Junior doctors’ contract set to be imposed – BBC News

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Ministers are expected to impose a contract on junior doctors in England later after a final offer was rejected by the British Medical Association.

It comes as negotiator Sir David Dalton advised ministers to do “whatever necessary” to end the deadlock.

The British Medical Association (BMA) rejected a “take-it-or-leave-it” deal on Wednesday, which included a concession on Saturday pay.

Health Secretary Jeremy Hunt is due to make a statement to Parliament soon.

The news has emerged as junior doctors concluded a second 24-hour strike at 08:00 GMT in their long-running dispute about pay and conditions.

The contract offered by the government would have seen those working at least one in four Saturdays get extra pay for each one they work. The move represented a more generous offer than the previous proposal, when the bar for extra pay was set at one in three.

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The offer also included increasing fines levied against trusts for over-working doctors, and increasing the extra pay medics get for very long hours.

The set of proposals was presented to the BMA on Tuesday evening, on the eve of the strike, and rejected on Wednesday afternoon when the walk-out was in full swing.

During the strike doctors provided emergency cover, but the stoppage led to the cancellation of nearly 3,000 routine operations and treatments. GP care was largely unaffected.

How will ministers impose a contract?

In theory, it’s pretty easy. Junior doctors rotate through jobs quickly so within six months of the new contract coming into force in August 80% of medics would be on it.

Between now and then hospitals will have to review their rotas and staffing requirements, before sending out offers to junior doctors in May.

But the big unknown is how the British Medical Association and medical workforce will react. Behind the scenes there has been talk of more strikes, mass resignations and non-signing of the contract.

Doctors have also warned of “brain-drain” with medics heading abroad, to other parts of the UK or into other sectors, such as the drugs industry. This, it seems, is unchartered territory -imposing a whole new contract on doctors is thought to have never been done before.

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The offer was made by Sir David, the chief executive of Salford Royal Hospital, who was brought in by ministers last month to broker a deal in the bitter dispute.

In his letter to the British Medical Association (BMA) on Tuesday, he said it was a final offer and that if it was rejected it would mean there is “no realistic prospect of a negotiated agreement”.

He has now advised ministers there is no more he can do in a letter sent on Thursday morning. It also says if ministers introduce a new contract they should make it as close as possible to the final offer he made on Tuesday.

The letter says Sir David’s stance is supported by both NHS Providers and the NHS Confederation, the key bodies with represent health managers.

Speaking to the BBC, Sir David said the “end of the road” had been reached with negotiations.

“We need to bring the matter to a close,” he added.

But in a letter to Sir David to reject the offer, the BMA stuck to its stance that any Saturday working should attract higher pay. It also reiterated its counter proposal made previously that basic pay be increased by only about half the 11% offered by ministers to help pay for it.

If imposed, the new contracts would then come into force from August. It is unclear at the moment how the BMA will respond to imposition, although their mandate allows them to call more strikes.

On Thursday the union said it would not be making a statement until the health secretary had addressed the House of Commons.

During the strike BMA junior doctor leader Dr Johann Malawana said the government had “attacked” and “patronised” the profession. There are 55,000 junior doctors in England – a third of the medical workforce.

“The health secretary can end this dispute, but he must put politics to one side and concentrate on agreeing a fair contract that delivers for patients,” Dr Malawana said.

Chris Ham, chief executive of the the King’s Fund think tank, said no government has ever previously imposed a contract on junior doctors, and to do so would be a “huge risk”.

“As long as that public support for junior doctors remains in place, the government has an uphill struggle to persuade the public it’s doing the right thing at the right time.

“Nobody argues against seven-day working. But there’s a really important discussion to be had about, will the junior doctors’ contract really help that – or are other things far more important? The government really is entering very dangerous territory.”

Junior doctors’ contract set to be imposed – BBC News