The GPC has indicated that it intends to contact LMCs as early as next week regarding decisions on whether or not to ballot doctors on potential mass resignations.
This revolutionary and controversial action will reach its three-month deadline at the end of next week.
Commenting on the issue, GPC deputy chair Dr Richard Vautrey indicated that action must be taken imminently if the issue is to be resolved satisfactorily.
“The timeframe for the motion is imminent. It is around 20 August [based on the conference motion timeframe]. It has obviously been discussed quite significantly within the GPC, and we have had a lot of engagement with NHS England since the conference itself. We are putting together a statement which we will be issuing shortly, relating to all these issues.”
The conference motion had declared LMCs did not accept that the GP Forward View was “an adequate response to the crisis in general practice and considers it to be sufficient grounds for a trade dispute”.
Numerous measures have been requested from NHS England, including setting a maximum limit on the number of patients GPs are required to attend to in a single day.
It is also requested that a nationally defined contract for GPs employed by other providers should be agreed.
The May LMC Conference motions in full are listed below:
AGENDA COMMITTEE to be proposed by Tower Hamlets: That conference does not accept the General Practice Forward View is an adequate response to the GPCs statement of need within the BMAs Urgent Prescription for General Practice, and considering this to be sufficient grounds for a trade dispute, unless the government agrees to accept the Urgent Prescription within 3 months of this conference, the GPC should ask the BMA to:
(i) ballot the profession on their willingness to sign undated resignations CARRIED
(ii) ballot the profession on their willingness to take industrial action CARRIED
(iii) ballot the profession as to what forms of industrial action they are prepared to take CARRIED
(iv) produce a report to practices on the options for taking industrial action that doesn’t breach their contracts CARRIED
AGENDA COMMITTEE to be proposed by Cambridgeshire: That conference with regards to the General Practice Forward View;
(i) Welcomes the acknowledgment of significant past underfunding and commitment to increased spending CARRIED
(ii) believes that most of the investment promised is conditional upon practices delivering transformation and service change CARRIED
(iii) recognises that only some of the demands of the profession have been included, and instructs GPC to continue to press for further dedicated resources to support GPs CARRIED
(iv) does not believe that there is sufficient urgency in the measures described CARRIED
(v) is concerned that the present financial state of the NHS makes the prospects of these financial flows unlikely CARRIED
The Junior Doctors Committee (JDC) of the British medical Association has called on the union to authorise further strike action as the ongoing row over contract continues.
The full council will be asked to support industrial action from early September, as healthcare professionals continue to play hardball with the government and authorities.
In response to the contractual terms offered to junior doctors, the JDC suggests that concerns that the organisation has expressed have not been satisfactorily addressed.
The contract was rejected by 58% of its members who voted in the ballot.
In a letter to members, Dr Ellen McCourt, who chairs the JDC, said the government had remained “persistently silent” on issues which, she said, had resulted in the contract being rejected.
“In light of this, the JDC Executive has voted to reject the proposed new contract in full and to call for formal re-negotiations on all of your concerns. In response to the government’s silence, JDC exec has today made a formal request for a special meeting of BMA Council to authorise a rolling programme of escalated industrial action beginning in early September.”
But Daniel Mortimer, chief executive of NHS Employers, was scathing on at the prospect of further industrial action, and its alleged impact on the health service.
Mortimer suggested that strikes “would achieve little or nothing, but place pressure on already stretched teams and services and causes worry, distress and disruption for patients, carers and their families”.
Many physicians and healthcare professionals will doubtless disagree with this stance, considering it to be something of a guilt trip.
Nonetheless, Mortimer suggested that during the past two months that dialogue had been taking place with the Junior Doctors Committee, and NHS Employers has “responded positively to concerns regarding the guardian role and whistleblowing”.
And the chief executive suggested that the conduct of the authorities was indicative of how seriously they took the contract and concerns of healthcare employees.
“Employers were hopeful that the continued positive engagement on other important topics… were a sign of how serious employers, Health Education England and the Department of Health were about honouring the agreements reached with the BMA.”
With six strikes having already occurred over the matter, including the first total walkout in the history of the NHS, there is no doubt that both sides would prefer to avoid further industrial action.
The BMA’s junior doctor leader, Dr Johann Malawana, has already resigned as a consequence of the BMA supporting the contract, which was later rejected by ballot.
