Junior doctors reject new contract

Junior doctors and medical students in England have voted to reject the contract that has been offered to them by the government.

British Medical Association members voted 58% to 42% against accepting the deal.

BMA leaders had urged members to accept the terms, which were announced in May after talks with the government resumed following six strikes.

BMA junior doctor leader Johann Malawana immediately resigned.

In a letter to members, Dr Malawana said the NHS was lurching "headlong into a wider crisis" that was of the government's making."I only hope that the next government realises that this vote is a demonstration of just how appalling frontline staff have been treated and undermined."

The BMA still has a mandate to take strike action, but it will be up to a new junior doctor leader to decide what the next steps are.

Ahead of the result of the vote being announced, senior sources at the BMA had indicated there was little appetite for prolonging the dispute given the climate in the country following the EU vote.

• Deal agreed on junior doctors contract
• Junior doctor contract: How the two sides moved
• What the dispute is all about

During the voting period, the government has been pushing ahead with introduction of the contract. New rotas are due to start for 6,000 newly qualified doctors in August, with the new pay system due to kick in later in the year.

Much of the rest of the 55,000-strong junior doctor workforce are then due to be moved on to the new contract from that point onwards. The government has yet to confirm whether there will be any change to these plans, with Health Secretary Jeremy Hunt only saying the outcome of the vote will now be considered.In May it was announced that talks at conciliation service Acas had finally resulted in a deal being agreed to end the long-running dispute, but the union said it would put the terms and conditions to a vote of members.

More than 100 road shows were organised where union leaders met with members to explain the new deal, which differed substantially from what the government had previously offered.

Instead of dividing the weekend between normal and unsocial hours, a system of supplements to be paid depending on how many weekends a doctor works over the course of a year was drawn up.

But many members remained unconvinced, believing it still did not properly reward them for the demands of the job, while they remained sceptical that the government's plans for a seven-day service would be properly funded.

What exactly do junior doctors do?

GP trainee Dr Francesca Silman, from London, said she voted against the new deal because of worries over working hours.

Dr Silman, who is part of the campaign group Justice for Health, said: "Moving forward, the Government must now acknowledge that it is not possible to provide a seven-day NHS without extra staff and funding.

"That it is not possible to create a contract that doctors feel is safe, by stretching the current workforce."

Various royal colleges representing doctors have said they hope talks will soon resume.

Danny Mortimer, chief executive, NHS Employers, who was one of the government's chief negotiators in the talks, said: "I am profoundly disappointed the BMA has rejected the proposed new contract for junior doctors.

"It is imperative that patients will not be made to suffer any further impact as a result of the rejection of the contract."

The vote was open to 54,000 BMA members - junior doctors and medical students in their final two years of their degree. Over two thirds took part.

Health Secretary Jeremy Hunt highlighted the turnout, pointing out that it meant only 40% of those eligible actually voted against the deal