Health department beefed up Keogh strike letter, says Independent

BMJ 2016; 352 doi: (Published 08 January 2016) Cite this as: BMJ 2016;352:i130
  1. Abi Rimmer
  1. 1BMJ Careers

The Department of Health for England strengthened a letter sent by the medical director of NHS England to the BMA that questioned whether striking doctors would respond in the event of a terrorist attack, the Independent newspaper has claimed.

The newspaper said that it had seen leaked emails showing that a letter sent by Bruce Keogh went through various revisions “to ensure concerns about the possible impact of a major incident during the strike were made as ‘hard-edged’ as possible.”1 It also claimed that the letter’s specific reference to terrorist attacks in Paris “may have been added by Department of Health officials.”

Keogh wrote to Mark Porter, the BMA’s chair of council, on 19 November last year, after the BMA announced that 98% of the junior doctors it had balloted had voted in favour of strike action over changes to their contract.2 In his letter Keogh sought assurances from the association that junior doctors taking part in industrial action would be available to respond to a major incident if needed.

At the time the BMA rebutted the concerns,3 and more than 3000 junior doctors accused Keogh of a “disrespectful and politicised” intervention in his questioning their loyalty to the NHS in the event of a crisis.4

The Independent claimed that the leaked emails, which were redacted, showed that Keogh was told by a health department official that “the risk of a ‘major incident’ would be ‘pressed quite hard in the media once the strike is formally announced.’” Keogh was also advised that “the more hard-edged you can be on this, the better,” the newspaper said.

The emails also showed that Keogh “would not be asked to speak to the media on the day the strike was declared ‘so long as’ his letter reiterated his opposition to strike action, and was ‘clear’ about the assurances the Department of Health wanted to hear from the BMA,” the newspaper said.

Responding to the claims, Keogh said in the Independent’s article, “Given the seriousness of potential industrial action and NHS England’s statutory responsibilities to ensure everything possible is being done to reduce all potential risk, it was entirely appropriate that all parts of the NHS—including the Department of Health, hospitals and NHS England—coordinated the operational response across the country.”

A Department of Health spokeswoman told the Independent that the planned industrial action created a major safety risk, “so it was absolutely right that ministers insisted on Sir Bruce Keogh giving his independent view of the NHS’s capacity to respond in the event of a major terrorist incident—particularly in the days following the devastating attacks on Paris.”

She added that it was completely right that the department expressed a view on communication with the BMA.

The BMA, however, told the Independent that the “level of political interference” was extremely concerning and would “only serve to worsen junior doctors’ lack of trust in the Government’s handling of negotiations.”


Cite this as: BMJ 2016;352:i130


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