Health Secretary Jeremy Hunt has insisted that the contract will be imposed on medics in England.
But it seems that this story has more mileage to run in the meantime.
Doctors’ union the British Medical Association (BMA) have announced plans for an “escalation” of strike action.
The BMA is strongly opposed to the government’s decision to impose a new contract on junior doctors.
And junior doctors have themselves voting on several occasions to support the position of the British Medical Association, with workers all over the United Kingdom concerned about both working conditions and future provisions for the NHS.
The chairman of the BMA’s junior doctor committee (JDC), Dr Johann Malawana, wrote to medics to confirm that the JDC had “voted to move towards an escalation of its planned action”.
Malawana stated that the “exact nature” of the action would be confirmed shortly.
Pay has also been a prickly issue for junior doctors, with the terms of the imposed contract ultimately resulting in a 30% reduction in salary for some individuals.
The union’s options include a full walkout by junior doctors, including those working in emergency services, or prolonged strikes extending beyond 48 hours.
In each of the junior doctor strikes so far, emergency staff have remained in post, but this is now thought to be under serious threat as the government continues to occupy an intransigent position.
A&E doctors are among those most concerned about the new contract and pressure for a full walkout has been growing among BMA members frustrated that the union has so far proved powerless to prevent the Government imposing a new contract.
According to the plans of Chancellor George Osborne, the new contract will come into effect in August, cutting pay for Saturday working in exchange for an uplift in basic pay.
“Today we heard strong voices at JDC highlighting the need to step up our action in the face of such Government obduracy,” Dr Malawana wrote to BMA members.
“We have shown solidarity, stated our case clearly and passionately to the public, and done everything possible to avert what could be the worst of all worlds for junior doctors. This is why JDC voted today to move towards an escalation of its planned action. The exact nature of this action will be confirmed shortly. We know that no doctor wants to take such action but the refusal of the Government to get back around the table forces us down this road.”
In addition to the junior doctors dispute, the government is facing numerous problems related to the NHS, most notably financial issues.
The best case scenario based on current figures is that NHS trusts across the country will be collectively £2.5 billion in deficit by the end of the fiscal year.
And numerous top doctors have spoken out to condemn the plans of the government to seek £22 billion in efficiency savings by the end of the decade, stating that this is simply impractical and logistically impossible.
The last thing that Chancellor George Osborne would choose is stringent strike action from junior doctors, but it seems that the inflexible position of the government has now made this a certainty.
The third junior doctors’ strike in relatively quick succession began today, as NHS employees continue their protest against contractual conditions being proposed by the government.
Public support for this industrial action continues to grow, as the Health Secretary, Jeremy Hunt, threatens to force the protesters to accept the conditions proffered.
This 48-hour walkout represents a further escalation in the ongoing dispute between the government, the British Medical Association and the doctors themselves.
It is clear that there is still considerable ground between the position of the government and junior doctors, and little prospect of an immediate brokering of an agreement.
Previous industrial action lasted half the length of this particular strike, yet public sympathy at picket lines remained strong.
A poll for the BBC showed that 65% support the industrial action, almost identical to the backing before the previous strike last month.
And the percentage opposing the strike has also fallen significantly, differing from 22% last month, to 17% in the most recent survey.
It is quite evident that the position of Jeremy Hunt, and his threats to impose the contract against the will of the BMA and junior doctors, is looking to be increasingly tenuous.
In addition to the new contractual terms, it is also believed that the desire of the government to create a so-called seven-day NHS culture is simply incompatible with the plans.
The BMA states the changes would increase the burden on its members and thereby compromise patient safety.
And Holmes has been strongly attacked by the Labour party in parliament for offering a statement on patient safety in the Commons, while neglecting to mention the strike even once.
Shadow health secretary, Heidi Alexander, commented: “How can he stand here and talk about patient safety when it’s him and him alone to blame for the current industrial action, for the destruction of staff morale and for the potential exodus of junior doctors to the southern hemisphere?”
Hunt responded by suggesting that the Labour Party is backing the British Medical Association against the needs of patients, a view that has been strongly criticised by doctors participating in the strike action.
Dr Anne Rainsberry, national incident director for NHS England, apologised to patients for the strike, emphasising that the health service would be tested.
