On Thursday 11th February, Jeremy Hunt announced that he would be unilaterally imposing a new contract on front-line doctors. In his infamous imposition letter, Hunt claimed he had the support of a whole raft of NHS CEOs. In fact, most of them had never seen the letter and did not agree with the imposition.
The BMA had proposed an alternative contract that was ‘cost-neutral’ (no more expensive than the existing deal) but kept Saturday as a weekend day with appropriate pay. Hunt couldn’t accept this because of his obsession with a ‘7-day NHS’, which we all know already exists. He therefore vetoed all such deals offered by the BMA, preventing any settlement that might scupper his plans to force doctors to work extra weekends for no extra pay. To add insult to injury, Hunt claimed that no doctor would work consecutive weekends, and then published ‘example rotas’ that had doctors working three weekends straight.
The BMA has now asserted that, by failing to provide “appropriate funding for the required level of workforce needed to deliver safe services and adequate training”, the government has broken the original ‘heads of terms‘ agreed during the initial negotiations in 2013. There will be no more talks based on ‘cost neutrality’ – that horse has now bolted, and the BMA will settle for nothing less than a fully-funded workforce. As Dr Johann Malawana of the BMA puts it, “We also know – and the public understand this – that if the Government wants junior doctors to take the brunt of delivering more services across seven days, they need to put their money where their mouth is.”
So will we be seeing an all-out strike in the coming weeks and months? The BMA have made it clear that they do not take such action lightly, and have done all they can to avoid harming patient care. But with the Conservative government working to impose an unacceptable contract that is based upon flawed ideology rather than evidence-based medicine, full strike action may be the only option left.