Junior Doctors: Contract

Lord Prior of Brampton Excerpts

Thursday 5th May 2016 Lords Chamber

[Baroness Symons of Vernham Dean (Lab)]

My Lords, I beg leave to ask a Question of which I have given private notice.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, my right honourable friend the Secretary of State for Health will write to the Academy of Medical Royal Colleges later this morning explaining that we are willing to pause the introduction of the new contract for five days from Monday should the junior doctors’ committee agree to focus discussion on the outstanding contractual issues: namely, unsocial hours and Saturday pay.

[Baroness Symons of Vernham Dean]

My Lords, I am not sure whether I am entirely happy with the Answer, but it is rather more hopeful than I was expecting and I am grateful to the Minister for it.

This dispute is of enormous importance to everybody. If there is no resolution, what will the Government do when thousands of young doctors refuse to sign contracts later this year and instead opt to become locums?

[Lord Prior of Brampton]

My Lords, given that we have the opportunity over the next five days to try to find a resolution to this dispute, it is probably not helpful now to talk about the “what ifs”. My experience of these situations is, the least said in public, the soonest mended. If the noble Baroness does not mind, I will not answer her question directly today.

[Baroness Walmsley (LD)]

Does the Minister accept that what he has said this morning, welcome thought it may be, is really rather too late? Trust is the most important element when it comes to the provision of medical services. The Secretary of State has already lost the trust not only of junior doctors but of a very large percentage of the general public. It has to be said that the BMA has also lost the trust of a certain percentage of the public. Trust is also important in political matters. We all accept the Government’s intention in their manifesto to provide more services seven days a week—of course, most junior doctors work seven days a week anyway—but does the Minister accept that imposing this contract at the end of the pause period is not the only way of achieving the Government’s objective? Further discussions with those who provide the services may very well find an even better way of providing these seven-day services to patients.

[Lord Prior of Brampton]

My Lords, I am not sure where that question ended up, to be honest. All I will say for today is that we have an opportunity over the next five days for the BMA and the Government to find a resolution to this issue. If we can, it will make the implementation of seven-day working across the NHS much easier.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the Government’s approach has been cack-handed throughout the process. It would have been much better if, instead of initially rejecting this proposal and now setting out some new conditions, the Government had accepted it. Obviously, we hope the outcome will be successful and the situation will be resolved. At the end of this process, we are left with thousands of junior doctors disengaged from the service because of the circumstances of the dispute and the alarmist statements issued by the Secretary of State. Will part of the discussions look at how the junior doctors are to be brought back into the fold and given the support they so richly deserve?

[Lord Prior of Brampton]

My Lords, I think there is general recognition that many of the issues that lie behind the dispute over the contract are not actually involved in the contract itself. It is about how junior doctors are trained, valued and integrated into hospitals and the workforce. These are much broader issues than just the contract, and I assure the noble Lord that the Government are fully aware of that. Once this dispute has been settled, we can start to resolve those bigger, deeper and more fundamental issues.

[Lord Patel (CB)]

My Lords, I am surprised but delighted at the news this morning that the Department of Health has agreed to enter into discussions with the junior doctors. I hope that both sides will enter into them in the spirit of finding a resolution, rather than finding faults. I am sure that the talks will resolve the issue, because as far as I am concerned striking is not the answer. Anything that prolongs the exercise is detrimental to patient care.

[Lord Prior of Brampton]

My Lords, I wholly, 100% agree with the words of the noble Lord.

[Lord Naseby (Con)]

Is my noble friend aware that the public will greatly welcome the magnanimity of Her Majesty’s Government in willingly moving forward and having further discussions over a short period? At the same time, though—I can only speak from having talked to some of my former constituents in Northampton—the public want to know what the benefit is to both the public and the junior doctors from this new contract. Maybe the time has come to publicise, through the standby agency of the COI, in an advertisement, exactly what the benefits are to both parties.

--- Later in debate ---

[Lord Prior of Brampton]

My Lords, rather than getting ahead of myself and addressing that issue, I would just say that we have five days to talk and for the Government and the BMA to try to come to an agreement. All our efforts over the next five days should be focused on that.

[Baroness Corston (Lab)]

My Lords, during the five-day process, will the Minister guarantee to revisit the department’s own equality analysis of the effect of the contract, given that it has expressly accepted that the contract discriminates against women in terms of unsocial hours and caring responsibilities but makes the amazing suggestion that this is a legitimate means of achieving a purpose? That is not fair to a profession that is becoming feminised, about which we should be pleased.

[Lord Prior of Brampton]

My Lords, I think we recognise the huge and vital role that women play. Some 60% of all medical students qualifying now are women. If we do not take care of women, we are not taking care of over half our workforce. Again, I do not think anything is to be gained from my making statements on this in public at the moment.

[Lord Wallace of Saltaire (LD)]

My Lords, does the Minister remember the EU working time directive, which a few years ago was touted as being disastrous for the training of junior doctors? It was said that it would make it completely impossible for them to be trained. Now that the Government are trying to push our junior doctors to work longer hours over more days, does that mean that all the fuss over the EU working time directive was a myth, or is this in an entirely different category?

[Lord Prior of Brampton]

No; the noble Lord has misunderstood the contract. The number of hours are coming down, not going up.

[Lord Watts (Lab)]

My Lords, the Government are pursuing a policy which is not evidence-based and is driven by dogma. Would it not be better to seek arbitration to get us out of the mess they have got us into?

[Lord Prior of Brampton]

My Lords, we now have a pause for five days. This is not dogma; we have two parties who have different views about a small part—about 10%—of the existing contract. Over the next five days we have a chance to resolve that.

[Lord Ribeiro (Con)]

My Lords, while the whole House welcomes this pause, I hope that, whatever happens, there will be an opportunity for an independent review to look at the very points that were made earlier about the lack of appreciation of and support for junior doctors. If there is one thing last week’s dispute has shown, it is that when consultants man the front door of a hospital, services are very much better. Will the Government consider having an independent review after this dispute to look at the future workforce?

--- Later in debate ---

[Lord Prior of Brampton]

My Lords, my noble friend will know that Dame Sue Bailey, the president of the Academy of Medical Royal Colleges, has been asked by the Secretary of State to look at these more profound issues outside the contract, and we must do that as a matter of urgency. However, we cannot do that constructively until we resolve the current dispute.