“Unfortunately the cumulative effect of these recurring strikes is causing disruption to thousands of patients, for which we can only apologise. A 48-hour stoppage puts considerably more pressure on the NHS. The impact of the action so far is broadly in line with what we were expecting but we know that the second day is going to be more difficult and have made sure plans are in place to respond to any rising pressures.”
But at picket lines, doctors stated that their primary concern is the welfare of patients, and that the new contract would simply compromise this.
Two further 48-hour strikes are planned for next month.
Sir David Dalton, the senior NHS boss involved in mediation with junior doctors in the NHS, has written to 45,000 trainee medics in an eleventh hour attempt to avoid the strike planned for next week.
Junior doctors are striking over new contractual conditions which the government intends to impose on them.
Dalton’s letter, sent on Wednesday, combines sympathy for the low morale that has been gathering among trainee doctors in England in recent years with a warning that the five-month-old dispute will rumble on even further unless a deal is agreed.
But with junior doctors continuing to strongly oppose the position of the government, with little potential for a resolution to the outstanding issues, it seems unlikely that the letter will have any significant influence.
Junior doctors are set to walk out from 8am on Wednesday, in what was set to be an unprecedented example of industrial action.
However, the British Medical Association announced that the full walkout that had initially been intended would be watered down somewhat, possibly with the intention of gaining greater sympathy from the public.
In particular, the re-allocation of hours at the weekend as essentially on-peak has caused considerable consternation among the doctors union and its members.
It has been reported that some junior doctors could see their pay cut by as much as 30% under the new arrangement.
Commenting on the strike action, the letter from Dalton emphasises the importance of compromise from both sides.
“It is clear that what is needed is a commitment on both sides to continue to talk on the key remaining issues and to find the room for settlement. Failure to do this will mean that no agreement can be reached. This would be sad in any circumstances but particularly so when there has been so much progress in the last month.”
The letter has been criticised by some as an attempt to drive a wedge between the British Medical Association trade union and its members, particularly the following section.
“It is really disheartening that at the end of last week the BMA declined an invitation to talk about the key outstanding issues (ie unsocial hours definition and associated payments), and have so far stated that they are unwilling to negotiate and reconsider these points at all.”
Dalton’s letter adds: “I came into these negotiations with a clear view – that the contract should be safe and fair for trainee doctors and effective and affordable for the NHS. I have served the NHS for over 36 years and hold firm to its values. You can be assured that I would never act in a way which compromised those values and that I strive to treat all staff in a fair and reasonable way.”
Despite the 11% pay rise that the government has offered, junior doctors remain reluctant to accept the contractual conditions that have been offered, despite certain provisions having been made by the government.
The British Medical Association has stated that there are financial and logistical issues that remain unresolved.
Despite the efforts of Dalton, it seems extremely unlikely that the planned industrial action on 10th February will indeed take place.
The planned strike by junior doctors will go ahead as talks with the government have failed to broker an acceptable agreement.
But union leaders have indicated that medics intend to provide emergency cover as they come under public pressure regarding the safety and health of the public.
This represents something of a compromise considering that the 10th February action was originally intended to be a full walkout.
However, the British Medical Association has now indicated its intention to minimise the impact of industrial action, possibly with the intention of currying favour with the public.
With polls indicating that the general populace is becoming favourable to the cause of junior doctors, it is perhaps felt by the British Medical Association that opinion is already being swayed in its favour.
Conversely, considering the decision regarding the walkouts, the British Medical Association has decided to take other measures instead.
Thus, the strike will last 24 hours in total, as opposed to the nine hours that were originally planned.
A full walkout has never happened before in the history of the NHS and would have led to a mass cancellation of routine treatments, such as knee and hip replacements, as consultants and other staff were redeployed to cover behind the junior doctors.
Commenting on the issue, BMA junior doctor leader Dr Johann Malawana indicated that some progress had been made, but that the government continues to take an entrenched position on cutting Saturday pay.
“What we are asking for is fair and affordable recognition of unsocial hours,” Malawana stated.
Malawana added that the union was hugely regretful of the disruption being caused by strike action, but that it was necessary in the context of the ongoing row.
While the government has made concessions, it still wants 7am to 5pm to be classed as normal working hours, therefore attracting no extra pay.
Although it is thought that the two sides are coming closer to a compromise, despite the strike action, this unsociable hours issue remains completely unacceptable to the British Medical Association.
