I wrote to the Department of Health about the imposition of the junior doctor contract

They wrote back:

Dear Dr Dawlatly,

Thank you for your recent email to the
Department of Health about junior doctors’ contracts.  I have been asked to reply.

doctors work incredibly hard across seven days.  Ministers value the huge
contribution they make to the NHS and agree that they deserve a fair,
professional contract that supports patient care.  Patient safety is the
absolute priority for the Secretary of State for Health.  He wants to
ensure that we have the safest healthcare system in the world by moving away
from a culture of long, unsafe hours and by ensuring that consultants are
available to make vital decisions about patient care across seven days.

consultants and junior doctors are crucial to ensuring patients receive the
high-quality care they need every day of the week.  The British Medical
Association (BMA) – the doctors’ union – called for reform of the junior
doctors’ contract in 2008.  The proposals
put forward for reforming the junior doctors’ contract and the consultants’
contract are designed to protect the safety of junior doctors and patients as
well as rewarding junior doctors more fairly and ensuring more consultant availability
over weekends to support the training of junior doctors.

Department has been making every effort, in good faith, to work with the BMA to
introduce a new contract for junior doctors that supports these principles
while maintaining average pay and ensuring no doctor is required to work longer
or unsafe hours.  After the BMA walked away from negotiations with NHS
Employers in 2014, the Department and NHS Employers accepted the
recommendations of the independent Review Body on Doctors’ and Dentists’
Remuneration in July 2015 and sought a return to negotiations.  The BMA refused to negotiate, rejected an
offer published and sent to junior doctors on 4 November, and balloted for
industrial action.

November the BMA, NHS Employers and the Department agreed to talks under the
auspices of the Advisory, Conciliation and Arbitration Service (ACAS) and this led
to negotiations involving ACAS beginning in December.  The Secretary of State appointed Sir David
Dalton, a respected trust chief executive, to take those negotiations forward
on behalf of the NHS and the Department.  Initial talks led to a revised
offer on 4 January, which the BMA refused to discuss, instead announcing that
industrial action would commence on 12 January.
Talks continued during that action with the BMA suspending further
action that had been planned for 26-28 January.

1 February Sir David wrote to the Secretary of State to advise him of the
progress of negotiations (see www.nhsemployers.org).  At the same time, the BMA announced
industrial action for 10 February – with junior doctors providing emergency
cover only, rather than the full withdrawal of labour that had previously been
announced.  Ministers believe this action
was regrettable and unnecessary, given that Sir David’s letter showed that the
parties had reached agreement on many issues, most notably on safety, education
and training and on many elements of a new pay structure.

detail on the safety, training and pay aspects of the 4 January revised offer
is set out at:


Sir David’s request, a letter was sent to all junior doctors in England, with
details of the revised offer.  It was
published at www.nhsemployers.org.

door remained open to the BMA to discuss the remaining issue of pay for
unsocial hours, as it agreed to do in the joint agreement at ACAS in
November.  Sir David made a further offer
to the BMA on 9 February, which was rejected.
Sir David wrote to the Secretary of State on 10 February.  He said that:

Despite the most recent progress and substantial
agreement on many elements of the contract, the BMA has refused to compromise
on its insistence that the whole of Saturday must be paid at a premium rate. In
contrast Employers’ position has moved several times, on each occasion offering
more hours attracting premium pay. Regardless of these changes no agreement has
been possible.

with other senior NHS leaders and supported by NHS Employers, NHS England, NHS
Improvement, the NHS Confederation and NHS Providers, Sir David asked the
Health Secretary to end the uncertainty for the service.  Sir David and his colleagues consider the new
contract both safer for patients and fair and reasonable for junior doctors.

11 February the Secretary of State announced that a new contract will be
introduced.  He also announced a review
into some wider and more deep-seated
issues relating to junior doctors’
morale, wellbeing and quality of life, which will be led by Professor Dame Sue
Bailey, President of the Academy of Medical Royal Colleges.  Further details will be set out shortly.

Government and junior doctors want to do the same thing by improving patient
care at weekends.  Ministers believe a
contract that is safer for patients as well as fair and reasonable for junior
doctors is a step towards that.
Ministers believe the further strike action announced by the BMA on 23
February is completely unnecessary as it will mean tens of thousands more
patients face cancelled operations, over a contract that was 90 per cent agreed
with the BMA and which senior NHS leaders have endorsed as fair and safe.  Ministers urge junior doctors to look at the
detail of the contract and the clear benefits it will bring, for them and for

With regard to MPs’ pay, this
is set by the Independent Parliamentary Standards Authority (IPSA).  IPSA is entirely independent of the
Government.  Therefore, you may wish to
contact IPSA direct for further information.
You can do so by writing to:

Independent Parliamentary Standards Authority

4th Floor

30 Millbank

London SW1P 4DU

I hope this reply is helpful.

Yours sincerely,


Ministerial Correspondence and Public

Department of Health


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