Hundreds of Leeds consultants express ‘grave concerns’ in damning open letter to Jeremy Hunt over junior doctor dispute

More than 360 senior doctors in Leeds have sent a damning open letter to Health Secretary Jeremy Hunt backing their junior colleagues ahead of potential strike action.

The statement of solidarity from senior doctors at Leeds Teaching Hospitals NHS Trust was sent as the British Medical Association (BMA) published the times and dates of possible industrial action amid a ballot that closes on November 18.

Consultants criticised the threat of imposing the new contract on juniors by August 2016, highlighted the “misuse” of statistics about weekend mortality rates and said they view the proposed changes as “demoralising and potentially detrimental to the quality of patient care”.

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The BMA said a strike, if voted for, would include a 24-hour “emergency care only” stint and two nine-hour “full walk outs” between December 1 and 16.

The Leeds junior doctor protest last month attracted around 3,000 protestors.The Leeds junior doctor protest last month attracted around 3,000 protestors.
The Leeds junior doctor protest last month attracted around 3,000 protestors.

The Leeds consultants’ letter reads: “Junior doctors have legitimate concerns about the effects of the proposed contract on patient safety and on their own wellbeing. We urge you to show them the professional respect they deserve by listening to their concerns and entering a genuine dialogue without the threat of contract imposition.”

The letter also highlighted how “coercing staff” by imposing a new contract “breeds distrust” and suggested the planned changes could mean future juniors would be paid “significantly less” while potentially working longer hours.

The Yorkshire junior doctor committee behind last month’s Leeds protest, which attracted 3,000 demonstrators, said the letter showed juniors have the “overwhelming support” of consultants and GP colleagues.

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Jeremy Hunt made a last-ditch pay offer to juniors in a bid to avoid a strike last week. It included an 11 per cent basic pay rise and a slight concession on the controversial move to redefine overtime – offering extra pay after 7pm on Saturdays as opposed to the previous 10pm. His offer was knocked back and the Government was urged to drop the threat of imposition.

The Leeds junior doctor protest in Victoria Gardens, Leeds, last week.The Leeds junior doctor protest in Victoria Gardens, Leeds, last week.
The Leeds junior doctor protest in Victoria Gardens, Leeds, last week.

A Department of Health spokesman said strike action “puts patients at risk”, adding that last week’s firm contract offer “protects the pay of every doctor working legal hours”.

The letter in full

Dear Secretary of State for Health,

We wish to express our grave concerns about the proposed changes to the contract for junior doctors. We write in our personal capacity as Consultants working in one of the largest NHS Trusts in the UK.

We view the proposed changes as demoralising and potentially detrimental to the quality of patient care and to clinical outcomes. The excellent care offered by the NHS to patients is dependent on its staff. The NHS needs a stable, motivated workforce of high calibre junior doctors. The report from the Review Body on Doctors’ and Dentists’ Remuneration states ‘the need to recruit, retain and motivate doctors and dentists’ as its first consideration in formulating recommendations. This objective is completely undermined by the contract proposals and the manner in which you are trying to enforce them.

Our main concerns are:

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● The threat of imposition of a new contract. Coercing staff is demotivating, breeds distrust and discontent and will result in further difficulties in recruitment and retention. Junior doctors are increasingly seeking work outside of England, on a background of existing manpower shortages and vacancies. Even a small increase in those leaving the NHS will have a disproportionate effect on safe staffing.

● The misuse of mortality data. The Government has wilfully misinterpreted mortality data to justify contractual changes despite clear warning from Sir Bruce Keogh that the data should not be used in this way.

● Hours controls and the removal of financial penalties for Trusts that fail to comply with the European Working Time Directive. This may result in junior doctors once again working excessive hours, which is neither good for them nor their patients.

● The proposed changes to standard working hours. Weekends and evenings are not considered to be normal working hours in comparable professional groups. Junior doctors deserve to be paid above the basic rate for the essential work they do at these times.

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● Inequitable effects on salary. Some groups of current or future junior doctors will be paid significantly less under the proposals. 
● Discriminatory gender impact. Changes to pay arrangements will disadvantage doctors who work part time. This will disproportionately affect female doctors.

● Uncertain pay-progression for academic trainees. Following an academic career path is already associated with financial penalties. To add further disincentives will increase the difficulty of recruiting and retaining academic trainees.

● The impact of the changes on training. Any decrease in junior doctors’ time spent working during normal working hours will have an adverse effect on training, and compromise patient safety in the long term.

Junior doctors have legitimate concerns about the effects of the proposed contract on patient safety and on their own wellbeing. We urge you to show them the professional respect they deserve by listening to their concerns and entering a genuine dialogue without the threat of contract imposition.

Yours sincerely,

366 senior consultants at Leeds Teaching Hospitals NHS Trust