On Saturday, Jeremy Hunt sparked what some are calling a war on doctors when he announced that the new junior doctors’ contract would be forcibly imposed without consent. This has come after weeks of public argument and animosity between the British Medical Association and the government over a new contract that would change the definition of unsocial hours to 7am until 10pm Monday to Saturday – whereas the current definition is 7am until 7pm Monday to Friday.
The BMA says that this change will endanger patient safety and will reduce the pay of most junior doctors – despite an 11% increase in the basic pay rate (the rate a doctor receives when they first begin working). There would also be a cut in the actual hourly pay for unsocial hours – a payment that some doctors rely on. This contract would lead to tired, overworked and underpaid doctors and a more risky climate for patients.
But Hunt is committed to a "7-day NHS". Indeed, Hunt’s stubbornness is based on a report which states that people are more likely to die in hospital at weekends. Yet, the co-author of the report has since stated that Hunt should not use the findings to change weekend working conditions. The co-author proposes that the more numerous deaths are actually caused, in part, by higher admittance rates at weekends, rather than relaxed hours for doctors. Hunt has bullishly disregarded this logic however, and has instead embarked on a crusade to impose an unsafe, low-paid contract on some of the most valuable people in our society. Hunt is unwilling to create his "7-day NHS" through additional resources and so he intends to stretch the resources already available to breaking point.
But Hunt's contract imposition is not only unsafe for patients and unfair for doctors. The whole idea of imposing a contract shows a basic lack of understanding by Hunt – either wilfully or merely based on pure ignorance – of basic UK employment law. According to the government's webpage on changing an employment contract, which applies to the public sector just as much as to the private sector, an employee whose contract is changed without consent has the right to refuse to work without being dismissed, to resign and claim unfair dismissal or, either alternatively or in addition, to take their case to an employment tribunal. To put things into perspective, the UK has approximately 53,300 junior doctors working in the NHS. That's 53,300 employees who could refuse to work, resign, or take the NHS to court.
The government does have a last resort which would allow it to change the contract. But, the government would be forced to sack all 53,300 junior doctors and rehire them on the new contract. The essential problem with this – as you can imagine – is that every single junior doctor would be entitled to dismissal payment, and would be able to take their case to an employment tribunal for unfair dismissal. Moreover, given the costs involved with employment tribunals, it doesn't seem too far-fetched to imagine the BMA supporting doctors financially to take the NHS to court in order to protest against the government's new contract.
But there is one other issue with Hunt's plan. The contract imposition procedure and the legal technicalities described above would have to be carried out by the employer of the junior doctors. You might think this individual would be the Health Secretary, but alas no. In 2012 when Andrew Lansley's Health and Social Care Act passed through Parliament it took away employer responsibilities from the Health Secretary and gave those powers and burdens to individual NHS employers. Last week, Hunt released a letter that he claims is signed by 20 NHS employers backing the contract imposition – except 11 of them have already distanced themselves from it, stating that they have grave doubts.
So, with legal restrictions allowing junior doctors to take their NHS employer to court, and a recent poll that showed that 90% of junior doctors were considering leaving the English NHS and moving to either Scotland, Wales, Northern Ireland, Australia or Canada, Jeremy Hunt has shown a real ignorance towards employment legislation, has neglected feasible reality and has treated thousands of healthcare professionals with contempt. Imposing this new contract may cost the government millions of pounds in dismissal payments, legal fees, or lost hours. It will make the NHS more unsafe and undermine the morale of invaluable NHS staff. Jeremy Hunt is a danger to our NHS, and he needs to learn basic employment law.