Responding to the claims of the union, a spokeswoman on behalf of the Department of Health was keen to emphasise concessions that had been made over the last few weeks.
In particular, guarantees regarding the number of weekends doctors would have to work, and a more generous offer regarding extra payments for Saturday work were cited.
The spokeswoman stated that these new agreements were indicative of the strong desire of the government to reach a deal, and that “it is regrettable that the BMA is proceeding with further unnecessary industrial action.”
With the two sides stubbornly sticking to their guns, resolution of the issue may still be some distance into the future.
A major opinion poll has suggested that public support for junior doctors has grown since the first industrial action was taken by NHS workers.
Junior doctors took strike action over pay and working hours earlier this month, and further strike action is planned for February.
And despite a series of talks between junior doctors, the British Medical Association and the government, there has been no agreement brokered on the issues as of yet.
Thousands of medical staff were involved in the action against health secretary Jeremy Hunt’s proposed changes to junior doctors’ contracts.
Yet a survey conducted by Opinium, during and immediately after the strike on 12th January, will at least be encouraging for junior doctors in terms of the public perception of the issue.
The survey indicated that 53% of the public believe that strike action is justified, with only 21% indicating that it is not.
This compares with a poll in October that found that 41% were in support of action with 26% against.
In what can be seen as a microcosm of the existing political situation, the demarcation between Conservative and Labour supporters was particularly marked.
The proportion of Conservative voters who said they thought the strikes were justified rose slightly from 27% in October to 36% in the latest survey, while backing among Labour voters grew more sharply, from 54% to 76%.
Of those who thought the strikes were justified, 72% said this was because “doctors already work long enough hours”, while 67% said “more doctors are needed rather than changes in hours”.
And it is also notable that there are concerns about the general public with regard to the safety of NHS patients.
Nearly half of those that supported the strikes indicated that they believed the changes proposed would be unsafe for those being treated by the NHS.
Another 39% believed that junior doctors are already underpaid for the demanding work that they are required to conduct.
Of those who still think the strikes are unjustified, just under three-quarters (74%) agreed with the statement that “other workers have to accept unsociable working hours”; 69% believed that “weekend and weekday NHS coverage should be the same”, the same proportion as thought that “doctors choose to do a job with unsocial hours anyway”.
The figures indicate that despite the fact that the medical profession is viewed as somewhat attractive and prestigious, there is still broad public support for the position and case of the junior doctors.
Opinium Research carried out an online survey of 2,003 UK adults from 12 to 14 January 2016
The 48-hour junior doctors’ strike due to start next Tuesday in England has been called off by the British Medical Association.
This decision comes in the context of negotiations and talks between the doctors’ union and the government.
However, the British Medical Association insisted that this latest manoeuvre in the ongoing dispute did not represent the reaching of a deal between the two parties.
With negotiations continuing to take place, it is still believed that a strike could go ahead on 10th February should the ongoing process fail to broker an agreement.
Despite the fact that the strike has been prevented, the planned industrial action in February is nonetheless considered to be potentially the most disruptive.
This cancelled strike would have seen junior doctors provide emergency cover, whereas the date in February will be a complete walkout.
The decision to call off next week’s strike is good news for patients. Last week more than one in 10 operations were cancelled because of the 24-hour walkout.
But although the news would seem to suggest that a compromise is near, reports have indicated that the two sides are still separated by considerable distance.
Payment for weekend working, career progression and the safeguards being proposed to stop hospitals over-working doctors still remain key sticking points.
The suggestion that the British Medical Association has called off the strike to indicate its concern for patients, while also ensuring that the ongoing talks can continue without disruption.
Commenting on the decision to suspend industrial action, BMA junior doctor committee chair Dr Johann Malawana indeed reflected this perspective.
“The BMA’s aim has always been to deliver a safe, fair junior doctor contract through negotiated agreement. Following junior doctors’ clear message to the government during last week’s action, our focus is now on building on early progress made in the current set of talks. On this basis, the BMA has today taken the decision to suspend the industrial action planned for 26 to 28 January, thereby giving trusts as much notice as possible so as to avoid disruption to patients.”
In addition, Malawana also indicated that there were still significant problems that needed to be overcome if the February walkout is to be avoided.
“It is important to be clear, however, that differences still exist between the BMA and the government on key areas, including the protection of patient safety and doctor’s working lives, and the recognition of unsocial hours. Significant, concrete progress will need to be made if future action, currently planned for 10 February, is to be averted.”
