GP trainee challenges MP over imposed junior doctor contract

A Midlands GP trainee has written to her MP ahead of this week's junior doctor strikes to call on health secretary Jeremy Hunt to pledge full funding for seven-day NHS services and drop plans to impose the junior doctor contract.

Dr Sarah Hamer (second from right) during Nottingham junior doctor protests
Dr Sarah Hamer (second from right) during Nottingham junior doctor protests

Alfreton, Derbyshire GP trainee Dr Sarah Hamer, whose husband is also a junior doctor, wrote to her MP Nigel Mills (Conservative, Amber Valley) inviting him to join junior doctors on the picket lines this week.

The letter - the third Dr Hamer has sent to her MP over the junior doctor contract dispute - warns that extending the NHS across seven days without proper funding will trigger its 'death' as a free-at-the-point-of-delivery service.

The letter comes as junior doctors prepare to take part on Wednesday in the first of three 48-hour strikes in protest at health secretary Jeremy Hunt's decision to impose a new contract.

GP leaders warned last week of the extent of the crisis facing general practice, with one in 10 practices now financially unsustainable. GPonline also exclusively revealed that in parts of the UK more than 20% of practices have been officially declared 'vulnerable'.

Read Dr Hamer's letter in full:

Dear Mr Mills,

This is my third letter to you and we met [recently] to discuss the junior doctor contract dispute. The new junior doctor contract that Mr Hunt has chosen to impose from August, should by now be causing you some serious concern.

We are told that this new contract has been imposed in order to provide more seven-day services (which still remain undefined), but it is interesting that contract negotiations actually started in October 2013, long before there was talk of a 'truly seven-day NHS'. The NHS is already seven days a week for emergencies. Mr Hunt has publicly stated that imposition was required in order to send a message to the public that the government will not be held to ransom.

Five-day elective services are already cracking under the strain. Between my husband and myself, more than half of the departments we have worked in our careers to date, had rota gaps. We have recently heard in the press how trusts are failing to meet the 18-week treatment target for the first time; and now an internationally renowned hospital has had to ask GP practices to stop referring cardiology patients into its outpatient services because it cannot cope.

To extend already crumbling five-day services across seven days without an increase in staff and resources will destroy what little staff morale remains and ultimately bring about the death of the NHS as a free at the point of delivery service available to all.

Junior doctors are already making the decision not to work in this country because of the unsafe and demoralising conditions. This can only get worse under the imposed contract. Not only will our working hours increase out of necessity, the safeguards that currently exist to protect us against this will be stripped away under the new contract.

I know of at least four doctors from my own student cohort of 90 who now live and work as doctors on a permanent basis in the Southern Hemisphere. They have all encouraged me to do the same. I know of at least the same number who have left medicine completely. Our country cannot afford to lose talent at this rate.

Whilst I welcome an inquiry into doctor morale, I fear that in the context of contract imposition it is meaningless, not least because its remit specifically excludes 'terms and conditions of employment'; I wonder whether Mr Hunt is hoping to cheer us all up by suggesting the hospital vending machines offer a new range of sandwich fillings for when we are feeling a little weary at 3am?

Please would you petition Mr Hunt to;
1) pledge seven-day funding for seven-day services.
2) remove the imposition so mutually agreed terms can be reached.
3) commission a meaningful review into morale, or save us all the bother and cancel it completely.
4) fully risk assess and trial his plans before implementation, as recommended in the Francis report.

5) simply admit to the public that the NHS is proving a bit of a nuisance to the government and that they'd like us to move to a private healthcare system. Quite frankly, I am sick of all the lies I am expected to swallow and the British public, and your constituents, deserve better.

I once again copy this letter to the local newspaper as everybody needs to understand that the future of their health service is under serious threat from a health secretary whose desire to save face outweighs his ability to prioritise the health of the nation, and who incidentally, allegedly authored a chapter on how to privatise healthcare (Direct Democracy; an agenda for a new model party).

You would be more than welcome to come and show your support for your NHS by joining us on the Royal Derby Hospital picket lines next Wednesday and Thursday.  Alternatively, please attend one of the life support teaching sessions or blood donation drive that local doctors have arranged so they can continue to contribute to society during the strike days.

As Professor Berwick, patient safety expert and author of the Cameron-commissioned Berwick Report, has wisely observed in the context of this dispute 'you cannot achieve excellence in combat with your future workforce, it makes no sense at all'.  Listening to junior doctors' concerns and acting on them could be the solution to a health service on the brink; we are, after all, your future consultants and GPs - if we aren't driven out that is.

Sarah Hamer

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