Oral statement to Parliament

Statement on junior doctors' contract

Health Secretary updates Parliament on the latest on the junior doctors' contract negotiations.

With permission Mr Speaker I would like to update the House on the junior doctors strike.

Earlier this month, the union representing doctors, the BMA, balloted for industrial action over contract reform. Because the first strike is tomorrow I wish to update the House on contingency plans being made.

Following last week’s spending review, no one can be in any doubt about this government’s commitment to the NHS, but additional resources have to be matched with even safer services for patients. That is why, on the back of mounting academic evidence that mortality rates are higher at weekends than in the week, we made a manifesto commitment to deliver truly 7-day hospital services for urgent and emergency care.

However, it is important to note that 7-day services are not just about junior doctor contract reform. The Academy of Medical Royal Colleges noted that “the weekend effect is very likely attributable to deficiencies in care processes linked to the absence of skilled and empowered senior staff in a system which is not configured to provide full diagnostic and support services 7 days a week.” So our plans will support the many junior doctors who already work weekends with better consultant cover at weekends, 7-day diagnostics and other support services, and the ability to discharge at weekends into other parts of the NHS and the social care system.

But reforming both the consultants’ and junior doctor contracts is a key part of the mix because the current contracts have the unintended consequence of making it too hard for hospitals to roster urgent and emergency care evenly across 7 days. Our plans are deliberately intended to be good for doctors – they will see more generous rates for weekend work than those offered to police officers, fire officers and pilots. They protect pay for all junior doctors working within their legal, contracted hours, compensating for a reduction in anti-social hours with a basic pay rise averaging 11%. They reduce the maximum hours a doctor can work in any one week from 91 to 72 and stop altogether the practice of asking doctors to work 5 nights in a row. Most of all they will improve the experience of doctors working over the weekend by making it easier for them to deliver the care they would like to be able to deliver to their patients.

Our preference has always been a negotiated solution but, as the house knows, the BMA have refused to enter negotiations since June. However, last week I agreed for officials to meet them under the auspices of the ACAS conciliation service. I am pleased to report to the house that, after working through the weekend, discussions led to a potential agreement early this afternoon between the BMA leadership and the government. This agreement would allow a time-limited period during which negotiations can take place, and during which the BMA agrees to suspend strike action and the government agrees not to proceed unilaterally with implementing a new contract. This agreement is now sitting with the BMA junior doctors’ executive committee, who will decide later today if they are able to support it.

However, it is important for the house to know that right now strikes are still planned to start at 8am, so I will now turn to the contingency planning we have undertaken. The government’s first responsibility is to keep its citizens safe. This particularly applies to those needing care in our hospitals so we are making every effort to minimise any harm or risks caused by the strike.

I have chaired 3 contingency planning meetings to date and will continue to chair further such meetings for the duration of any strikes. NHS England are currently collating feedback from all trusts but currently we estimate the planned action will mean up to 20,000 patients may have vital operations cancelled, including approximately 1,500 cataracts operations, 900 skin lesion removals, 630 hip and knee operations, 400 spine operations, 250 gall bladder removals and nearly 300 tonsil and grommets operations.

NHS England has also written to all trusts asking for detailed information on the impact of the strikes planned for 8 and 16 December which will involve not just the withdrawal of elective care, but the withdrawal of urgent and emergency care as well. We are giving particular emphasis to the staffing at major trauma centres and are drawing up a list of trusts where we concerns about patient safety. All trusts will have to cancel considerable quantities of elective care in order to free up consultant capacity and beds. So far, the BMA has not been willing to provide assurances they will ask their members to provide urgent and emergency cover in areas where patients may be at risk and will continue to press for such assurance.

It is regrettable that this strike was called even before the BMA had seen the government’s offer, and the whole house will be hoping today that the strike is called off so that talks can resume. But whether or not there is a strike, providing safe services for patients will remain the priority of this government as we work towards our long term ambition to make NHS care the safest and highest quality in the world. I commend this statement to the house.