The British Medical Association and the Health Secretary seem at loggerheads over the logistics of a seven-day National Health Service, with Jeremy Hunt telling the doctor’s union he will impose a new contract if negotiations to support the plans are unsuccessful.

The current consultant contract, dating back to 2003, allows senior (non-emergency) doctors to opt out of weekend shifts, leaving many hospitals with inadequate coverage over the weekend.

In a speech delivered at The King’s Fund today, Hunt will give the BMA until September to negotiate on changes to contracts for both hospital consultants and junior doctors to secure a seven-day service. “Be in no doubt: if we can't negotiate, we are ready to impose a new contract,” he will say, according to reports.

But the BMA has slammed his ultimatum as “nothing more than a wholesale attack on doctors to mask the fact that for two years the government has failed to outline any concrete proposals for introducing more seven-day hospital services”.

Avoidable deaths

Hunt has been gunning for a 24-7 NHS for some time, on the basis that data shows patients are more than 15% more likely to die if admitted on the weekend, equating to around 6,000 avoidable deaths a year.

But BMA chair Mark Porter says the issue now is not over the principle but how it will be implemented. “Doctors support more seven-day hospital services and have repeatedly called on the government to outline how they will fund and staff them. Despite whatever the health secretary may claim, his simplistic approach ignores the fact that this is a much broader issue than just doctors’ contracts,” he said.

The health secretary, he argues, “should be working with us, not setting artificial deadlines and attacking the very people who are the leading advocates for patients, protecting and improving patient care in the face of unprecedented rising demand and funding deficits”, and he accused the government of trying to “distract from its refusal to invest properly in emergency care”. 

GPs next?

Maureen Baker, chair of the Royal College of GPs, said Hunt’s announcement “will sound the alarm bells for hardworking GPs who fear we will be next in line - even though we are already being pushed to our limits in trying to provide a safe five-day service for our patients”.

“There is already a severe shortage of GPs and it's difficult to see how we can be stretched even further to provide routine seven day opening,” she warned.