NHS bosses cited in letter 'don't back imposition of junior doctor contracts'


Several NHS chief executives who apparently put their names to a key letter used by Jeremy Hunt to justify imposing new contracts on junior doctors have withdrawn their support for such a plan.

The names of 20 health trust bosses in England were attached to a letter advising the Government to do "whatever it deems necessary" to break the deadlock with young medics.

But now at least nine say they never supported the idea of forcing junior doctors to accept new contracts and did not back the Health Secretary's move.

A number say they support the Government's contract offer but do not back doctors having to accept it.

In his letter to Mr Hunt on Wednesday, Sir David Dalton, the chief executive of Salford Royal NHS Foundation Trust who was brought in to broker a deal, wrote: "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.

"I can confirm that this position is supported by both the NHS Confederation and NHS Providers, together with support from chief executives across the country, and their names are supplied."

But it is unclear whether the chief executives saw the letter's text before it was sent to Mr Hunt, and many have now distanced themselves from imposed contracts.

Sir Andrew Cash, head of Sheffield Teaching Hospitals NHS Foundation Trust (FT), said: "I support the improved offer made this week as fair and reasonable, but I do not support imposition", while Andrew Foster, of Wrightington, Wigan and Leigh NHS FT, said: "I have not supported contract imposition. I have supported the view that the offer made is reasonable."

Claire Murdoch, head of the Central and North West London NHS FT, said she was not even aware that her name was on the letter until it was published, and immediately asked for it to be removed.

In a statement to the Commons, Mr Hunt said the BMA had proved "unwilling" to show flexibility and compromise.

He said that with the backing of major NHS groups including NHS Employers and NHS England, Sir David "has asked me to end the uncertainty for the service by proceeding with the introduction of a new contract that he and his colleagues consider both safer for patients and reasonable for junior doctors".

"I have therefore today decided to do that."

But shadow health secretary Heidi Alexander later raised a point of order in the House of Commons to suggest that Mr Hunt may have "inadvertently misled" MPs when he made his announcement, because of the withdrawal of support by chief executives.

Junior doctors have pledged to fight on since the announcement and the British Medical Association (BMA) said it would "consider all options", raising the possibility of further strikes in the battle over pay and conditions.

Royal colleges and unions have expressed dismay at the Health Secretary's move, which comes after weeks of deadlock between the BMA, Government officials and NHS Employers.

Dr Johann Malawana, the BMA's junior doctor committee chairman, said: "The decision to impose a contract is a sign of total failure on the Government's part."

He accused Mr Hunt of "ploughing ahead with proposals that are fundamentally unfair". The BMA has already staged two strikes.

He said: "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."

Strikes and legal actions are possibilities, while some junior doctors may refuse to sign new contracts which are due to be implemented from August.

The major sticking point has been over weekend pay and whether Saturdays should attract extra "unsocial" payments.

Currently, 7pm to 7am Monday to Friday and the whole of Saturday and Sunday attract a premium rate of pay for junior doctors.

But the Government wants the Saturday day shift to be paid at a normal rate in return for a hike in basic pay.

The BMA has rejected this and has urged Mr Hunt to accept its proposal to reduce the 11% rise in basic pay offered by ministers and instead have better premium rates on Saturdays.

Mr Hunt said the new contract will mean an increase in basic salary of 13.5% and that three quarters of doctors will see their take-home pay increase.

No doctor working contracted hours would see a pay cut while too many night shifts and long shifts will also be limited.

Under the new contract, 7am to 5pm on Saturdays will be regarded as a normal working day.

Doctors working one in four or more Saturdays will receive a pay premium of 30%.

Mr Hunt said: "While I understand that this process has generated considerable dismay among junior doctors, I believe that the new contract we are introducing - shaped by David Dalton and with over 90% of measures agreed by the BMA - is one that, in time, can command the confidence of both the workforce and their employers."

Ms Alexander told Mr Hunt: "Imposing a contract is a sign of failure, it's about time you realised that."

BMA council chairman Mark Porter said the move would be seen as "threatening and dictatorial" and warned nurses and other clinical staff to prepare for similar treatment, while Labour leader Jeremy Corbyn said imposing contracts was "provocative and damaging."