Junior doctors: Contract imposition is a black day for the NHS

The damage done by health secretary Jeremy Hunt's decision to impose a new contract on junior doctors could take a generation to reverse, says BMA deputy chairman Dr Kailash Chand. Writing in a personal capacity for GPonline, he says it was one of the saddest days in his 30-year NHS career.

Jeremy Hunt has displaced Andrew Lansley as the worst health secretary I've seen, with his unilateral decision to impose an unfair and unjust junior doctor contract. In my work in the NHS for over 30 years, I have seen some tragic, sad, heartbreaking things as a physician, but yesterday was one of the saddest days of my career.

This is clearly an ideologically driven, dictatorial, high-handed act, rather than an attempt, to come to a reasonable solution for all junior doctors. If the government succeeds with its bullying approach of imposing a contract on junior doctors that has been roundly rejected by the profession it may well seek to do the same for consultants, GPs and nurses. The imposition of a national contract on 53,000 junior doctors will lead to further demoralisation of the profession.

Junior doctor strikes

Does Jeremy Hunt realise that this punitive contract will result in our best juniors being creamed off by lucrative contracts abroad and furthermore, that it will put many bright youngsters off studying medicine? The inevitable effect of this is to put healthcare provision and patient safety throughout England at risk, with the daunting prospect that it could take a generation to reverse the damage.

We are already in the middle of a recruitment crisis. If even a tiny proportion of England’s 53,000-strong medical workforce leave, it will spell chaos for the NHS.

Recent official NHS figures, covering the arrival of the latest round of new junior doctors, show that acute medicine was still short of the new recruits it needed, as were renal medicine, elderly medicine, psychiatry and general practice. The irony is that by driving UK trainees abroad or to locum agencies, the DH ends up picking up a far bigger bill than it would have had by simply treating them with fairness.

Jeremy Hunt’s tactics have throughout seemed aggressive, self-defeatingly crude and mostly alienating. The health secretary, in my view, is solely to blame for this confrontation with junior doctors.

As geriatrics and acute general medicine consultant David Oliver pointed out in the BMJ recently, Mr Hunt falsely attacked doctors’ 'nine to five culture' and a 'lost sense of vocation'. He had to be pushed into going to the arbitration service ACAS after initially rejecting a BMA offer.

Junior doctor contract

He tried to bypass the BMA by writing directly to junior doctors, and reportedly vetoed a deal to end the junior doctor dispute which was supported by the NHS’s own negotiators.

The way he used statistics to worry patients into backing his party's seven-day NHS plans has been widely criticised, and NHS chief executives are backing away from his claim that they supported the imposition of the junior doctor contract.

The government has had a clear agenda to force junior doctors into working more hours for less pay, to help deliver its ill-thought-out, seven-day NHS pledge, in the face of a £22bn NHS efficiency savings programme, essentially imposing a seven-day service with five-day funding.

Mr Hunt won’t be forgiven for breaking the bond of trust with the medical profession. Imposing the contract on junior doctors surely flies in face of evidence that the staff engagement and wellbeing on which the NHS depends is crumbling. The BMA’s 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.

Today’s junior doctors are the consultants and GPs of tomorrow. They have been trained in some of the best institutions in the world at huge cost to the taxpayer. It is time for the profession and public to get behind them for their just fight or risk them being lost to the NHS forever.

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