Junior doctor England

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Hunt 'irrationally' imposed contract, claims Justice for Health

health reform; Jeremy Hunt; Health secretary; Secretary of state for health
HUNT: Doctors’ group Justice for Health argued that Mr Hunt had acted beyond his remit in seeking to impose new terms and conditions

Health secretary Jeremy Hunt’s decision to impose a new junior contract in England was irrational and lacking in clarity, a court has heard.

Doctors’ group Justice for Health argued that Mr Hunt had acted beyond his remit in seeking to impose new terms and conditions on doctors, rather than to merely recommend them to employers.

Justice for Health’s counsel Jenni Richards QC said Mr Hunt’s parliamentary statement on 6 July, when he said he was imposing the contract in the wake of junior doctors’ decision to reject the Government’s offer, failed to meet standards of transparency and clarity, and that Mr Hunt acted irrationally.

Ms Richards told the high court in London earlier this week that the case was not about determining the merits or demerits of the contract itself, or the Government's associated pledge for a seven-day NHS, but that the decision to impose was wrong.

Ms Richards, citing primarily the 6 July announcement, as well as numerous occasions prior to it including a statement to the Commons on 18 April, said that Mr Hunt repeatedly implied that he was taking the decision to impose the contract.

She said: ‘The health secretary's statements [on 18 April] are unequivocal: the contract will be introduced for all junior doctors and that is the decision he has personally taken.

‘It is clear the health secretary [expressed] to Parliament and the public that he had the power to take the decision as to the contract that was used for the employment of junior doctors.

‘He assumed powers when he has no such powers.’

In making his announcement, Mr Hunt also failed to clarify what the immediate impact of his decision would be and that implementation of the contract was in fact at the discretion of individual trusts.

 

Selective approach to evidence

Another aspect of Justice for Health’s case against the health secretary was that his decision to introduce a new contract for junior doctors was the result of irrational reasoning.

Ms Richards explained that Mr Hunt had made clear that a new contract was an essential part of the Government’s wider policy of a seven-day NHS, itself designed to address the issue of excess patient deaths at weekends.

She said that in reality there was much conflicting evidence over the weekend effect and its cause, but that Mr Hunt had chosen only to heed those studies that supported his case for imposing a new contract.

Describing it as ‘a failure of sufficient enquiry’ on the part of Mr Hunt, Ms Richards said that the failure to consider wider evidence on weekend deaths had led to irrational decision-making.

She said: ‘The health secretary is not entitled to ignore such material which is at least as weighty if not more in its totality.

‘It is his duty to engage substantively with that evidence and, having done so, have a rational, logical basis for choosing one [course of action] over the other. We say he has not done that.’

In making his announcement, Mr Hunt also failed to clarify what the immediate impact of his decision would be and that implementation of the contract was in fact at the discretion of individual trusts.

 

No obligation

Representing the health secretary, Clive Sheldon QC said Mr Hunt had never taken any decision to compel health employers to use the new contract.

He added that there was no evidence that any employers had believed they were legally required to adopt the new contract.

He said: ‘We say simply as a starting point that the claimants have mischaracterised the health secretary's decisions [regarding the contract].

‘The decision was not to mandate NHS Employers to implement the junior doctors’ contract … he was giving a green light to employers to act on the new model contract that had been agreed and approved.’

Mr Sheldon added that there was furthermore no evidence that any employers in the health service had been misled over what their powers were with regard to the contract or that they were introducing it against their will.

He said: ‘There is nothing to suggest that employers do not want to implement the contract. The evidence is to the contrary.’

The two-day hearing brought by Justice for Health concluded on 20 September, with Mr Justice Green’s ruling on the case expected to be published on 28 September.

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