Independent letter voicing anti-strike sentiment ‘toughened up’ by government officials, reports reveal

An official letter, which was part of discussions about junior doctors’ plans to strike, was edited to make it as "hard-edged" as possible by Department of Health (DoH) officials, it has been revealed.

The letter, from independent medical director of NHS England Sir Bruce Keogh to the British Medical Association (BMA), questioned whether striking junior doctors would return to their duties in the wake of a Paris-style terror attack, and made suggestions to ensure concerns about the possible impact of a terror attack were strengthened, helping to build a case against the strike, reports have said.

But it has emerged that drafts of the letter were seen and edited by health secretary Jeremy Hunt's officials before it was sent.

Email exchanges with the DoH, first published by The Independent, revealed Sir Keogh would not be asked to speak with the media on the day strike action by junior doctors was declared - providing his letter to Dr Mark Porter, chair of council at the BMA, made clear he opposed strike action.

According to reports, an unnamed official told Sir Keogh: "I am sure then that JH (Jeremy Hunt) will be interested to see the proposed final product; my hope is that if you are able to make these changes we will be able to get him over the line." The BMA condemned the actions of the DOH, and a spokesperson said: "This level of political interference is extremely concerning and will only serve to worsen junior doctors’ lack of trust in the government’s handling of negotiations."

Liberal Democrat health spokesperson Norman Lamb said he also feared trust between the government and junior doctors would be damaged. "This revelation raises serious concerns about potential political interference with the independent medical director of NHS England. Jeremy Hunt must explain exactly who was involved in toughening up of language in this letter.

"We need a cross party commission to look at how we secure the long-term future of the NHS and social care, but Jeremy Hunt must now immediately get back around the negotiating table and resolve this dispute with junior doctors that are such an integral part of our NHS."

However, the DOH defended its involvement in editing the letter, which was published online the day it was announced that junior doctor had voted in favour of strike action. "Industrial action of the kind planned by the BMA creates a major safety risk for patients so it was absolutely right that ministers insisted on Sir Bruce Keogh giving his independent view of the NHS' capacity to respond in the event of a major terrorist incident - particularly in the days following the devastating attacks on Paris,” a spokesperson said.

NHS England also released a statement from Sir Keogh: “Given the seriousness of potential industrial action and NHS England’s statutory responsibilities to ensure everything possible is being done to reduce all potential risk, it was entirely appropriate that all parts of the NHS - including the DoH, hospitals and NHS England – co-ordinated the operational response across the country," he said.

Junior doctors are currently set to hold three periods of strike action, with the first scheduled for 12 January for 24 hours. The action is being taken after the BMA and the NHS failed to reach an agreement over a new contract for junior doctors due to take effect in August.

The main sticking point is pay for working unsociable hours. Under the proposed contract the number of hours that would qualify doctors for higher pay rates would be reduced. Saturday hours, for example, were previously classed as ‘unsociable’ but this would be changed to regular work time, while the higher rate would only apply after 7pm.