A Department of Health spokesman naturally placed a positive emphasis on this latest decision. “The strike that took place last week was unnecessary while talks are ongoing, so it’s extremely welcome news that the BMA has suspended next week’s action. In the end, the government and junior doctors want to do the same thing by improving patient care at weekends – and we look forward to further constructive discussions.”
Talks aimed at averting strikes in the continuing conflict over junior doctors’ contracts are continuing.
The government has warned the complainants that it could impose its controversial new contract on junior doctors.
With employees in the health service continuing to oppose the government position, it seems that talks are still somewhat deadlocked.
Meanwhile, the British Medical Association (BMA) and the government have begun a planned two days of talks, according to the conciliation service ACAS.
The new contract has been particularly controversial owing to elements related to pay and career progression.
In particular, it has been suggested that as a result of the government redefining the notion of off-peak hours that some junior doctors’ pay could be reduced by as much as 30 per cent.
The government had suggested prior to the recent strike that the two sides were close to an agreement, but a spokesperson on behalf of the BMA disagreed strongly.
It was indicated that there were as many as sixteen different areas of disagreement between the union and government, and thus talks clearly have some way to go in order to broker a satisfactory impasse.
Junior doctors returned to work at 08:00 GMT on Wednesday following the end of their first 24-hour walkout, which led to the cancellation of about 3,300 operations.
Talks are intended to alleviate two further strikes, with the first planned for 26th January, and the second, on 10th February involving a refusal to take part in emergency care.
Commenting on the issue, BMA council chairman Dr Mark Porter, indicated that there is still significant disagreement between the two parties, and “not just one remaining issue” as had been suggested by Health Secretary Jeremy Hunt.
Porter stated that “there are some serious issues about patient safety and recognition of junior doctors’ contributions that need to be sorted here.”
With the issue causing serious discord, the government has signalled its intention to address the concerns of doctors.
The government’s new head negotiator, Sir David Dalton, outlined his determination to “engage with the BMA team directly and listen to their outstanding concerns”.
Yet despite the conciliatory tone, it seems that the government is reserving the right to utilise the so-called ‘nuclear option’.
It has been widely reported that the government will impose the contractual conditions on junior doctors if no adequate agreement can be found.
Ministers offered doctors an 11% rise in basic pay last year, but that was offset by curbs to other elements of the pay package, including payments for unsociable hours – they have maintained there is not extra money for junior doctor pay.
Trainee nurses and midwives are planning a major campaign against government plans to make them pay for their own training with student loans.
The industrial action comes in the context of learning that their earnings will be cut by nearly £1,000 annually.
Chancellor of the Exchequer George Osborne has announced this measure in the Autumn Statement, and after consultation with union representatives, trainee nurses are ready to take action.
Osborne had announced that NHS bursaries, which are paid to student nurses to cover their living costs while studying, will be converted into formal student loans that will have to be repaid, depending on future earnings.
This will make it extremely difficult for people of modest means to enter the nursing profession.
And it contributes to an overall impression that studying at university is becoming prohibitively expensive, as well as something that incurs a huge amount of debt for most students.
Under the controversial reform, nurses will also have to pay £9,000-a-year student tuition fees for the first time.
This means that student nurses are expected to begin their careers in the NHS at least £50,000 in debt, with an immediate demand from the student loans company to begin paying off this amount.
The current starting salary for a nurse is £21,692 – rising to £22,799 by 2020, Meaning that the level of debt will be effectively 250 per cent of the average starting salary.
With the government plans causing a lot of anger among students, it has now been indicated that nurses will indeed protest strongly against these plans.
This is just the latest problem that the Conservative government has experienced with regard to NHS contracts, after similar industrial action was proposed by junior doctors.
Having encountered difficulties with both junior doctors and nurses, there is the overwhelming impression that the Conservative government is out of touch with the requirements and opinions of NHS rank and file.
The organiser of the nurses’ campaign is Danielle Tiplady, 29, who is in the final year of her nursing degree at King’s College London.
Tiplady outlined the financial situation for many people entering the nursing profession.
“People who have had children have told me they cannot afford to become nurses now – they cannot face that much money going out of their wage. It’s daunting having that much debt as well. We really contribute to patient care. It doesn’t just affect students, it affects the whole country because if you don’t have nurses, then who is going to look after people?”
