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DERMOT MURNAGHAN: Now junior doctors could go back to the negotiating table ahead of Tuesday’s strike if the Health Secretary agrees to a new proposal being brokered by the Labour party.  A group of MPs, cross-party, have written to Jeremy Hunt the Health Secretary urging him to try out the new working rules for junior doctors in a small number of locations only.  The government has dismissed the proposal as ill-informed political opportunism.  Well I am joined now by the Shadow Health Secretary, Heidi Alexander, who has been brokering that very letter, a very good morning to you.  So just lay out the proposals and how difficult was this to get MPs from all parties to support this view?  

HEIDI ALEXANDER: Good morning Dermot.   What I’ve done today along with MPs from a number of parties is we have written to Jeremy Hunt over the weekend to suggest that if he is so intent upon proceeding with a new junior doctor contract that it would be reasonable, given the concerns that have been expressed, to pilot it in a small number of Trusts first and then to have an independent evaluation of the impact of that contract both on staffing in terms of the training opportunities that are available, the hours, the rosters that doctors have to work in hospitals but crucially on patient care as well.  I feel very strongly that this whole dispute has gone on for too long, it’s really distressing for everyone that works in the NHS and I think it’s time for Jeremy Hunt to put the party politics to one side and actually it’s a constructive suggestion.  

DM: It’s an interesting proposal and as you say, you have had support from all parties.  

HEIDI ALEXANDER: Yes, so the signatories to the letter are Dr Dan Poulter who was a Health Minister in the former coalition government, a Conservative MP, Norman Lamb who was also a former Health Minister, Liberal Democrat and Dr Philippa Whitford who is the SNP spokesperson on health and is actually still a practising surgeon so she does know her onions when it comes to the NHS.  

DM: So at the heart of this, going way back to the original allegations I suppose made by the Health Secretary was that more people die, more people suffer harm in the NHS at weekends than they do during the regular working week, 6000 deaths is a figure that was used, 11,000 in some cases.  Your monitoring of that would be to see whether that is actually the case, is that right?

HEIDI ALEXANDER: There isn’t any evidence that links changing junior doctors contracts and staffing arrangements amongst junior doctors per se with the increased likelihood of mortality amongst people who are admitted to hospitals at weekends and so what we are saying in this letter is almost to Jeremy Hunt, put your money where your mouth is and if you are so confident that this change will actually have the impact that you say that it will, pilot it, have an independent evaluation of it and then let’s work out how we proceed from there.  

DM: Have you got any body in mind or would it be a new body that would do the monitoring?  

HEIDI ALEXANDER: Well I think Jeremy Hunt would need to sit down urgently today, this afternoon, with the BMA to talk about what the scope of the pilot would be.  I think it should be in a limited number of hospital trusts.  Jeremy Hunt claims that he has a whole series of Chief Executives who support the contract, he tried to claim he had Chief Executives who supported the imposition of the contract but that all unravelled quite spectacularly so what I think we need to find is a number of hospital trusts where we could actually monitor what this contract means and iron out some of these perceived problems – and they are big problems with this contract around the impact it would have on the rosters, the shift patterns that junior doctors would have to work, the impact that it would have on women because there are lots of concerns about how the changes to antisocial hours payments and on call payments would deter women from staying on in the profession and there is also a new proposal contained in this contract for safeguarding the junior doctors with respect to the number of hours that they would work.  We need to know that that new mechanism that is being proposed actually has teeth and will be effective because if it’s not the only people that will be losing will be patients.

DM: But Heidi Alexander, you are opening the door aren’t you, for a change in the labour position by saying trial it, independently monitor it and therefore if the independent monitoring body says this actually works, it is causing fewer deaths at weekends, patient care, patient experience is now improved by this new contract, you are saying you would abide by that decision?

HEIDI ALEXANDER: We need to explore how this contract would work in practice and we need an independent evaluation of the contract’s impact in regard to staffing and patient care.  I think that is a reasonable and constructive position for the Labour party to adopt.  

DM: Okay, we’ve got that far but the next step, however long the trials go on for, the next step if it is deemed to work is to say okay, Jeremy Hunt, you were right.  

HEIDI ALEXANDER: If it is shown to improve patient care and to have a positive impact upon junior doctors with regard to the hours that they are working and the quality of care that they are able to provide, I think any reasonable person at that point would say we need to look at what the evidence shows us and move forward in a constructive way because what I’m interested in is ensuring that care is of the highest quality and is available for patients whenever they go to hospital because I agree that if you go into hospital as an emergency on a Sunday morning, you should bet the same quality of care as if you go in on a Tuesday afternoon.  

DM: And in the face of a major strike now, obviously involving emergency care as well, your position at this very moment is still to support it if Mr Hunt turns this offer down?

HEIDI ALEXANDER: My position and the Labour party’s position is that Jeremy Hunt in the next 36 hours has to do everything in his power to avoid this unprecedented strike action happening within the NHS.   

DM: And you are confident that if Mr Hunt says yes, we’ll consider this, the BMA would call it off?

HEIDI ALEXANDER: I think if Mr Hunt agrees to the principle of a pilot across a limited number of sites and audits the impact upon patient care, then I think the BMA would be wise to be consulting their members very quickly about the prospect of not going ahead with the strike action on Tuesday and Wednesday of this week.  

DM: Shadow Health Secretary, very good to see you, thank you very much indeed.  Heidi Alexander there.