Original letter from Dr Gee and colleagues

03 April 2016

Dear Mr Hopson,

We are writing to you to express our concerns regarding the junior doctors contract. The escalation of strike action is something nobody wants, is not in the best interest of patients and does not help trusts provide the care they would want to.

However, the vast majority of junior doctors, consultants, Medical Royal Colleges and the public support the position of the BMA and that the current planned contract is not safe for patients and not fair for doctors. It is frustrating that you have stated that the escalation of strike action makes negotiations impossible because it was clear before the announcement of escalation that the government were not willing to listen.

Junior doctors have been speaking out in large numbers at their concerns regarding the contract and how this relates to the weekend effect and the still as yet undefined ‘7 days NHS’. There is no evidence that having more junior doctors at the weekend will improve care and the government have not investigated this. There has been no research into how many extra doctors are needed to staff a 7 days NHS or how much this will cost. The Francis report stated that any major change in care provision needed to be risk and impact assessed and the government have not done this.

That being said a properly funded and staffed 7 day NHS could be great, could improve efficiency and possibly patient care and is something most doctors support the idea of. However, there is already a huge recruitment crisis in the NHS. Hospital trusts are spending increasing amounts on locum staff because there aren’t enough doctors already. The contract will stretch staff further, will worsen the recruitment crisis and cost money through the increased need for agency staff. The contract discriminates against women and will put off a large number of women from applying to medicine or continuing with their training. The further stretching of staff in post and the rota gaps this will create during the week will then put patients at risk and this is something no one wants to see.

Staff, not just junior doctors but porters, health care assistants, nurses, radiographers from across the country have been writing to their CEOs in large numbers (8,000 signatures on over 50 letters) asking for trusts to speak out against imposition. While foundation trusts could choose to not impose the contract fines from Health Education England have been suggested and further fines is not what the NHS needs.

However, if hospital trusts across this country could, in a unified voice, ask for the government to drop the imposition of the junior doctor contract and return to negotiations under a moratorium then this could halt the current planned strike action and see a contract developed that would retain staff, would train the brightest and best in this country, fill the rota gaps which keep costing trusts millions and could lead to an NHS where there are enough highly skilled doctors to provide the 7-day NHS the government have promised.

We request that you consider asking for the government to stop the imposition of the junior doctor contract and to appeal for further negotiations to occur to bring an end to this dispute.

We look forward to your reply,

See here for full list of junior doctor signatories

Response from Chris Hopson, chief executive, NHS Providers

11 April 2016

Dear Dr Gee

Thank you for your letter of 3 April 2016 regarding the new junior doctor contract, signed by several hundred of your fellow junior doctors.

As the membership organisation and trade association for NHS foundation trusts and trusts, we appreciate how angry many junior doctors feel about the current situation. Our strong preference was for a negotiated settlement to the dispute and it is a source of disappointment to us that this has not been achieved.

Following the end of negotiations between Sir David Dalton and the BMA, it was for the Secretary of State to decide how to proceed. As you know, he has now taken the decision that there will be a phased introduction of a new contract from August 2016 and the final details of the contract were published last week by NHS Employers.

We are aware that there have been suggestions that individual foundation trusts may choose not to introduce the new contract. However, as has been covered in the media, trusts have been advised by Health Education England (HEE) that a situation where local employers effectively offer different terms will not be acceptable. In particular, implementation of the national contract will be a key criterion for HEE in making its decisions on future investment in training posts.

In light of all this, our members will now be engaging with junior doctors locally on what the final contract means for them, including rota design and the implementation timetable. We would encourage you and your fellow junior doctors to participate in this process. We would also encourage you to engage with the independent review of wider non contractual issues affecting junior doctors led by Professor Dame Sue Bailey.

Yours sincerely

Chris Hopson