Hundreds of consultants from the Royal Free London NHS foundation trust have written to the health secretary, Jeremy Hunt, to express their support for junior doctors and to back possible industrial action.

In a letter to the Guardian, the 505 consultants, who will bear the brunt of any potential strike, say they recognise that junior doctors are an integral part of the health service.

“An empowered, rested, happy and appropriately remunerated workforce across all cadres of medical, nursing and allied health professional staff is essential to sustain high clinical standards in the face of increasingly complex healthcare delivery challenges,” they add.

“We regret, yet clearly understand, that public protest and possible industrial action by doctors has become necessary to safeguard these basic requirements.”

On Thursday, Hunt condemned what he described as “extreme action” after the British Medical Association (BMA) said junior doctors would take industrial action on three days in December if, as expected, their ongoing ballot approves it.

The health secretary is preparing for a fierce battle with the medical profession, despite warnings by NHS bosses and leading doctors that a protracted dispute will seriously disrupt services at a time when they are under the most pressure.

Junior doctors, 20,000 of whom staged a protest in London last month, are angry that the proposed new contract will hugely extend the normal working pattern in which doctors can be told to work their 48 hours – from the existing 7am-7pm Monday to Friday, to 7am-10pm from Monday to Saturday.

Junior doctors protesting against Jeremy Hunt’s proposed new contracts in London last month. Photograph: Jane Stockdale/Rex Shutterstock

They are concerned that safeguards that stop hospitals forcing them to work dangerously long hours and the banding system that dictates how much they are paid, especially in overtime, will both disappear.

Hunt has insisted that no junior doctor will lose out financially under the new contract, which will see maximum working hours per week fall from 91 to 72. He said the aim of the new system was to ensure more doctors were on duty at weekends to help deliver the promised seven-day NHS by 2020.

The minister made a bid to avert strikes with a fresh deal, including an 11% rise in basic pay and overtime pay after 7pm on Saturday evenings. Flexible pay premiums would be applied to more specialities than just general practice and A&E care, with acute medical ward staff and psychiatrists benefiting, he added.

But the consultants from the Royal Free in Hampstead, north London, emphasised that junior doctors were dedicated to their patients and the NHS and already worked 24/7 to deliver frontline care. “We, as their supervisors, are responsible for both their training and wellbeing. We remain grateful for the work they do alongside us every day and night, very often beyond their contracted duties,” they write.



“Protecting the health of the public – patients and personnel alike – remains the foremost objective of doctors. We therefore encourage Jeremy Hunt to urgently reconsider his stance and facilitate meaningful negotiations to resolve this avoidable impasse.”

Johann Malawana, the BMA’s junior doctors committee chairman, said the increase in basic pay was misleading as it would be “offset by changes to pay for unsocial hours – devaluing the vital work junior doctors do at evenings and weekends”.

The NHS has 45,000 trainee doctors in England, of whom 30,000 belong to the BMA. Hospitals around the UK are bracing themselves for having to cancel thousands of planned operations and outpatient clinics if the BMA’s ballot leads to the walkouts on 1, 8 and 16 December.



Dr Sarah Wollaston MP has said the three-day strike plan is ‘far too extreme’. Photograph: Martin Godwin/The Guardian

Dr Sarah Wollaston, chair of the Commons health select committee and a GP, said the plan was “far too extreme”, coming in the middle of what is traditionally the busiest period of the year for the NHS.



“I think it is not putting patients first, I think this will be highly unsafe for patients,” she told BBC Radio 4’s Today programme on Friday.

“When you think of the number of procedures that might not be emergencies but are extremely urgent, to have three days, including two of them a full walkout, will be putting patients in significant harm.”

Wollaston said the new contracts would actually reduce the maximum working hours, “so the argument that it is unsafe because people will be treated by tired doctors just doesn’t hold weight, I’m afraid.”

Dr Mark Porter, chair of the BMA council, said the association was giving NHS bosses time to plan for the event of a strike. He told Today: “We have no intention of endangering patients, which is why we’re giving the service time to plan for running a service when junior doctors aren’t there.

“I don’t think that it’s going to be impossible to keep patients safe and to run proper emergency services, even in the complete absence of junior doctors.

“That of course is one of the dilemmas about doctors taking industrial action – we don’t do it lightly at all – but the point is to keep patients safe while exerting pressure on employers on the dispute that we’re in.”

Wollaston said: “Even if they give this notice, they know the NHS is under great pressure. To have three days where effectively we are cancelling all routine procedures, the kind of procedures that consultants undertake – for example, cardiac catheterisations for people who are having a heart attack – how are consultants going to be able to get on with that sort of really important work?”

The health secretary and the BMA have accused each other of refusing to return to the negotiating table after talks broke down. The Guardian understands that Hunt has rejected a number of personal, private overtures made to him in recent days to try to reach a compromise with junior doctors’ leaders.

The BMA’s ballot on industrial action closes on Wednesday at 5pm and the results will become public the next day.