Patients need to have a say on the junior doctor’s contract dispute

An open letter to Jeremy Hunt and The BMA

We are patients who have had life-changing illnesses, injuries, or disabilities. We have worked for years to get patients and carers to be more involved in healthcare policy and practise at a local and national level. We do not “represent” anybody. This statement is a collation of individual views and does not represent the wider patient and public voice.

We are not on anyone’s “side” in the junior doctor’s dispute and feel that neither of you—Jeremy Hunt or the BMA—do, can, or should “represent” the voice of patients. Yet both sides claim to have patient concerns at the heart of their thinking.

Some of us were for the previous strike action. Some of us were against. But now, none of us support the current decision to take strike action. We feel patients may be harmed. Previously, patients were reluctant to put their heads above the parapet. Now, on social media at least, voices against the strike are more frequent.

We want you both to get back to the table. However—and this is paramount—we also want patients to be included in a way that may help get us through the current impasse.

Patient and public involvement is now part of healthcare orthodoxy. There are admirable examples where it has been done well. But there are vast areas where it does not happen. This is one of them.

An article seven months ago in the Health Service Journal is still valid and sets out the basis for the role patients could have played, and could play in helping to solve the dispute.

If this dispute is strictly about pay, then fine. The two of you should be able to sort it. But if it is about pay AND conditions, then it is about patient safety. And if this is about patient safety (and both sides say it is), then enough is enough—patients need to have a say.

We believe, had patients been involved earlier, the content of the new contract might have been different and the process might have gone better—minds would have been able to focus truly on what matters to patients; what we mean by “safety” and “seven day working” could have been explored; an honest debate could have been had about resource constraints and possible trade offs.

Without patients, the dispute has become binary and confrontational. When elephants fight, the grass gets trampled. We need a new model of healthcare decision making that is about real dialogue. The current dispute is a crisis. But it may also be an opportunity to model a new vision for healthcare and for patients to help—this impacts on all our lives. Nothing about us without us. Are you listening?

Paul Buchanan
Alison Cameron
Laura Cleverly
Lynne Craven
Roz Davies
Sibylle Erdmann
Trevor Fernandes
David Festenstein
David Gilbert
Anya de Iongh
Karen Maskell
Christine Morgan
Patrick Ojeer
Tessa Richards
Michael Seres
Sue Sibbald
Rosamund Snow
Dominic Stenning