Junior Doctors Contract

Heidi Alexander Excerpts

Monday 30th November 2015 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

I thank the Secretary of State for his statement, and for advance sight of it. When we last debated junior doctors contracts in this Chamber, the Health Secretary was too busy to attend, so I am glad that he has found time to be here today.

May I start by saying that I strongly welcome what the Health Secretary has announced? Nobody wants to see industrial action, not least the junior doctors. Hopefully, common sense will prevail. However, I have a number of issues on which I wish to press the Health Secretary, including how services tomorrow might still be affected, workforce morale, and what happens next.

A week and a half ago, I wrote to the Prime Minister suggesting independent ACAS talks to resolve this dispute. My proposal was immediately supported by the Academy of Medical Royal Colleges and accepted by the British Medical Association. It took the Government a further five days to agree to enter talks. The issue is this: given that a number of operations have already been cancelled, is it not the case that if the Health Secretary had agreed to this proposal when it was first put to him, he could have avoided, or at least mitigated, any disruption to patients tomorrow?

During my urgent question in this House on Friday 20 November, the Minister of State for Community and Social Care was asked 12 times about ACAS involvement, and 12 times he refused to agree to talks. Will the Health Secretary say very clearly why it took the Government so long to agree to talks, and why Ministers initially appeared to rule out the proposal?

Secondly, the Health Secretary will know that this dispute has been deeply damaging to workforce morale. Many junior doctors will have already voted with their feet, or would have been planning to do so over the coming months. Has the Department made any estimate of the effect of the dispute on staff recruitment and retention? What action is the Secretary of State taking to stop the brain drain of our brightest medics to countries such as Australia and New Zealand?

It was clear from my conversations with junior doctors that they felt that they were the first line of defence in a fight for the future of the NHS. Whether that is right or wrong, it is a remarkable situation in which our junior doctors find themselves. Will the Health Secretary now set out his approach to negotiations with other groups of staff about pay and conditions? Does he accept that we cannot keep asking our NHS workforce to do more for less?

Finally, I say gently to the Health Secretary that his handling of these negotiations has been a lesson in precisely how not to do it. I trust that today’s announcement will mark a change in tone and approach on the part of the Government. With that in mind, let me say this to the Health Secretary: everyone in this House agrees that if someone goes to hospital in an emergency on a Sunday, they should get the same treatment as they would on a Tuesday. The Health Secretary has repeatedly failed to make the case for why reforming the junior doctor contract is essential to that aim.

I make a genuine offer to the Health Secretary today. I am prepared to work with him on a cross-party basis to do everything possible to eradicate the so-called “weekend effect” and we will support any necessary reforms to achieving that aim. In return, he needs to be absolutely clear about what needs to change in order to deliver that. As many studies have concluded, there needs to be much more research into why there is a weekend effect, so that we can ensure that we focus efforts on the actual problem. Will he today commit to commissioning new independent research into how reforming staffing arrangements at the weekend might help improve the quality of weekend services? Does he understand that part of the problem has been that he has implied that junior doctors are to blame for differential mortality among patients admitted at the weekend? What other steps will he take to ensure that we have consistent seven-day services, including ensuring that social care is available outside the working week? Will he update the House on the consultant contract negotiations, which are separate to the junior doctor negotiations and are more directly linked to seven-day services?

I welcome the fact that the Health Secretary finally agreed to ACAS talks last week and I welcome the news from those talks today. Nobody wants patients to suffer and I hope that now we can start to put this whole sorry saga behind us.