The ruling on Wednesday from the Royal Courts of Justice on the junior doctor contract was a victory for no-one. But it highlighted how damaging it is to remove accountability for the NHS from the Secretary of State for Health.
Jeremy Hunt was part of the contract negotiations, although Wednesday’s ruling is explicit about him only having jurisdiction over the Trusts, not the Foundation Trusts. Nor does he have any power over the countless other arms length bodies.
He made specific statements about imposition. They were taken so seriously by Sir David Dalton that he advised the government to ‘do whatever is necessary to end uncertainty for the service and to make sure a new contract is in place’ which was widely regarded as giving Jeremy Hunt the go-ahead to go for his threatened ‘nuclear option’. Simon Stevens, along with the CEOs of the NHS Confederation and NHS Providers supported Sir David Dalton’s advice.
All this was widely reported in the press. It was taken so seriously by the junior doctors that it triggered the strikes.
In the evidence given by Mr Daniel Mortimer, the Chief Executive of NHS Employers, he told the court that ‘it was no secret that NHS Employers, as well as other NHS bodies with a national oversight role, have a preference for the adoption of the Contract’.
It is, in fact, essential, that a national contract is agreed. The regular movement of junior doctors between hospital trusts makes a dangerous nonsense of the idea of individually negotiated contracts. Yet the contract as it stands is not safe for patients, not fair for doctors and leaves all power in the unaccountable hands of the unelected Health Education England. They have threatened to remove training from hospitals, part of whose whose status and income depend on such contracts, should they not impose the disputed contract. That’s imposition by another route.
It is a mess, whose only virtue lies in exposing the danger of turning the NHS into a marketplace and having a Secretary of State for Health who can meddle without accountability. The junior doctors must focus their attention on NHS England, NHS Education England, NHS Employers and NHS Providers who have the power to renegotiate a fair and safe national contract without regard to Jeremy Hunt's false and ideologically-driven statements on a '7 day NHS'.