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Junior doctors' contract should be scrapped, argues leading doctor

BMJ

The junior doctors' contract "should be discarded and replaced with one drawn on a clean sheet," argues Neena Modi, Professor of neonatal medicine and president of the UK Royal College of Paediatrics and Child Health.

In an editorial for The BMJ today, Professor Modi says the total breakdown of trust between government and junior doctors "represents a catastrophic failure of senior leadership at all levels."

She says, it's "time for acknowledgment of deep malaise around medical training and honest public debate on the state of the NHS."

Last week, a High Court rejected arguments over the legality of the actions of the health secretary, Jeremy Hunt, in connection with a new contract for doctors in training. The ruling was the latest twist in a long drawn out, damaging dispute that has brought thousands of young doctors onto the streets to protest.

Professor Modi argues that the NHS "is in disarray" and that it is "a testament to the dedication of junior doctors and all other frontline healthcare staff that the public has been largely shielded from the consequences of this chaos." The corollary is that most people are unaware of the extent of the change the NHS is undergoing, she adds.

"Their protest is both an expression of breaking point frustration with their training and a clarion call to the country to wake up and recognise the true state of the nation's health services," she writes.

Professor Modi argues that there is "an overriding need to re-establish trust, restore morale, and respect young doctors as the professionals that they are."

She also believes that the contract, regardless of any further tweaks, "will forever be damaged goods, and in this same spirit of building trust should be discarded and replaced with one drawn on a clean sheet."

Finally, "patients and the public must be part of a conversation, conducted with integrity, about the nation's health services," she adds.

The questions are clear, she says. Do we want healthcare that is efficient, effective, and equitable, delivered by a modern public sector organisation driven not by financial incentives but by pride in outcomes measured to rigorous standards? Do we consider health a commodity or an essential component of a just society, crucial to the economic wellbeing of the nation?

"The painful political awakening of a generation of young doctors may ultimately prove the catalyst to find a way forward," she concludes.

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Editorial: Junior doctors' dispute leaves big questions about state of NHS http://www.bmj.com/content/355/bmj.i5342

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