Considering the plans of the Conservative government to switch to a seven-day NHS culture, it is clear that there is a real rift between reality and expectation.
The planned strike by junior doctors in England has been postponed, although significant disruption has already been guaranteed by the cancellation of operations.
Following an eleventh hour breakthrough in talks, the British Medical Association agreed to cancel the walkout.
Despite this last-minute decision, over 4,000 patients have already been told that treatment due for tomorrow will be cancelled.
Further walkouts scheduled for later in December have also been suspended for the time being.
The decision of the British Medical Association follows a preliminary agreement between the two sides following assistance from ACAS.
News of the decision to suspend the strikes only came on Monday night; just hours before the first walk-out was due to begin at 8am on Tuesday.
Both sides in the dispute will now spend the next few weeks combing the agreement in order to assess the fine detail.
However, a joint statement which has been distributed by ACAS makes it clear that this is only a temporary situation.
The British Medical Association has until 13th January to reinstate industrial action should the next round of talks prove to be unsuccessful.
Figures acquired ahead of the proposed strike indicate that around 15 per cent of operations have been cancelled as a result of the planned industrial action.
Commenting on at the last minute cancellation of the strike, Dr Barbara Hakin, of NHS England, described the breakthrough as “pleasing”.
“This is in the best interests of patients although we can only apologise for the disruption caused to anyone who has already had their operations cancelled for tomorrow,” Hakin stated.
Health Secretary Jeremy Hunt had spoken to the House of Commons earlier in the day, and assured MPs that every effort will be made to minimise the effects of the strike on the functioning of the health service.
Hunt told the assembled MPs that changes to the contracts of the junior doctors were necessary owing to “the unintended consequence of making it too hard for hospitals to roster urgent and emergency care evenly across seven days”.
The Health Secretary also claimed that the plans would be good for junior doctors. “Our plans are deliberately intended to be good for doctors – they will see more generous rates for weekend work than those offered to police officers, fire officers and pilots,” Hunt added.
Meanwhile, as the British Medical Association assesses its position on the subject, it continues to argue that the changes proposed by the Health Secretary will compromise patient safety.
Some doctors had also claimed that they will lose as much as 30 per cent of their earnings as a result of the proposed contracts.
The British government has agreed to enter into talks with ACAS over the ongoing dispute with junior doctors.
This eleventh hour effort is intended to mitigate against the threat of strikes, but the union representing junior doctors has underlined that they have not been called off at the time of writing.
Responding to the threat of strike action, Health Secretary Jeremy Hunt has indicated that he is willing to utilise the conciliation service.
Hunt had initially stated after the strike ballot results were revealed last week that he would be unwilling to enter any form of mitigation process.
At the time, Hunt had said the industrial action, due to start next week, should be cancelled to “avoid harming vulnerable patients”.
The British Medical Association (BMA) had responded strongly to this statement, indicating that the strikes would indeed take place as planned.
And although it seems that Hunt is attempting to avoid strike action, the BMA has maintained its position on the subject, at least for the time being.
The first day of action is Tuesday, starting at 8am and lasting 24 hours.
ACAS is an independent body that can help parties – normally an employer and unions – resolve employment disputes.
Because the two sides in this particular case are simply requesting conciliation, ACAS will merely be required to host the talks rather than offering any meaningful or binding recommendations.
Writing to the leader of the BMA, Dr Mark Porter, Hunt claimed that it was important for the two sides in the dispute to work together.
The Health Secretary claimed that the long running dispute could be resolved amicably were the two sides to work together in a spirit of conciliation and cooperation.
Nonetheless, Hunt also expressed his disappointment that the BMA had refused to agree to the offer that he had made previously.
He also emphasised the potential threat to safety that the strike action that is due to take place next week would represent.
However, despite the apparent intention of Hunt to enter into some form of conciliatory talks, the letter sent by the Health Secretary makes no mention of dropping his previous threat to impose the contract.
The BMA had strongly opposed this policy previously.
Commenting on the letter, the aforementioned Dr Porter stated that the talks would be critical for the future of the NHS.
“We hope to start these talks as soon as possible in order to reach a collaborative agreement for the benefit of patients and the NHS. Importantly, Jeremy Hunt must finally remove his threat of imposition in order to defer Tuesday’s industrial action.”