HSJ’s round-up of the day’s must read stories and biggest talking points
- Today’s must know: Junior doctors lose High Court challenge to contract
- Today’s talking point: NHS free to ‘abandon payment by results’
- Today’s other talking point: Julie Moore intervenes over future of inadequate hospital
- Today’s risk: Landmark patient data probe sparks ‘serious concerns’
No celebration after court decision
There will be very few senior figures in the NHS who did not expect junior doctors to lose their High Court showdown with the government.
It was always the case that individual employers would introduce the contract when doctors rotated to their new jobs and any suggestion Jeremy Hunt had acted illegally seemed far fetched.
And so it came as no surprise to most commentators who have followed the dispute that the junior doctors lost their court action.
Mr Justice Green could not have been clearer in his judgment on Wednesday afternoon that the health secretary had acted lawfully: “I have concluded that the decision adopted by the secretary of state fell squarely within the scope of his lawful powers…
“When all the relevant material is read objectively and in its proper context there is no lack of clarity or transparency.”
There was some deserved criticism of Mr Hunt for his loose language in Parliament, which had allowed doctors to misunderstand how the contract was being introduced. HSJ has previously chastised Mr Hunt for this during the course of the dispute.
The judge also rejected claims that the evidence base for seven day services reforms were inadequate: “There is a cogent body of evidence from authoritative sources which supports both the existence of a weekend effect and a causal connection between that adverse effect and a shortage of skilled staff.”
He said Mr Hunt was entitled to take a view as to how to proceed to try to tackle this problem.
While those in Richmond House will be pleased with this result, the NHS is left with a generation of junior doctors who feel mistreated, lied to and undervalued.
That is no cause for celebration.
Last days of PbR
Simon Stevens has said he and Jim Mackey are “entirely open” to health economies dropping payment by results in favour of alternative funding systems for the next two years.
The NHS England chief excuitve, speaking about the perverse incentives of the payment by results tariff, said areas could choose to move instead to “allocate funding on a programme basis”.
Planning guidance published by NHS England and NHS Improvement last week said groups of organisations will soon receive “whole system” control totals – designed to enable flexibility in financial flows. However, it did not discuss a shift away from payment by results.
Speaking to NHS leaders at the HSJ Commissioning Summit, Mr Stevens said: “There’s absolutely nothing stopping any health system coming forward and saying, ‘We want to move the money around between us in the following ways, which would have the following impacts on what the control totals would look like for individual trusts or [clinical commissioning groups]’.
“It needs to stack up in the round, but if you come forward and say, ‘We’re not buying emergency clicks of the turnstile any more, this is the way we’re going to allocate funding on a programme basis across our population with the agreement of all the organisations involved’, that’s absolutely fine with Jim and me.”
Mr Stevens also said the government wants the NHS to “get on with the task” of overhauling services in line with the Five Year Forward View and there is “no new reform plan” for the health service.