Updated noon: 14 chiefs now deny support for contract imposition

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14 chief executives out of 20 who were listed on Sir David Dalton’s letter say they did and do not support imposition of new contract
Contrasts with Jeremy Hunt’s apparent suggestion to Parliament that he had their backing
Sir David tells HSJ the chief executives listed had not been asked to sign up to support contract imposition
One chief executive reveals she asked for her name to be removed at the draft stage

Fourteen of the twenty chief executive signatories to David Dalton’s letter to Jeremy Hunt on the junior doctor contract have told HSJ that they do not support imposition of the contract.

Their words contradict the health secretary’s apparent suggestion to Parliament on Thursday that he had their backing for an imposed contract. One of the 14 has said the chiefs had not been asked to sign up to support the recommendation that the government should “do whatever it deems necessary to end uncertainty… and to make sure that a new contract is in place”.

A further three signatories declined to give their explicit support for imposition when asked directly to do so.

On Friday morning one chief executive confirmed her name had been attached to a draft of the letter but that she had asked for it to be removed because she does not support imposition of the contract.

Sonia Swart, who leads Northampton General Hospital Foundation Trust, said: “I was one of the chief executives who made a small contribution to the work led by Sir David Dalton. I confirmed to him that I considered the final package on offer was safe, fair and reasonable. I do not support imposition of the contract, though if it proceeds I recognise this brings new challenges for us all.”

Central and North West London Foundation Trust chief executive Claire Murdoch yesterday issued a statement saying she was “unhappy” to be included on the list and at being perceived to be supporting the government’s plan to impose a contract on junior doctors.

Six other signatories to the letter – in which Sir David advised the government to do “whatever it deems necessary” after the British Medical Association rejected a final offer – have said they were not lending support for an imposed contract.

These are: Sheffield Teaching Hospitals chief executive Sir Andrew Cash, Nottingham University Hospitals Trust chief Peter Homa, Royal Free London FT chief David Sloman; Wrightington, Wigan and Leigh FT chief Andrew Foster; West Suffolk FT chief Stephen Dunn; Miles Scott from St George’s, Milton Keynes University Hospital FT’s Joe Harrison, the Royal Wolverhampton Trust’s David Loughton, Leicestershire Partnership Trust’s Peter Miller, Dartford and Gravesham’s Susan Acott, East Kent University Hospital’s Matthew Kershaw, Royal United Hospitals Bath’s James Scott and University Hospitals Bristol’s Robert Woolley.

Mr Foster also said on Thursday: ”The letter we supported was a different one to that published today.” He posted on twitter an image of the statement the chief executives had agreed to support, which says, ”that the NHS needs certainty… and that a continuation of the dispute, with a stalemate and without clear ending, would be harmful”.

The two signatories which declined, when asked by HSJ, to give their explicit support for imposition are: University Hospitals of Leicester Trust’s John Adler; and Heather Tierney-Moore of Lancashire Care FT.

Informing parliament this morning of his decision to impose the contract, Mr Hunt said: “Sadly, despite this progress and willingness from the government to be flexible on the issue of Saturday pay, Sir David wrote to me yesterday advising that a negotiated solution is not realistically possible.

“Along with other senior NHS leaders and supported by NHS Employers, NHS England, NHS Improvement, the NHS Confederation and NHS Providers, he 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.”

The organisations he cited, and the 20 chief executives, were listed at the end of Sir David’s letter, as having “confirmed that the best and final position of NHS Employers is considered ‘fair and reasonable’” and “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”.

Speaking to HSJ on Thursday, Sir David said the chief executives listed had not been asked to sign up to support contract imposition.

He said: “The statement that they agreed to was confirming that the best and final position was considered fair and reasonable, and that they believed the NHS needed certainty and not continuation of the stalemate.

“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.

“I neither want to say they do, or that they don’t [support imposition]. There is a variety of opinion in this.”

Sir David told HSJ that he supported imposition of the contract.

The DH declined to comment.

This story was updated during the afternoon and evening of 11 February, and three times on 12 February - once at 10am and again at 11am and 12.15pm, to reflect additional chief executives making statements in relation to the letter.

At a glance position of the 20 chief executives on the original letter released:

For imposition

Sir David Dalton - Salford Royal Foundation Trust

Sheena Cumiskey - Cheshire & Wirral Partnership NHS FT.

