Junior Doctors Contract

Diane Abbott Excerpts

Wednesday 6th July 2016 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The NHS is only as strong as the morale of its staff, and the rejection of this contract by the junior doctors sadly reveals that morale and trust in the Government are at rock bottom. Yesterday, to mark the 68th anniversary of the NHS, I visited my local hospital, Homerton University hospital, and met some of the wonderful nurses. One of their main concerns was the abolition of the bursary, but they were also genuinely worried that NHS staff were no longer valued. The Secretary of State must accept that his handling of the junior doctor dispute has exacerbated this feeling among all NHS staff.

I have sat in this Chamber and heard the Secretary of State say that junior doctors have not read the new contract, do not understand the new contract, or have been bamboozled by their leadership, but now that the junior doctors have rejected a renegotiated contract recommended by their leadership, he must begin to understand that his handling of this dispute has contributed to the impasse. There should be no suggestion that the junior doctors’ decision is somehow illegitimate. The turnout in the ballot was higher than in the general election in 2015.

I welcome the fact that the Secretary of State will not let up on efforts to eliminate the gender pay gap and that he will commission an independent report on how to reduce and eliminate that gap, and look at shared parental leave as well. That is an important concern among doctors. I also welcome the fact that the imposition of the contract will be phased, but at this time of general instability I urge the Government to reconsider imposing the contract at all.

It has not helped for the Government to treat junior doctors as the enemy within. It has not helped junior doctors’ morale that it was implied at one time that the only barrier to a seven-day NHS was their reluctance to work at weekends, when so many of them already work unsocial hours, sacrificing family life in the process. I am glad that the Secretary of State acknowledged today that junior doctors are some of the hardest working staff in the NHS, working some of the longest and most unsocial hours, including many weekends, but the vote to reject the contract is a rejection of the Government’s previous approach.

The Secretary of State knows that the BMA remains opposed to the imposition of any contract, believing that imposing a contract that has not been agreed is inherently unfair and an indictment of the Secretary of State’s handling of the situation. The junior doctors committee is meeting today to decide how it will proceed. Labour Members look forward to hearing the outcome of that meeting and how we can best continue to support the junior doctors.

Public opinion is not on the Government’s side. It is evident that the public will have faith in their doctors long after they have lost faith in this or any other Government. It is not too late to change course. The Government need urgently to address the recruitment and retention crisis and scrap the contract. Although I appreciate that the contract has been in negotiation for many years, the Government should give talks with the junior doctors one more chance. If they crush the morale of NHS staff, they crush the efficacy of the NHS itself.

[Mr Hunt]

I welcome the hon. Lady to her place for the first statement to which she has responded and welcome her on the whole measured tone, with one or two exceptions. I will reply directly to the points she made.

First, the hon. Lady maintains the view expressed by her predecessor, the hon. Member for Lewisham East (Heidi Alexander), who is in her place this afternoon, that somehow the Government’s handling of the dispute is to blame. We have heard that narrative a lot in the past year, but I say with the greatest of respect for the hon. Member for Hackney North and Stoke Newington (Ms Abbott)—I do understand that she is new to the post—that that narrative has been comprehensively disproved by the leaked WhatsApp messages that were exchanged between members of the junior doctors committee earlier this year.

We now know that, precisely when the official Opposition were saying that the Government were being intransigent, the BMA had no interest in doing a deal. In February, at the ACAS talks, the junior doctors’ aim was simply to

“play the political game of…looking reasonable”—

their words, not ours. We also know that they wanted to provoke the Government into imposing a contract, as part of a plan to

“tie the Department of Health up in knots for…months”.

In contrast to public claims that the dispute was about patient safety, we know that, in their own words,

“the only real red line”

was pay. With the benefit of that knowledge, the hon. Lady should be careful about maintaining that the Government have not wanted to try to find a solution. We have had more than 70 meetings in the past year and we have been trying to find a solution for more than four years.

The question then arises whether we should negotiate or proceed with the introduction of the new contracts. Let me say plainly and directly that if I believed negotiations would work, that is exactly what I would do. The reason I do not think they will work is that it has become clear that many of the issues upsetting junior doctors are in fact nothing to do with the contract. Let me quote a statement posted this morning by one of the junior doctors’ leaders and a fierce opponent of the Government, Dr Reena Aggarwal:

“I am no apologist for the Government but I do believe that many of the issues that are exercising junior doctors are extra-contractual. This contract was never intended to solve every complaint and unhappiness, and I am not sure any single agreement would have achieved universal accord with the junior doctor body.”

The Government’s biggest opponents—in a way, the biggest firebrands in the BMA—supported the deal and were telling their members that it was a good deal, which got rid of some of the unfairnesses in the current contract and was better for women and so on. If the junior doctors are not prepared to believe even them, there is no way we will be able to achieve consensus.

If the hon. Lady wants to stand up and say that we should scrap the contract, she will be saying that we should not proceed with a deal that reduces the maximum hours a junior doctor can be asked to work, introduces safeguards to make sure that rostering is safe and boosts opportunities for women, disabled people and doctors with caring responsibilities—a deal that was supported by nearly every royal college. If the alternative from Labour is to do nothing, we would be passing on the opportunity to make real improvements that will make a real difference to the working lives of junior doctors.

The hon. Lady and I have a couple of the more challenging jobs that anyone can do in this Chamber. She has been in the House for much longer than I have, so she will know that. The litmus test in all the difficult decisions we face is whether we do the right thing for patients and for our vulnerable constituents, who desperately need a seven-day service. The Government are determined to make sure that happens.