Junior doctors fail in high court challenge of new contract"s legality

Junior doctors have lost a judicial review challenging the legality of a controversial new contract, which is now set to be introduced by Jeremy Hunt next week.

In a judgment published on Wednesday, Mr Justice Green rejected arguments presented at the high court by five junior doctors that the health secretary had exceeded his powers.

A Department of Health spokeswoman said: “We welcome this clear decision by the judge that the secretary of state acted entirely lawfully. We must now move on from this dispute to the crucial job of making sure patients get the same high standards of urgent and emergency care every day of the week, which involves more than the junior doctors’ contract.

“We urge the BMA to remove all threat of further industrial action so we can work constructively with junior doctors to address their wider concerns and better recognise their vital importance to the NHS.”

The junior doctors nevertheless claimed the judgment as a victory. They said it showed the contract was not being imposed, which they argued meant junior doctors were not legally compelled to sign the new agreement and could continue to negotiate the terms and conditions.

The Department of Health said it would be seeking repayment of taxpayers’ money spent defending the case up to the previously agreed cap of £70,000 and would use the funds to make a charitable grant to NHS charities.

The doctors had argued that the health secretary had no power, whether solely or with others, to take a decision as to the terms on which junior doctors were employed, only to make recommendations, that Hunt had acted in breach of the requirements of transparency, certainty and clarity and that he had acted irrationally.

But Green rejected all three grounds. He further said he did “not accept the claimants’ argument that the evidence base upon which the minister acted was inadequate”, and he rejected the suggestion that Hunt had misled parliament.

In a two-day hearing last week at the Royal Courts of Justice in London, Jenni Richards QC, for Justice for Health, asked the court to quash Hunt’s decision to bring in the new contract, which she maintained he had no power to do, especially since the Health and Social Care Act 2012 reduced the scope of the health secretary’s powers.

The health secretary, Jeremy Hunt, is now set to impose the new contract next week. Photograph: Toby Melville/Reuters

But Gavin Sheldon QC, appearing for Hunt, rejected the doctors’ arguments and said that their case was without substance. The health secretary had not decided to “compel” NHS trusts to use the new contract, he had merely approved it, Sheldon said.

“The secretary of state has not gone outside the scope of his powers,” he told the court. “The secretary of state has been clear about what his powers are.”

The five doctors’ high court legal challenge was crowdfunded by £300,000 from about 10,000 donors, most of them fellow junior doctors. They hoped that the court’s ruling would embarrass Hunt, and make it difficult for him to execute his threat to impose the contract, by finding that he had acted outside his powers or the law.

Many junior doctors, frustrated that eight days of strike action between January and May had failed to force Hunt to lift his threat of imposition, hoped that the lawsuit might delay or even scupper altogether Hunt’s plans.

The British Medical Association is facing a backlash from its members after first announcing, and then last Saturday calling off, plans for a series of four all-out strikes by junior doctors as a way of increasing the pressure on Hunt.

As things stand, NHS trusts across England will start phasing in the contract from next week in a process that will take about 18 months to put all 54,000 doctors below the level of consultant on to the altered terms and conditions.

This week Sir David Nicholson, who was the chief executive of the NHS in England until 2014, criticised ministers’ handling of the year-long junior doctors’ dispute.

“Clearly the government overall got it wrong,” Nicholson said. He said given that today’s generation of junior doctors wanted to work more flexibly and have more control over their lives, “it seemed to me that the way the conversation was going … I was really worried that it was less to do with the issues around that particular problem and more to do with a general idea that somehow we needed to put the junior doctors in their place.”

Junior doctors fail in high court challenge of new contract"s legality

Retendering NHS 111 contracts could cost millions

111 line replaced NHS Direct as the amount to phone for urgent but non-emergency care. Photograph: Alamy

The bungled launch of the NHS 111 support is likely to cost the health service millions of pounds, in accordance to an investigation by the British Health-related Journal (BMJ).

The services was thrown into turmoil last July soon after one particular of the major providers, NHS Direct, announced it planned to pull out of its contracts due to significant monetary troubles.

The price of retendering the contracts is most likely to be really high, the BMJ stated. In just a single region impacted, the West Midlands, the reprocurement approach will cost £500,000, it located.

The NHS 111 line, which replaced NHS Direct as the number to phone for urgent but non-emergency care, has been riddled with teething issues considering that its inception on 1 April. Sufferers have complained of calls going unanswered, bad suggestions offered and calls getting diverted to the wrong part of the nation.

A month following the launch, leading medics mentioned the “problematic” roll-out of the technique had left several patients not being aware of in which to flip. NHS England launched an investigation into the tips line right after a quantity of incidents, like 3 deaths, have been linked to the support.

NHS Direct initially won 11 of the 46 contracts across England to give the 111 service. But in July it announced it would be unable to provide the service in North Essex, Cornwall, Somerset, Buckinghamshire, east London and the City, south-east London, Sutton and Merton, West Midlands, Lancashire and Cumbria, Greater Manchester, Merseyside and Cheshire.

A spokeswoman for NHS Direct said the contracts, which covered far more than a third of the population of England, have been “financially unsustainable”. In October the organisation announced that it was to close soon after projecting a £26m deficit for this economic 12 months.

Dame Barbara Hakin, chief operating officer at NHS England, mentioned: “NHS 111 is now a steady and improving service and we are assured it will continue to get better. I have been impressed by the way that the employees providing these companies across the country have turned the circumstance all around on behalf of the public.

“NHS 111 gives a excellent services with large levels of public fulfillment. Calls are answered promptly and a lot more individuals are obtaining accessibility to the support as we move to complete coverage in February 2014. The latest urgent care review identified the important role that 111 can play. The concept of calling for suggestions first is crucial for patient care outcomes and we are committed to guaranteeing 111 plays its complete element in this.”

Labour’s shadow wellness minister Andrew Gwynne explained: “It is now clear that ministers wasted hundreds of thousands on flawed contracts. Labour warned the government at the outset that 111 was fundamentally flawed but they pressed ahead with the rollout irrespective.

“David Cameron is responsible for its shambolic introduction. The destruction of NHS Direct – a trusted, national support – is one particular of his worst acts of vandalism.”

Retendering NHS 111 contracts could cost millions