Anna Warrington on opposing the junior doctors’ contract

anna_warringtonIn the past few months I have thrown myself into opposing the junior doctors’ contract that Jeremy Hunt has threatened to impose from August 2016. Along with a small team I arranged a 20 000 people strong protest in London, and I have contributed to a series of national news stories highlighting the truth behind the spin around Mr Hunt’s contract.

To begin with I was spurred on by a deep anxiety. I could see how unsafe the contract promised to be with it’s extension of working hours, how detrimental to the growth of a high quality staff with it’s penalisation of academic pursuit, how profoundly compromising for workforce retention and recruitment by making being a doctor economically less viable. I was anxious for the welfare of patients, of junior doctors, of the NHS as a whole.

However, as my efforts to oppose Mr Hunt’s contract have progressed, I am increasingly spurred on by a sense of moral outrage. Because Mr Hunt seems to have started out with the belief that doctors are simply obstacles in the way of his misguided “7 day” vision for the NHS and has translated that into a total intransigence with regards to his vision and an almost nihilistic unwillingness to communicate with doctors about it.

For the Secretary of State of Health to have adopted such a position with regards to his workforce is, in my view, not only outrageous, but also outright dangerous. To begin with, it led him to threaten imposition of a contract that he knew doctors had specific concerns about with regards to patient safety and workforce impact. He brushed these concerns aside without engaging with them, turning instead to the media to highlight “excess deaths” on weekends—as if by persuading the press to agree to his vision, it would render doctors’ concerns unimportant. Of course we now know that he appears to have misused data to put a spin on his vision, compounding his error.

Mr Hunt continued to appeal to popular media opinion when he announced an “11% pay rise” for junior doctors on the eve of the ballot for industrial action. He did not talk to the BMA about this proposal. He disingenuously omitted to mention the concurrent, and larger, pay cut for junior doctors through loss of the pay banding system. He didn’t begin to address doctors’ concerns about patient safety. All the while his premise appeared to be that if he could persuade the public (with what could be seen as misinformation), it wouldn’t matter what doctors thought of the contract.

But in my view what doctors think of the contract is of vital importance. It is a critical mistake for Mr Hunt to think that if he can win a battle through the media for public support for his contract, it’ll make it justifiable to impose. Sure it’ll make it easier for him to impose the contract without jeopardising his own public profile. But he’ll still be imposing a contract that doctors see as a real threat to patient safety and workforce training, retention, and recruitment. And really, they should know.

Mr Hunt has finally acquiesced to negotiations, but I doubt he will drop his starting position that doctors are an obstacle to his vision of the NHS. I doubt too that he will ever allow engaging sincerely with doctors concerns to trump his campaign for media prowess. As negotiations go forward, I think that total vigilance will be necessary to keep patient safety and workforce skill, strength, and welfare at the centre of any future junior doctors’ contract, or indeed any future consultants’ or allied health professionals’ contracts. Whilst the strikes have been withdrawn, I fear that industrial action for the good of the NHS is only just beginning.

Anna Warrington is one of the organisers of the Junior Doctors London Protest October 2015 and a CT 2 ACCS Anaesthetics.

Competing interests: I am a member of the BMA.