In total there are 55,000 junior doctors in England - representing a third of the medical workforce. The BMA has just over 37,700 members.
Those opposed to the contract argue that despite including an 11% pay rise it will see normal working hours extended to include Saturdays and up to 10pm every day except Sunday, meaning extra pay for unsocial hours will no longer apply at those times. Salaries will be linked to level of responsibility rather than time in post, while annual pay rises will be scrapped in favour of recognition for training and development.
The BMA argues that medics will be worse off, career progression will be undermined and long working hours will be compounded, putting patients at risk.
Health secretary Jeremy Hunt updated parliament on the junior doctors' contract on February 11, stating that the government had held a “strong preference” for a negotiated solution. “Our door remained open for three years, and we demonstrated time and again our willingness to negotiate with the BMA on the concerns that they raised,” he said. “However, the definition of a negotiation is a discussion where both sides demonstrate flexibility and compromise on their original objectives, and the BMA ultimately proved unwilling to do this."
David Dalton, the chief executive of Salford Royal NHS Foundation Trust, wrote in a letter to the BMA that this offer is the “best and final position” on the outstanding issues. “Since the start of my involvement I have always been clear that I wanted to achieve a position that was 'fair and reasonable' and that would carry the support of the Service,” he wrote. “Following involvement of a senior reference group and a wider involvement of other senior leaders in the NHS, I can confirm that this improved offer is judged as having achieved this objective.”
Dr Johann Malawana, BMA junior doctor committee chair, described the decision to impose the contract as a "sign of total failure" on the government’s part. "Instead of working with the BMA to reach an agreement that is in the best interests of patients, junior doctors and the NHS as a whole, the government has walked away, rejecting a fair and affordable offer put forward by the BMA," he said. "Instead it wants to impose a flawed contract on a generation of junior doctors who have lost all trust in the health secretary.
“This is clearly a political fight for the government rather than an attempt to come to a reasonable solution for all junior doctors. If it succeeds with its bullying approach of imposing a contract on junior doctors that has been roundly rejected by the profession it will no doubt seek to do the same for other NHS staff.
“Our message to the government is clear: junior doctors cannot and will not accept a contract that is bad for the future of patient care, the profession and the NHS as a whole, and we will consider all options open to us,” he added.
Johnny Marshall, director of policy for the NHS Confederation, said it is “disappointing" that the contract negotiations have not reached an agreed solution. "An engaged clinical workforce is critical for the NHS to deliver the best care to patients," he said. "Following today’s announcement it is important that non-pay related concerns raised by junior doctors, particularly around training and morale, are addressed. We need to work closely with our clinical community to ensure we attract and retain the best staff in the NHS.”