The trust’s statement said: ”CWP advise the government to do whatever it deems necessary to end uncertainty for services.”

Not supporting imposition

Claire Murdoch - Central & North West London Foundation Trust

Andrew Foster Wrightington - Wigan & Leigh NHS Foundation Trust

David Sloman - Royal Free London NHS Foundation Trust

Miles Scott - St George’s University Hospitals Trust

Stephen Dunn - West Suffolk Foundation Trust

David Loughton - Royal Wolverhampton Trust

Sir Andrew Cash - Sheffield Teaching Hospitals Foundation Trust

Joe Harrison - Milton Keynes Foundation Trust

Peter Homa - Nottingham University Hospitals Trust

Matthew Kershaw - East Kent Hospitals University Foundation Trust

Peter Miller - Leicestershire Partnership Trust

Susan Acott - Dartford & Gravesham Trust

James Scott - Royal United Hospitals Bath Foundation Trust

Robert Woolley - University Hospitals Bristol Foundation Trust

Have not responded

Clare Panniker - Basildon & Thurrock University Hospitals Foundation Trust

Sir Leonard Fenwick - The Newcastle Upon Tyne Foundation Trust

Unclear

John Adler University Hospitals of Leicester Trust

Heather Tierney-Moore Lancashire Care Foundation Trust

Full quotes

Claire Murdoch

Claire Murdoch: ‘I have told NHS Employers to remove my name and they have done so’

In a statement to HSJ, Claire Murdoch said: “I was very unhappy to see my name added to an endorsement of the final offer from NHS Employers. As whether it was ’fair and reasonable’ was exactly what I’d asked.

“The Guardian subsequently have me as supporting the imposition. I have told NHS Employers to remove my name and they have done so.”

David Sloman, chief executive of the Royal Free London FT, told HSJ: “I am profoundly disappointed that the national negotiations have failed to reach an agreement with the BMA on a new contract for doctors in training.

“I have the upmost respect for junior doctors, know how hard they work to deliver patient care and want to enjoy working with them for many years to come.

“I do believe that the contract offered is reasonable however I do not support contract imposition.

“My view is that the best way to reach resolution is negotiation.”

Likewise, West Suffolk FT chief executive Stephen Dunn said on Twitter he was “not supporting imposition” by signing the letter, but rather the view that Sir David’s offer to junior doctors was an improvement on the original.

Wrightington, Wigan and Leigh FT chief executive Andrew Foster, who was also listed as in support of the letter, said on Twitter: “I have not supported contract imposition. I have supported the view that the offer made is reasonable.”

St George’s chief executive Miles Scott said on Twitter: ”To be clear, I supported the contract offer but not imposition.”

East Kent University Hospitals chief executive Matthew Kershaw said: ”I do support David [Dalton]’s offer as better than anything that has gone before and David and the negotiating teams’ opinion that this was the best offer possible. I wasn’t asked about imposition and I have supported finding a resolution but not imposition.

”I haven’t asked for my name to be removed as I was asked to support getting a resolution for all parties benefit and I agree with that but not imposition which is a matter for the Secretary of State.”

Royal United Hospitals Bath Foundation Trust Chief Executive James Scott said: “I have not supported contract imposition. I have supported the view that the NHS needs certainty on the Junior Doctor’s contract and that the latest contract offer was fair and reasonable. It is really important that we have certainty over the working arrangements for new Junior Doctors starting with us on August 1.”

Dr Sonia Swart, chief executive of Northampton General Hospital Trust, said in a statement: ”I do not support imposition of the contract, though if it proceeds I recognise this brings new challenges for us all. At NGH, we will endeavour to implement the new contract sensitively and with as much joint working as we can achieve in the circumstances. We remain committed to engaging with the trainees who spend time with us, and to doing all we can to help restore their morale and confidence in their future as clinicians upon whom the NHS (including NGH) will depend.

“I share the disappointment of most (if not all colleagues) that an agreed settlement could not be achieved. NGH has a track record of appreciation of, and reliance on, trainee doctors, and I have taken many opportunities over the years to reiterate that we hugely value their commitment and skill.”

A spokeswoman for University Hospitals Bristol told HSJ: ”[Chief executive] Robert [Woolley] did not give his support to the imposition of a contract on junior doctors.”