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Contract enforcement 'could deepen NHS recruitment crisis'

Published 03/05/2016

Mark Porter says the Government is trying to
Mark Porter says the Government is trying to "undermine trust in doctors"

The new contract for junior doctors could have a "damaging effect" on patient care and deepen the recruitment crisis in the NHS, a leading doctor has warned.

The imposition of the contract will be the "final straw" for many doctors who are considering leaving medicine altogether or moving abroad to practice, Professor Jane Dacre said.

The exodus of staff is a "tragedy for the NHS and a colossal loss of potential", the president of the Royal College of Physicians said.

"The reason I am so worried about it is because of the damaging effect on the next generation of doctors, and in turn on patient care," said Professor Dacre, speaking at an urgent meeting called by the British Medical Association (BMA) to discuss the "funding and workforce crisis across the UK health service".

Prof Dacre, who is not involved in the dispute, continued: "Across the country there are not enough doctors to cover the current clinical workload, in particular the acute on call work. Many shifts are unfilled representing a significant risk to patient safety. Every day, trainees and consultants alike are asked to work extra shifts to cover these gaps.

"Put bluntly, we are under-doctored, underfunded and overstretched.

"Junior doctors already work seven days per week in acute and emergency care. Doctors are moving to other countries for more supportive working and learning environments and many are considering leaving medicine entirely.

"They do not feel safe, valued or supported and the imposition of the contract is the final straw. This is a tragedy for the NHS and a colossal loss of potential."

Prof Dacre questioned how the Government planned to implement a seven day service.

She said she was recently asked to cover a locum shift on the Isle of Wight. "How desperate is that?" she continued. "If the president of the Royal College of Physicians is being asked to cover senior house office posts 70 miles away, if we have neither enough trainees nor consultants to run the service now, how are we going to implement a safe seven-day service?"

"How are we going to do that if we can't fill the posts as there are not enough trainees in these specialities? The trainees we do have are so fed up they are leaving? It isn't just doctors who provide hospital care - where is everyone else?"

She added: "My worry, and that of other professional groups, is that the squeeze on the junior doctors is only the beginning, and our other clinical colleagues are next in line."

Dr Mark Porter, chairman of council at the BMA, told the meeting that t he Government has created a "bitter and intractable" dispute with junior doctors and has "forgotten" the meaning of negotiation

"The Department of Health thinks it has an overview, but it's more that of a distant satellite, in a strange orbit all of its own," Dr Porter said.

"How else can you explain the biggest thing it has done to the health service this year - creating a bitter and intractable dispute with junior doctors, which wiser heads in Cardiff, Edinburgh and Belfast have managed to avoid?

"Here's a solution. We'll both back away from the cliff edge, restart talks and start the work of rebuilding junior doctors' confidence. They just want to serve their patients in a health service that supports them.

"The Government must drop its cynical and corrosive tactic of trying to undermine trust in doctors. Making laughable accusations that doctors don't work weekends, or that GPs don't do out of hours, doesn't soften us up in negotiations. And it doesn't fool the public either. It just squanders the morale of decent people.

"The Government has forgotten what negotiation even means."

Last week, junior doctors went on all-out strike for two working days. For the first time in the history of the NHS, junior doctors in England stopped providing emergency care during the walkouts.

More than 125,000 appointments and operations were cancelled and will need to be rearranged.

This figure is on top of almost 25,000 procedures cancelled during previous walkouts.

The BMA is urging Health Secretary Jeremy Hunt to halt the imposition of the contract and reopen negotiations.

The union has not made any decisions about how to proceed.

A Department of Health spokesman said: "What isn't being said at this conference is that the BMA agreed with 90% of the junior doctors contract, and that initial figures show a similar number of training places have now been filled this year compared to last.

"Had the BMA agreed to talk about Saturday pay as they promised, we'd have an agreement by now to tackle the clear independent evidence that standards of care are not uniform across the week. Our reforms are underpinned by £10 billion extra to deliver the NHS' own plan for the future, including almost £4bn upfront this year."

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