The government has provoked the potential strike by NHS junior doctors by tearing up an agreement that would have settled the dispute, the Conservative minister who was in charge of the negotiations has told the Guardian.

In a scathing indictment of the government’s handling of the new contract for England’s 53,000 junior doctors, Dr Dan Poulter, a health minister until May, revealed that Jeremy Hunt had triggered “understandable” widespread anger among them by reneging on the basis of a deal.



Hunt set aside an in-principle agreement with the British Medical Association (BMA) and replaced it with plans that endanger patients’ safety by risking exhaustion among all trainee medics in England by forcing them to work up to 90 hours a week, claims Poulter, who is still a Tory MP.

“However, the junior doctor contract that has emerged over the summer – the contract that the Department of Health now wants to impose – is very different from the one being discussed this time last year. Then there was no talk of 90-hour weeks, no talk of large numbers of junior doctors having their pay cut,” Poulter said.

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Poulter’s insider account, in an article for the Guardian, is embarrassing for the health secretary, who is trying to avoid industrial action by doctors over plans that have sparked an unprecedented backlash by the medical establishment.



Poulter added: “There was instead a recognition by the Department of Health that now appears to have been lost: that better pay and work-life balance incentives were needed to ensure doctors were attracted to A&E and other gruelling specialities. Now we are seeing junior doctors, for the first time ever, balloting for strike action over their contract of employment.”

Facebook Twitter Pinterest Dan Poulter said the deal being offered to junior doctors is very different from the one that was discussed last year. Photograph: Felix Clay/the Guardian

He accuses Hunt of changing tack because the NHS is desperate to identify ways of saving money to help tackle a£30bn hole in its budget that is expected to emerge by 2020. And he warns that cutting junior doctors’ pay – many face losing between 15% and 40% of their earnings under the new contract – will undermine David Cameron’s ambition to create a seven-day NHS because there will be too few doctors to staff it as a result of disillusionment.



The new contract that Hunt is threatening to impose would extend junior doctors’ normal working time, in which they are paid at standard rates, from the 60 hours between 7am-7pm Monday to Friday to the 90 hours between 7am-10pm Monday to Saturday. That would deprive many of them of extra pay for working antisocial shifts, a key cause of anger that resulted in thousands of junior doctors taking to the streets of London and Manchester in protest last week.

Imposing the new contract would be highly damaging for the NHS by worsening already significant shortfalls in the number of young doctors choosing to go into key areas of medicine, such as A&E, paediatrics, psychiatry and general practice, added Poulter, who works part-time in the NHS and is training to become a psychiatrist after a spell in hospital medicine. It will also mean another key Tory pledge, to increase the number of GPs by 5,000 by 2020, is doomed to fail, he said.



Poulter, who resigned from the BMA in the two and a half years he was a health minister, relates how the Department of Health was “close to an in-principle heads of terms agreement” with the union’s junior doctors committee in September last year. But the representatives of junior doctors broke off talks after their colleagues in the BMA’s consultants committee did so over major obstacles to agreement over which days and hours hospital consultants should work in a seven-day NHS.

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Dr Johann Malawana, the chair of the BMA junior doctors committee, whom Hunt met for talks last week, said: “This is a damning account of how badly the government has handled the junior doctor contract. Rather than working with the BMA to agree a contract that is safe, fair and values the vital contribution junior doctors make to the NHS, the government is riding roughshod over the process and trying to impose a contract that would be bad for patients, junior doctors and the NHS as a whole.”

Heidi Alexander, the shadow health secretary, said Poulter’s account underlined that Hunt’s handling of the negotiations had been “shambolic”.

She added: “This is a devastating critique of Jeremy Hunt’s handling of the dispute. It adds to the growing chorus of voices throwing doubt over the government’s ability to deliver a seven-day NHS. There is already a shortage of key staff in the NHS and, as Dan Poulter warns, this is likely to get worse should the government impose a contract that leads to doctors working longer hours for less pay.”

The General Medical Council has received more 4,000 requests from doctors for a certificate that would allow them to work abroad, fuelling fears of a large-scale exodus of junior doctors from the NHS, since the government announced it planned to impose the new contract.

The Department of Health disputed Poulter’s claims about what the new contract would mean for junior doctors. A spokesman said: “These claims are incorrect. Our proposals will mean average pay will not go down and there is no intention to increase working hours. In fact, we want to offer more safeguards over total hours worked for junior doctors than ever before. We call on the Junior Doctors Committee to re-enter negotiations and work with us to put in place a new contract that’s safe for patients and fair for doctors.”