4. Whether the terms and conditions of the junior doctors contract were finalised before he took the decision to introduce that contract. (904253)

May I start by echoing the thoughts of my the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), for the people of Brussels, with whom we stand shoulder to shoulder?

In my statement to the House on 11 February, I gave a broad outline of the new terms for doctors and dentists in training, which were recommended as fair and reasonable by Sir David Dalton. I am still reviewing the exact terms, alongside the equality impact assessment, and finalised terms will be published shortly.

When the Secretary of State declared that he was imposing the contract on junior doctors last month, he claimed the support of senior NHS leaders, many of whom subsequently denied supporting his position. Given that foundation trusts are free to offer their own terms, how does he envisage enforcing that contract?

We consulted widely with NHS leaders about the terms of the new contract, and they confirmed that it was fair and reasonable. Any decision to proceed with a new contract when it is not possible to have a negotiated settlement is inevitably controversial, but we wanted to ensure that independent people thought that the terms of the contract were fair. I think we have done that, and when junior doctors see their new contracts—as they will do shortly—they will realise that we were right to say that.

Underlying the dispute over the junior doctors contract is a long-standing problem of morale among junior doctors, and a failure to pay enough attention to their experiences in training. I welcome the Government’s decision to launch an independent review led by Professor Dame Sue Bailey, and I ask my right hon. Friend to update the House on the progress and timing of that review.

As ever, my hon. Friend speaks with great knowledge about NHS matters, and she is right to say that some of the underlying issues have nothing to do with contractual terms but are about very big changes in the way that training has happened over recent years, in particular the loss of the firm system and the sense of camaraderie that was part of the deal for junior doctors in training. We would like to see whether we can rectify some things that have gone in the wrong direction, but we have not yet had the co-operation of the British Medical Association for that independent review, which is led by the highly respected Professor Dame Sue Bailey. I hope that the BMA will co-operate with that, because it is a big opportunity to sort out some long-standing problems.

There are currently 4,500 gaps for trainees in the NHS. Junior doctors often have to cover those gaps, which can mean having to do extensive extra shifts, or even covering two roles at the same time. It looks as if that situation will get worse, because fewer than half of the most junior trainees have applied for ongoing training this year. Does the Secretary of State accept that that represents a serious threat to patient safety?

The purpose of the changes is to improve patient safety, and particularly to deal with the issue that we have higher mortality rates for people who are admitted to hospital at weekends than for those admitted during the week. Because of the confrontational approach taken by the BMA, it has been difficult to negotiate an agreement, but we are committed to doing the right thing. What is right for patients is also right for doctors. We have been talking about morale, and the biggest way to dent doctors’ morale is to prevent them from giving the care that they want to give patients, so we must sort that issue out.

I suggest that what is good for doctors is also good for patients, and if people are being texted four or five times a day and asked to do a second shift to cover for a junior and a senior post at the same time, that is not good for either. On 11 February the Secretary of State said that he was imposing the contract to bring stability to the NHS, but that has not exactly gone well. What is his plan to re-establish his relationship with junior doctors and get us back out of where we are now?

With the greatest respect, we are trying to solve a problem that in Scotland is being ducked. We want a seven-day NHS with mortality rates that are no higher at weekends. There is no plan in Scotland to deliver that across the whole NHS. Rather than sniping, the hon. Lady should recognise that, in the interests of patient safety, we need to take difficult decisions. In the end, doctors will see that it is the right thing for them, too.

First, on behalf of the Opposition, I associate ourselves with the comments made by Ministers about the tragic events in Brussels, and offer our condolences and solidarity to the people there.

Yesterday in Westminster Hall, there was a debate calling on the Health Secretary to resume meaningful contract negotiations with the BMA. The Health Secretary was not there—I do not know, but perhaps he was out buying a leaving present for the Chancellor—but if he had been, he would have heard his junior Minister confirm that, since the announced imposition, the Government have made no attempt to prevent further industrial action. They know more industrial action is coming. Do they not owe it to patients who would be inconvenienced by further strikes to get off their backsides and do something to prevent it?

The reason we made the decision to proceed with the new contracts is that we had independent advice that a negotiated settlement was not possible. On that basis, we decided that it was important to have certainty for the service by making clear what the new contract is. The contract that we decided on is one that strikes a mid-point between what the Government wanted and what the BMA asked for. It is a fair contract and a better contract for patients. The Labour party would support it if it was really on the side of patients.