Weekend effect: The row that set the NHS against Jeremy Hunt

Analysis: The former health secretary's fight to lead the country can hardly be more bruising than the feud with junior doctors that defined his tenure

The bitter row over junior doctors’ contracts, which sparked the first all-out strike in NHS history, has left deep scars for a generation of medics and an indelible legacy for prime ministerial hopeful Jeremy Hunt.

In the largest study to date of the phenomenon known as the “weekend effect” UK researchers again found little sign that poor care is behind increased death rates for people who go into hospital on Saturday or Sunday.

The weekend effect made national headlines after a 2015 study in the BMJ identified that patients admitted to hospital between Friday and Monday were 15 per cent more likely to die within 30 days than patients admitted on a Wednesday.

This amounted to 11,000 extra deaths a year and the former NHS England medical director Sir Bruce Keogh, who led the study, said it was “unassailable” proof of the need to improve care over the weekends.

The government had been negotiating reforms to the junior doctors’ contracts but talks with the British Medical Association had stalled and the study was seized on as justification of the need for change.

At conference Mr Hunt, who was parachuted into the toxic swamp left by Andrew Lansley’s 2012 health reforms, would regularly quip that he had the safest job in government.

But until this point he had walked the tightrope with aplomb, and had won fans among patient groups with his mantra of making the health service the safest and most transparent in the world.

Things turned dramatically when he insisted the government could forcibly impose a contract on the junior doctors to cut unsociable hours pay entitlements at weekends and evenings.

The claim that this would allow hospitals to include more staff on the weekend rota, and thus address the weekend effect, rang hollow for already overworked junior doctors.

They warned that with already inadequate numbers of staff on the wards it would simply mean they were made to work longer hours, increasing exhaustion and putting patients in danger – a point Mr Hunt would later concede.

The decision to focus on junior doctors, rather than senior consultants who are able to opt out of weekend work – and whose contracts are still to be overhauled – fuelled suspicions the reforms were a pretence for savings demanded by the austerity regime.

Emails showing the government’s own advisors warning the seven day plan was unlikely to address the weekend effect and saying it would be “rash and misleading” to call the deaths avoidable fanned the flames.

The walkouts began with shocking public support but politicking on both sides of the dispute meant the BMA also saw its reputation tarnished.

But it was Mr Hunt’s image as a non-controversial reformer that suffered the biggest blow.

His remarkable staying power, becoming the longest serving health secretary in history, cannot be disentangled from the mess the fiasco left and he claimed that being the health secretary would in all likelihhod be his “last big job in politics”.

That claim was jettisoned when the biggest debacle of them all meant the foreign secretary role opened up, and now he has his eyes on becoming prime minister.

But whether he can shake the albatross of the junior doctors strike so easily, remains to be seen.