Intended for healthcare professionals

Observations Junior Doctors’ Strike

Megaphone diplomacy fails in junior doctor contract dispute

BMJ 2016; 352 doi: (Published 18 February 2016) Cite this as: BMJ 2016;352:i961
  1. Andy Cowper, editor
  1. Health Policy Insight
  1. andycowper{at}

Jeremy Hunt’s imposition of a new junior doctors’ contract in England, after negotiations failed over pay for Saturday working and a second strike took place,1 is unlikely to mark the beginning of the end of this dispute. If clinicians and politicians remain as polarised as they are now, this could be only the end of the beginning. Patients, the NHS, and its less politicised clinicians may get stuck in a place of strife.

Both sides leaked to the media throughout, deepening mutual mistrust. The failure of NHS Employers (the representative body tasked with negotiating new contracts on behalf of the government) to make meaningful progress in talks with junior doctors’ leaders saw the senior NHS manager David Dalton take over negotiations, at Hunt’s request.

Hunt’s actions put him firmly in the frame of this dispute: intervening here (and elsewhere) contrary to the 2012 Health and Social Care Act’s intended political devolution.

Dalton’s public letter to Hunt,2 supporting his contract offer and apparently encouraging its imposition, unravelled with embarrassing haste, as 14 of its 20 NHS chief executive co-signatories publicly insisted that they did not support imposition of the deal.3

Successful negotiators avoid entrenching their positions, enabling give and take. Running commentary in the traditional and social media saw both sides contesting the moral high ground of patient safety. …

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