The College of Medical Associate Professionals (CMAPs) has noted the statement issued by the United Medical Associate Professionals (UMAPs) following the High Court’s decision on permission for its judicial review of the Leng Review recommendations, together with the subsequent communication issued by the Leng Review team to stakeholders. 

We want to address one aspect of that communication directly. 

The Leng Review team’s communication refers to “the uncertainty which has been caused by the judicial review.” CMAPs does not accept that characterisation. It reverses the reality experienced by Associates, employers and patients over the past year. 

That uncertainty did not arise because Associates exercised their lawful right to seek judicial review of decisions that directly affect their careers and their patients’ care. It arose because the Review’s recommendations were implemented rapidly and inconsistently, without the protocols, governance, guidance and impact assessments needed to apply changes of this magnitude safely, fairly and coherently. The judicial review did not create the uncertainty; it was a response to it. 

It is also important to be clear about what the High Court has, and has not, decided. The decision was made on the papers, without an oral hearing, and the Court has not considered the substantive merits of the case. We understand that UMAPs is considering an application for reconsideration, which we would support. A refusal of permission at this stage is not an endorsement of the Review’s recommendations, nor is it evidence of their legal or practical robustness. We would encourage the Leng Review team to describe the decision in those terms, rather than as providing “further assurance” of the recommendations’ robustness. 

Throughout this process, Associates have repeatedly been expected to accept sweeping changes to their professional practice while legitimate questions about implementation, patient safety, workforce planning and fairness remain unanswered. Seeking independent judicial scrutiny of those decisions is neither unreasonable nor obstructive; it is a legitimate safeguard within a democratic society governed by the rule of law. 

This has been a difficult period for Associates, their supervising colleagues and the patients they serve. Confidence will not be restored by rewriting the recent history of how this uncertainty arose; it will be restored through transparency, accountability and an honest acknowledgement of the consequences of implementing major policy changes without adequate preparation. 

CMAPs shares the stated wish to move forward constructively. But constructive engagement has to start with an accurate account of the sources of uncertainty, and with the same respect for Associates that would be extended to any other regulated healthcare profession. We remain ready to engage on that basis.