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Is Jeremy Hunt really backing down in the junior doctors row? Is Jeremy Hunt really backing down in the junior doctors row?
(about 4 hours later)
Jeremy Hunt has written an unusually emollient letter to junior doctors with whom he is locked in a bitter row over pay and working hours. He lauds the 53,000 trainee medics whose work is “vital” to the NHS and seeks to empathise with them in their anger by saying that he is “saddened by the distress that is being caused to junior doctors”.Jeremy Hunt has written an unusually emollient letter to junior doctors with whom he is locked in a bitter row over pay and working hours. He lauds the 53,000 trainee medics whose work is “vital” to the NHS and seeks to empathise with them in their anger by saying that he is “saddened by the distress that is being caused to junior doctors”.
He offers a combination of clarifications, reassurances and “absolute guarantees” on key points of dispute – and also some genuinely new concessions – in a bid to stop the festering fury producing a vote for strike action.He offers a combination of clarifications, reassurances and “absolute guarantees” on key points of dispute – and also some genuinely new concessions – in a bid to stop the festering fury producing a vote for strike action.
Related: Hunt tries to stop junior doctors' strike with pay and working hours guaranteesRelated: Hunt tries to stop junior doctors' strike with pay and working hours guarantees
What has Hunt offered?What has Hunt offered?
It is a skilfully drafted letter which should give the British Medical Association’s junior doctors committee (JDC) much to think about as it ponders its next move – ie to press ahead or not with its planned ballot on industrial action in light of Thursday’s move by the health secretary.It is a skilfully drafted letter which should give the British Medical Association’s junior doctors committee (JDC) much to think about as it ponders its next move – ie to press ahead or not with its planned ballot on industrial action in light of Thursday’s move by the health secretary.
On the key issues for doctors Hunt seems to be saying the right things. He has clarified that juniors will not have to work longer than they do now, which is an average of 48 hours a week, and that the seven-day NHS that lies behind the new contract will not presage a return to what some senior doctors call “the bad old days” of 90-hour weeks. Hunt reminds the JDC that, as a champion of patient safety, he knows that juniors knackered from working too many hours pose a real risk.On the key issues for doctors Hunt seems to be saying the right things. He has clarified that juniors will not have to work longer than they do now, which is an average of 48 hours a week, and that the seven-day NHS that lies behind the new contract will not presage a return to what some senior doctors call “the bad old days” of 90-hour weeks. Hunt reminds the JDC that, as a champion of patient safety, he knows that juniors knackered from working too many hours pose a real risk.
What about pay?What about pay?
On the loss of overtime for working in the evenings and weekends – money which juniors see as vital, given their starting salary is £22,636 – Hunt pledges that he is not looking to cut the cost of employing junior doctors, that their average pay will not go down and that the “great majority of junior doctors [will be] at least as well paid as they would be now”.On the loss of overtime for working in the evenings and weekends – money which juniors see as vital, given their starting salary is £22,636 – Hunt pledges that he is not looking to cut the cost of employing junior doctors, that their average pay will not go down and that the “great majority of junior doctors [will be] at least as well paid as they would be now”.
Crucially, he adds that doctors will still be paid extra for working overnight and on Sunday and – in a major concession – indicates that he is prepared to think again about reclassifying 7am-10pm on Saturday as normal working time. That climbdown may give the JDC just enough scope to avoid a walkout or work to rule no one wants. Crucially, he adds that doctors will still be paid extra for working overnight and on Sunday and – in a potentially major concession – indicates that he is prepared to think again about reclassifying 7am-10pm on Saturday as normal working time. That climbdown may give the JDC just enough scope to avoid a walkout or work to rule no one wants but Hunt would probably need normal time not to include any of Saturday and maybe even weekday evenings too, it it is to curry favour.
Hunt has also tried to reassure A&E doctors that just-qualified medical students will not be deterred from joining that branch of medicine, or from going into general practice – two areas of care already struggling with recruitment and retention – by ensuring that what he calls “flexible pay premia” – financial incentives in plain English – will be on offer.Hunt has also tried to reassure A&E doctors that just-qualified medical students will not be deterred from joining that branch of medicine, or from going into general practice – two areas of care already struggling with recruitment and retention – by ensuring that what he calls “flexible pay premia” – financial incentives in plain English – will be on offer.
Related: Jeremy Hunt letter to junior doctors in fullRelated: Jeremy Hunt letter to junior doctors in full
Will it work?Will it work?
The letter could tease out important differences of opinion within the doctors’ union, as some in its top ranks, including its leader Dr Mark Porter, privately doubt the wisdom of a strike. It is also an important moment for Hunt, with most of the medical profession believing he has unwisely and inexplicably set off a dispute with a key element of the NHS workforce, and risked an exodus of young doctors overseas from an already strained service, for no obvious gain.The letter could tease out important differences of opinion within the doctors’ union, as some in its top ranks, including its leader Dr Mark Porter, privately doubt the wisdom of a strike. It is also an important moment for Hunt, with most of the medical profession believing he has unwisely and inexplicably set off a dispute with a key element of the NHS workforce, and risked an exodus of young doctors overseas from an already strained service, for no obvious gain.
Also, although it is addressed to JDC chair Dr Johann Malawana, whose committee represents most juniors, it is also clearly aimed straight at the rank-and-file 53,000. For example, on the touchstone issues of whether the proposed new contract would lead to pay cuts and even longer hours for juniors, Hunt not only says that it definitely will do neither but blames the BMA for trainee medics believing that it would do in the first place.Also, although it is addressed to JDC chair Dr Johann Malawana, whose committee represents most juniors, it is also clearly aimed straight at the rank-and-file 53,000. For example, on the touchstone issues of whether the proposed new contract would lead to pay cuts and even longer hours for juniors, Hunt not only says that it definitely will do neither but blames the BMA for trainee medics believing that it would do in the first place.
But Hunt is clearly still angry at the doctors’ campaign. “I am saddened by the distress being caused to junior doctors who were misled by the calculator on the BMA website into believing that their pay will be cut by 30% and that they will be asked to work many more hours each week,” his letter says. However, it is doubtful whether blaming the BMA – which has gained 5,000 new members in just 10 days until earlier this week – will persuade many to see it his way, especially given doctors’ widespread distrust of him. Some will surely see this as a classic divide-and-rule attempt to outwit a trade union.But Hunt is clearly still angry at the doctors’ campaign. “I am saddened by the distress being caused to junior doctors who were misled by the calculator on the BMA website into believing that their pay will be cut by 30% and that they will be asked to work many more hours each week,” his letter says. However, it is doubtful whether blaming the BMA – which has gained 5,000 new members in just 10 days until earlier this week – will persuade many to see it his way, especially given doctors’ widespread distrust of him. Some will surely see this as a classic divide-and-rule attempt to outwit a trade union.
That many medical and NHS organisations responded (mainly positively) to Hunt’s letter long before the JDC had issued its own decidely non-committal statement highlights how difficult it is for it to give a unified answer that will be in tune with the still very, very angry mood of those it represents. That 14,000 junior doctors have already signed up to attend a major protest march and rally in London on Saturday 17 October indicates how strong feelings are running.That many medical and NHS organisations responded (mainly positively) to Hunt’s letter long before the JDC had issued its own decidely non-committal statement highlights how difficult it is for it to give a unified answer that will be in tune with the still very, very angry mood of those it represents. That 14,000 junior doctors have already signed up to attend a major protest march and rally in London on Saturday 17 October indicates how strong feelings are running.
The beginning of the end of the junior doctors’ dispute? That is still too close to call.The beginning of the end of the junior doctors’ dispute? That is still too close to call.