• Internal emails show BMA leader wanted paediatrics to be excluded from full walkout
  • Withdrawing emergency care for children would be “difficult line to defend”
  • Full emergency strikes planned for 26 and 27 April with no exclusions

EXCLUSIVE: Internal emails from the British Medical Association show junior doctors’ leader Johann Malawana urged his union colleagues to exclude paediatric services from next week’s emergency care strike.

The junior doctors’ committee chair warned it would be a “difficult line to defend”.

johann malawana

johann malawana

Johann Malawana: ‘Doctors withdrawing care from children would be a difficult line to defend’

He said the move was vital to ensure doctors continued to support the industrial action and that it was the “right thing to do” if the BMA was to retain the reasonable ground.

The plea was rejected by the committee and a full withdrawal of labour by thousands of trainee doctors is set to go ahead at 8am-5pm on 26 and 27 of April.

It will be the first time that junior doctors have taken strike action that will not include providing emergency care to NHS patients.

The government is pressing ahead with plans to impose the junior doctors’ contract despite the threat of two judicial reviews and opposition by a number of royal colleges.

In an email to the committee dated 21 March, Dr Malawana told members: “Having taken a lot of very private soundings and talked to lots of people I am going to suggest that any full withdrawal of labour excludes emergency paediatric services.

“I hope the committee will support me in this decision. I think from a [communications] perspective and to try and ensure we get the sign up of [doctors] as well as retaining the reasonable ground, it is the right thing to do.”

In a second email on the same day he said: “The reasoning being that doctors withdrawing care from children would be a difficult line to defend.”

He said he would be comfortable explaining how consultants would be available to cover other specialties including maternity, “but I think it also gives the profession more ability to sign up to an escalation and increase participation”.

He added: “Even [doctors] not in the services covered I think would feel more comfortable being able to talk about and point to this as something that demonstrates our absolute desire not to take [industrial action].”

The president of the Royal College of Paediatrics and Child Health spoke on Friday about her fears over the contract being imposed and the risk to paediatric services.

Professor Neena Modi said: “We fully support the provision of effective and efficient primary and secondary healthcare seven days a week but deeply regret that this has been conflated with the imposition of a non-negotiated contract upon doctors in training.

“Paediatrics already has an average 12.5 per cent shortfall in trainee numbers, rising to 20 per cent in sub-specialties such as neonatal intensive care. The imposition of the new contract has led to eight resignations of trainee paediatricians in the London region alone in the last three months, more than in the previous two years.

“It is becoming increasingly difficult to sustain the provision of safe healthcare services for UK children.”

A BMA spokeswoman said on Friday: “In refusing to get back around the table the government has left junior doctors with no option but to take further action. For the sake of patients as well as doctors the government must listen to concerns from all sides calling on it to step back from the brink and get back around the negotiating table. It is not too late to remove the threat of imposition and end this through talks.”

The BMA has publicly urged the government to return to negotiations but HSJ understands the union’s refusal to discuss weekend pay has not changed. Health secretary Jeremy Hunt has said the “matter is closed” after three years of talks and delays.

Health minister Ben Gummer said: ”Senior NHS leaders have been clear that removing emergency cover puts patients at risk and now we learn that even Johann Malawana, who is leading the junior doctors’ strike, has personally argued that his colleagues should not participate in a full walkout. What we are seeing is an organisation in turmoil and regrettably, that turmoil is now impacting directly on patient safety. This is yet more evidence that the BMA should call off this dangerous and damaging strike.”