Doctors’ union threatens to ‘consider all options’ in continuing fight after health secretary says it rejected his final offer

Ministers have decided to impose a new contract on NHS junior doctors after the British Medical Association rejected a “best and final” offer to settle the bitter dispute, Jeremy Hunt has told MPs.

In a Commons statement, the health secretary confirmed that he was finally acting on his longstanding threat after months of negotiations with the doctors’ union had failed to produce a settlement.

He blamed his move on the BMA’s refusal to negotiate on the key issue of whether Saturday should become part of a junior doctor’s normal working week. He accused the union of being inflexible on an issue that was vital to delivering the government’s manifesto pledge to introduce a seven-day NHS by 2020.

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Hunt acknowledged that imposing a new contract would cause “considerable dismay” among junior doctors but insisted that it was a good deal for them, which in time would earn their confidence.

The minister repeated his longstanding claim that higher death rates among patients admitted to hospitals at weekends meant that a seven-day NHS offering the same quality of care across the week was needed, requiring junior doctors to work more often at weekends.

Junior doctors reacted angrily to the announcement, with some saying they planned to quit the NHS in protest. Although Hunt claimed that many hospital bosses and NHS organisations backed his move, the wider medical profession has greeted the announcement with alarm.

The BMA made it clear that it would fight the move, branded Hunt a “bully” and said it would now “consider all options open to us”. That is understood to include further industrial action including, potentially, an all-out strike that would see junior doctors refuse to work at all, even in emergency areas of care such as A&E, emergency surgery and intensive care. They continued covering those areas in the strikes on 12 January and 10 February to protect patient safety.

“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,” the union said.

Dr Johann Malawana, chair of the BMA’s junior doctors committee, said: “The decision to impose a contract is a sign of total failure on the government’s part. Instead of working with the BMA to reach an agreement that is in the best interests of patients, junior doctors and the NHS as a whole the government has walked away, rejecting a fair and affordable offer put forward by the BMA. Instead it wants to impose a flawed contract on a generation of junior doctors who have lost all trust in the health secretary.”

Imposition could prompt a generation of “alienated” junior doctors to continue their careers outside the NHS, Malawana added

Facebook Twitter Pinterest A doctor protests outside St Thomas’ hospital in London. The BMA said junior doctors ‘cannot and will not accept a contract that is bad for the future of patient care, the profession and the NHS’. Photograph: Callum Welsh/The Guardian

“This is clearly a political fight for the government rather than an attempt to come to a reasonable solution for all junior doctors,” he said. “The government’s shambolic handling of this process from start to finish has totally alienated a generation of junior doctors – the hospital doctors and GPs of the future – and there is a real risk that some will vote with their feet.

“Our 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.”

Doctors’ leaders fear that imposing a contract that has sparked huge protests and two strikes will reduce further the already diminishing number of young doctors choosing to work in the NHS. The health service is is already short of doctors in key areas of care, such as A&E.

“We are shocked and dismayed at the government’s decision to impose a contract on our dedicated and committed junior doctors,” said Dr Maureen Baker, chair of the Royal College of GPs.

“Imposing a deal on junior doctors is wrong-headed, will inevitably damage morale across the NHS – and may damage patient care,” Baker added.

NHS trusts in England will introduce the new contract from August. Under it, Saturdays – from 7am to 5pm – will for the first time become part of the normal working week for all 45,000 junior doctors. That will infuriate trainee medics – all doctors below the level of consultant – as they have resisted during recent negotiations any suggestion of Saturday becoming part of “plain time”, the hours for which they are paid only at their basic rate.

Hunt has also decided to extend junior doctors’ plain time from 7pm on weekdays to 9pm. The two moves together will mean that trainee medics will lose generous overtime payments they have received until now for working antisocial hours. However, Hunt sought to cushion the blow by announcing that their basic pay would rise by 13.5%, which is 2% more than the 11% he previously offered.

Labour’s Heidi Alexander, the shadow health secretary, warned Hunt in the Commons that his decision to impose the contract “could amount to the biggest gamble with patient safety this house has ever seen”.

“This whole dispute could have been handled so differently. Everyone, including the BMA, agrees with the need to reform the current contract. But hardly anyone thinks the need to do that is so urgent that it justifies imposition, and all the chaos that will bring,” she added.















