This Commons Library briefing provides background information on the introduction of a new contract for doctors in training (junior doctors) in England, including a summary of the proposed changes, and background on negotiations between NHS Employers and the BMA. The briefing also provides some brief information on the delivery of seven day services and proposed changes to the consultant contract.Jump to full report >>
On 11 February 2016 the Health Secretary Jeremy Hunt announced he would proceed with the introduction of a new contract for junior doctors, as he said a negotiated solution with the BMA was not realistically possible. The new contract will be implemented for new junior doctors, and those junior doctors changing roles, from 3 August 2016. Jeremy Hunt told the Commons:
“Along with other senior NHS leaders and supported by NHS Employers, NHS England, NHS Improvement, the NHS Confederation and NHS Providers, [chief negotiator Sir David Dalton] has asked me to end the uncertainty for the service by proceeding with the introduction of a new contract that he and his colleagues consider safer for patients and fair and reasonable for junior doctors. I have therefore today decided to do that.”
The BMA is opposed to the imposition of the new contract and has already led a number of days of industrial action against what it describes as a flawed contract. The Chair of the BMA Junior Doctors Committee, Dr Johann Malawana said:
“…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.”
On 23 February the BMA announced plans for three 48-hour “emergency care only” strikes, starting at 8am on 9 March, 6 April and 26 April. On 23 March the BMA announced that the industrial action scheduled to start on 26 April will change from 48-hour emergency care only to a full withdrawal of labour by junior doctors between the hours of 8am and 5pm on Tuesday 26 and Wednesday 27 April (18 hours in total). The BMA has also issued proceedings to launch a judicial review challenging the lawfulness of the health secretary’s decision to impose the new junior doctor contract.
On 31 March NHS Employers published the final junior doctors’ contract, setting out the terms and conditions of service to be imposed from August. The Department of Health also published an equality impact assessment and family test.
While opinion differs as to how close the BMA and NHS Employers were to an agreed settlement, it appears a key sticking point in the final stages of negotiations was the question of unsocial hours premiums for work on Saturdays. Jeremy Hunt’s statement to Parliament on 11 February set out the Government’s rationale for the introduction of a new contract for junior doctors. He said that while the Government had made some concessions on Saturday pay premiums, the new contract would help hospitals afford additional weekend rostering. He said that the latest offer from NHS Employers would mean junior doctors working on one in four or more Saturdays would receive a 30% pay premium. He also said that the new contract would give doctors a basic pay rise of 13.5% (NHS Employers’ previous offer had been an 11% increase) to compensate for the reduced number of unsocial hours for which premiums would be paid. Responding for the BMA, Dr Johann Malawana has said: “If the government wants more seven-day services then, quite simply, it needs more doctors, nurses and support staff, and the extra investment necessary to deliver them.”
The negotiations only relate to the junior doctor contract in England. The Scottish Government has repeated assurances to the BMA made in August 2015 that it will not be seeking to impose any new arrangements on trainees in Scotland. In September 2015, Welsh Government officials issued a statement to BMA Cymru Wales indicating that they will retain the current junior doctor contract in Wales. The Northern Ireland health minister, Simon Hamilton, has said he would like to develop a negotiated solution for Northern Ireland.
See the further reading section of this briefing for coverage of the most recent developments.
 Junior doctors defy health secretary with three 48-hour strikes, Guardian, 23 February 2016
Commons Briefing papers CBP-7314
Author: Tom Powell