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Open letter to the Chief Executives of NHS Providers and the NHS Confederation

The day after last week's junior doctor strike Jeremy Hunt announced in parliament that he would impose the highly controversial and unpopular contract. He justified this decision by stating that he had the support of NHS leaders and employers including 20 CEOS of Trusts across the country. 14 out of 20 NHS CEOs, who were listed in the annex of the letter, subsequently asked for their names to be withdrawn as they did not support imposition.

Please see Clive Peedell's open letter to the Chief Executives of NHS Providers and the NHS Confederation asking them to clarify their own position on supporting the imposition of the junior doctor contract. If you would like to add your signature to please add your name and your position to the form at the end of the letter (optional - you can call yourself NHS or NHA supporter if you do not want to share your job title). Please share this letter in your own networks.

Open letter to the Chief Executives of NHS Providers and the NHS Confederation

Dear Mr Hopson and Mr Webster,

We the undersigned call on you to clarify your position on the imposition of the junior doctor contract. Your organisations, NHS Providers and the NHS Confederation represent the vast majority of NHS organisations within the NHS family. You were both supporters of Sir David Dalton's letter to the Secretary of State, Jeremy Hunt, on the 10th of February, which contained the following paragraph:

Following consultation with Chief Executives and other leaders in the service, it is clear that the NHS needs certainty on this contract and that a continuation of a dispute, with a stalemate and without any clear ending, would be harmful to service continuity, with adverse consequences to patients. On this basis I therefore advise the government to do whatever it deems necessary to end uncertainty for the service and to make sure that a new contract is in place which is as close as possible to the final position put forward to the BMA yesterday. I can confirm that this position is supported by both the NHS Confederation and NHS Providers, together with support from Chief Executives across the country, and their names are supplied.”

On the following day, Jeremy Hunt made a statement in Parliament to announce that a new contract would be imposed on junior doctors, clearly citing the support of Sir David Dalton’s letter to justify his decision:

Along with other senior NHS leaders and supported by NHS Employers, NHS England, NHS Improvement, the NHS Confederation and NHS Providers, he (Sir David Dalton) has asked me to end the uncertainty for the service by proceeding with the introduction of a new contract that he and his colleagues consider both safer for patients and fair and reasonable for junior doctors. I have therefore today decided to do that.”

Controversially, 14 out of 20 NHS CEOs, who were listed in the annex of the letter, subsequently asked for their names to be withdrawn as they did not support imposition. Since you also signed the annex and represent such a large number of important NHS organisations, which include the NHS Trusts of the CEOs that have withdrawn their names, this has created a very confused situation.

The annex stated the following:

The following Chief Executives have confirmed that the best and final position of NHS Employers is considered ‘fair and reasonable’. They also confirm that the NHS needs certainty on the Junior Doctors’ contract and that a continuation of the dispute, with a stalemate and without clear ending, would be harmful to service continuity, with adverse consequences to patients.”

Sir David Dalton has since further muddied the waters by telling the Health Service Journal that the listed signatories and CEOs had not been asked to sign up to support imposition. He stated that “if anyone wants to make an inference from this that they supported imposition then that is their inference, but that is not what the signatories have committed their names to”. The wording of the annex and the actions of 14 out of the 20 CEOs to withdraw their names would seem to contradict his assertions.

The imposition of a contract on junior doctors is an unprecedented move by the Secretary of State with potentially extremely serious consequences for the recruitment and retention of doctors into the NHS. A potential exodus of doctors could have profound effects on the service and patient care and safety could be put at risk. Jeremy Hunt quoted your support and that of 20 NHS CEOs in a Parliamentary statement to justify his decision to impose the contract. Since 14 out of the 20 NHS CEOs have subsequently denied support for imposition, we seek clarification of your own positions on this matter as soon as possible. We would therefore be grateful if you could answer the following questions:

1. Do you support Jeremy Hunt's decision to impose a new contract on junior doctors?

2. If you do support imposition, how does this reflect the views of your member organisations? Have you asked for their views?

3. Did your decision to sign the annex of the letter involve your executive boards, your member organisations, or was this a CEO decision alone?

We would appreciate a reply as soon as possible,

Yours sincerely,

Dr Clive Peedell

Consultant Clinical Oncologist

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