends entirely on the great people who work in services across the community for the benefit of patients.

It is clear that many of these vital people are seriously unhappy and have very low morale.

There is a big shortage of GPs and many will leave the professional shortly. Alongside this, Trusts have been unable to recruit the nurses and other health professionals they need, and hospital doctors are united in opposition to the imposed contract changes.

It is clear that the acrimonious dispute over the junior doctors’ contract is unnecessary and damaging.

Doctors have a very real concern that the imposed terms will stretch the existing resource too thinly and will threaten the quality of patient care, while driving the next generation away from joining the profession.

To deliver an expanded seven day working week a sober and comprehensive review of proper staffing levels is needed, not selective soundbites.

The Patients Association calls for an independent review to propose a viable way forward that will improve services to patients while being fair to all doctors.

This is all against a background of an NHS which has missed a whole range of service targets for months and appears unable to offer a sustainable service in summer or winter, while at the same time spending has exceeded the current budgets.

Concurrently local authority social care spending has been cut significantly and this is adding to the pressures on hospitals and harming patients.

Services are failing large numbers of the public and through our helpline we hear daily about the impact on individual patients and carers.


Josie Irwin, head of employment relations for the Royal College of Nursing

The imposition of the junior doctor contract sets a worrying precedent. It reflects poorly on the Government’s attitude towards industrial relations and staff morale in the NHS.

Like junior doctors, most nurses are already working seven days a week, and they agree that patient care on Saturday and Sunday should be the same as on a Tuesday.

Nurses’ pay has fallen 14% in real terms between 2010 and 2015 and as a result many rely on their unsocial hours payments to make ends meet.

Our members are increasingly anxious that there will now be moves to take their unsocial hours payments away as well, and concerned that this will have a detrimental impact on patient care.


Danny Mortimer, chief executive of NHS Employers

I am saddened and hugely frustrated that an agreed deal has not been reached with the BMA. The NHS needs certainty on this contract and a continuation of a dispute would be harmful to patients, and the NHS. Over the last 4 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.


Dr Johnny Marshall, director of policy, NHS Confederation

It is disappointing that the contract negotiations have not reached an agreed solution. An engaged clinical workforce is critical for the NHS to deliver the best care to patients.

Following today’s announcement it is important that non-pay related concerns raised by junior doctors particularly around training and morale are addressed. We therefore welcome Professor Dame Sue Bailey and the Academy of Medical Royal College’s review into this area.

We need to work closely with our clinical community to ensure we attract and retain the best staff in the NHS.


Colenzo Jarrett-Thorpe, Unite national officer for health

We are very concerned that imposition of a national contract on 45,000 employees is disproportionate and will lead to further demoralisation which could be irreparable for a generation.

Many junior doctors are already looking at jobs abroad or at alternative jobs in academia or the private sector.

The losers are certainly the doctors, but more importantly, patients. Doctors and other NHS staff repeatedly ‘go the extra mile’ for patients by working well beyond their contracted hours of work. This could become a thing of the past due to the high-handed way they have been treated.

Jeremy Hunt has adopted a very macho posture and thinks he is re-running the Tory onslaught against the miners in the 1980s – junior doctors are not ‘the enemy within’ and the secretary of state should not use this portrayal.

However, this won’t wash as the vast majority of the public are behind the junior doctors as they know the wonderful care they give in the over-stretched NHS.

Junior doctors are already working seven days-a-week. The fundamental issue here is that Hunt won’t provide sufficient new funding to ensure a properly resourced seven days-a-week service.

He is trying to do this on the cheap at the expense of patient safety, and the terms and conditions of the junior doctors.

Unite calls on Hunt to seriously rethink the imposition and get back around the table with the British Medical Association (BMA). In the meantime, we will offer all the support of the union to the junior doctors, since an attack on them is an attack on all NHS workers.

 Imposition of this contract has been branded by many HR directors as ‘the nuclear option’. Improving the service to patients is the last thing it will achieve.”