The health secretary, Jeremy Hunt, has been accused of compromising the care patients receive during the week by not taking forward his pledge to hire more junior doctors to help deliver a seven-day NHS.



The Liberal Democrats’ health spokesman, Norman Lamb, said that with juniors now having to work more at weekends, already under-staffed hospitals had fewer medics on duty on weekdays.



He said Hunt had done little to make good on the hiring pledge he made in parliament during the year-long dispute over junior doctors’ contracts.



“My fear is that unless you can guarantee that there will be more junior doctors employed, imposing a change which involves more hours being worked at weekends will inevitably reduce the numbers of hours worked during weekdays when the pressure is at its greatest,” Lamb said. “This could result in real safety concerns.”

In a letter to Lamb, Hunt failed to provide any detail of how many more junior medics would be trained and employed this year or any other year before the end of this parliament in 2020.

He has previously acknowledged the potential for too few doctors being on duty between Monday and Friday as a result of the new contract he imposed in October on all 54,000 junior doctors working in the NHS in England.



Hunt told Lamb that it was up to hospital trusts to expand their junior doctor workforce, raising doubt that his previous assurance would be acted on.

Nor did the letter provide any detail on how many extra trainee medics would join the NHS this year, despite Hunt having told Lamb in the House of Commons on 5 September that he would give him a number.



“This letter from Jeremy Hunt fails to reassure me,” Lamb said. “There appears to be no clear plan as to when more junior doctors will be employed and yet the changes are being imposed immediately.

“There seems to have been no assessment of the number of additional junior doctors needed to ensure that additional weekend hours won’t have a dangerous effect on weekday cover. Jeremy Hunt has failed to provide the evidence to back up his claim that the problem will be addressed by additional junior doctors.”



When Lamb first raised the prospect of shortfalls in weekday medical rotas affecting care standards in a Commons debate on the dispute on 19 May last year, Hunt told him: “The short answer is that we need to increase the NHS workforce.”

Hunt’s letter, however, simply restated the government’s longstanding pledge that there would be 11,500 more doctors by 2020 than there were in 2015.

Dr Nadia Masood, a member of the Justice For Health campaign group and the British Medical Association’s junior doctors committee, said she shared Lamb’s concerns about weekday care.



“Weekday care is already suffering. The NHS is struggling every day of the week. So yes, if we are going to remove more doctors from weekday shifts to staff the weekends, weekday care will deteriorate. We need more doctors every day of the week, not just weekends,” she said.



Masood said she had never believed Hunt’s pledge to recruit more junior doctors, “because he and the government have repeatedly shown themselves to be deceitful with NHS-related issues to further their own political agenda, for example [their claims about] £10bn extra funding to the NHS.”



She said ministers and Health Education England, the medical training and education agency, “have no idea how many doctors we actually need. They are making it up as they go along, which is a staggeringly incompetent way to handle something as valuable as our National Health Service”.

In his letter to Lamb, Hunt said: “Health Education England does not expect significant change in the overall numbers of training posts and trainees, but it cannot say how many there will be at any point in time.

“The number of non-consultant non-training medical staff employed is for providers [NHS trusts] to determine based on the workforce required to deliver services … It is therefore difficult to provide the expected total number of junior doctors by grade.”

The Department of Health said: “The new junior doctors contract is making it easier for hospitals to roster doctors at weekends as well as improving patient safety right across the week. Working with Health Education England, we will ensure that the NHS has a further 11,000 doctors by 2020 – as well as increasing the number of medical training places by 1,500 in a year’s time.”