On Monday evening, the British Medical Association walked out of talks with the Government and announced that junior doctors would be taking industrial action which will last for four days –

  • Withdrawing elective cover for 24 hours next Tuesday;
  • Escalating the same action for 48 hours later in January;
  • Holding an unprecedented full walkout in early February.

As Professor Dame Sally Davies, the Chief Medical Officer, has previously said, the action the BMA proposes “is a step too far. I urge junior doctors to think about the patients that will suffer and I ask the union to reconsider its approach.”

The BMA’s decision is particularly disappointing given that we had made good progress in talks, talks which had restarted in December after the decision to go to ACAS. Danny Mortimer, Chief Executive of NHS Employers, and who has been conducting negotiations on behalf of the Government, confirmed that in those talks we had resolved 15 of the 16 issues put forward by the BMA before Christmas – everything apart from weekend pay. However after the Government presented an improved offer on Monday, it took less than an hour for the BMA to walk away. In fact, they issued notice of industrial action to some organisations whilst negotiations were still going on.

The Government priority is patient safety and making sure that the NHS delivers high-quality care 7 days a week – and we know that’s what doctors want too. So it is hard to understand why the BMA are forcing a strike that risks patient safety at the most challenging time of year for the NHS. The case for change is unarguable –

• Seven studies in the last five years talk about the weekend effect, including two in the last six weeks;

• New-born deaths are 7% more likely, emergency surgery deaths are 11% more likely, stroke deaths 20% more likely and cancer deaths 29% more likely for those admitted at or around weekends, which is why a truly 7-day NHS was a key promise in our Manifesto.

As the NHS Medical Director, Professor Sir Bruce Keogh, has said, the new contract will improve safety if implemented correctly, and this deal is a very fair one for doctors –

  • 75% of doctors will see their salary increase – and everyone working within legal hours will have their pay protected;
  • A reduction in Saturday working rates will be offset by an 11% increase in basic pay, which will mean doctors’ pensions pots also go up;
  • It will mean better rostering of doctors, ending the current situation where hospitals roster three times less medical cover at weekends compared to weekdays, and more support for consultants;
  • It cuts the maximum working week from 91 to 72 hours, and introduces a new maximum shift pattern of 4 night shifts or 5 long day shifts – compared to the current contract which permits 7 consecutive night shifts or 12 consecutive long day shifts;
  • It gives greater flexibility on rotas, so that juniors no longer have to miss special occasions due to inflexible rostering.


Let’s remember that the Spending Review confirmed an additional £3.8 billion for the NHS next year – but we can’t make Labour’s mistake of investing that money without also asking for reforms that improve patient care. Indeed Labour negotiated the current deeply flawed junior doctor contract in 1999, followed by the consultant contract (which gave a specific opt-out from weekend working) in 2003, and the GP contract (which allowed opting out of out-of-hours care) in 2004. Their reforms made things worse for patients, but the Government are determined to make the NHS the safest, highest quality healthcare system in the world.


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