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Seven day plans do not rely on spreading workforce more thinly, Hunt says

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4849 (Published 06 September 2016) Cite this as: BMJ 2016;354:i4849
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}bmj.com

The government’s plans for a seven day NHS do not rely on stretching the existing medical workforce more thinly, the secretary of state for health, Jeremy Hunt, has said.

Speaking in the House of Commons on Monday 5 September Hunt commented on a number of matters that were concerning junior doctors in England.1 His comments came after the BMA announced that it had decided to suspend planned industrial action by junior doctors in England next week, after discussions with NHS England.2

Hunt welcomed the association’s decision to suspend the strike but highlighted concerns over future five day strikes planned for October, November, and December. He said that the planned action was “unprecedented in length and severity and will be damaging for patients, some of whom will already have had operations cancelled.”

Focusing on the debate around plans for a seven day NHS, Hunt said that he recognised that many doctors had concerns about “precisely what the government means by a seven day NHS.” He said that, although the changes to the junior doctors’ contract were cost neutral, “our seven day services policy is not cost neutral and will be funded out of the additional £10bn (€12bn; $13bn) provided to the NHS this parliament.”

While the pay bill for current junior doctors will not increase, Hunt said that the government expected the pay bill to go up as it employed more doctors. “That means our plans are not predicated on simply stretching the existing workforce more thinly, or diluting week day cover,” he said.

Although the government needed to reduce weekend premium pay rates, it was more likely to affect consultants and diagnostic staff than junior doctors, who already work evenings and weekends, Hunt added.

“Finally, we have no policy to require all trusts to increase elective care at weekends,” Hunt said. He said that the government’s seven day services policy was focused on meeting four clinical standards relating to urgent and emergency care.

“Despite these reassurances, there may remain honest differences of opinion on seven day care,” Hunt said. “But the way to resolve them is through cooperation and dialogue, not confrontation and strikes, which harm patients.

“To those who say these changes are demoralising the NHS workforce I say nothing is more demoralising or more polarising than a damaging strike. It is not too late to turn away from the path of confrontation and put patients first and I urge everyone to consider how their own individual actions in the coming months will impact on people who desperately need the services our NHS offers.”

During his speech Hunt also argued that the long term cause of the dispute between the BMA and the government was “largely about pay.” He added, “But I recognise that for the majority of junior doctors there are a much broader range of concerns including the way their training is structured, the ability to sustain family life during training periods, the gender pay gap, and rota gaps.”

Hunt also said that Ellen McCourt, chair of the Junior Doctors Committee, which made the decision to go ahead with further strike action, had previously supported the deal negotiated between the BMA and the government in May this year.3 “Ellen McCourt personally negotiated and supported in May,” Hunt said. “She said then the new contract was ‘safer for our patients, safer for our junior doctors . . . and also fair.’”

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