New deal is unjust, say top doctors

Hundreds of hospital doctors have warned that a new contract for consultants will lead to an exodus of British doctors from the National Health Service.

They have voiced "extreme concern" about the proposed consultant contract framework, which is described as unjust, discriminatory, divisive and demeaning.

More than 500 doctors signed a letter complaining about the impact of several key aspects of the new contract, which is currently under consultation. In September, the British Medical Association (BMA) will vote on whether to accept the deal.

In a letter to the Daily Telegraph yesterday, doctors described as "demeaning and unprofessional" plans to place NHS consultants directly under the control of central and local managers.

There are fears that bad relationships with managers, however small in number, could place undue pressure on the hospital doctors, who have previously enjoyed greater freedom to decide how their time is used.

"It damages the morale of doctors, who already give substantially more to the NHS than their current contract demands," the letter states.

"The priority of NHS consultants has always been to deliver the best possible care to patients. Trusts have increasingly been slaves to the politically motivated "target of the week" set by central government. Under this contract, they would have the unrestricted, unchallengeable freedom to make financial service the objective and priority of consultants."

Other proposals to give enhanced contracts to senior consultants who have been in the job more than seven years have been called "divisive and underhand". The doctors threaten immediate legal action if the separate contracts are implemented.

Younger doctors feel that they very often provide out-of-hours work for the NHS and work in the most intense jobs. "Pay cuts for the hardest-working doctors are unjust," the letter says.

Concerns about the work-life balance are also expressed, as the contracts extend working hours to up to 10pm on weekdays, plus Saturday and Sunday mornings. "This runs completely counter to the Government's stated aim to improve the family-friendly nature of work within the NHS."

The BMA, however, is urging members to accept the contract, which has been negotiated over the past nine months.

"The negotiators and the BMA annual meeting have all backed that contract and are recommending it to consultants," a BMA spokeswoman said. "We need to reassure people on the points they are worried or unhappy about."

Having listened to the concerns of consultants in a series of regional meetings, the BMA appreciates that there are "genuine difficulties". However, it is confident it can convince members they are getting a good deal.

Some doctors still want the Government to return to the negotiating table. But sources close to the Secretary of State for Health, Alan Milburn, said: "This is a negotiated agreement with the BMA. It is good news for the National Health Service and it is good news for consultants. That is why the BMA is recommending acceptance of it."

Among the signatories of the letter were Dr Trevor Pickersgill, a specialist registrar in neurology at the University College of Wales in Cardiff, William Saywell, a consultant radiologist from the East Somerset NHS Trust and Paul Irwin, a consultant urologist at Leighton Hospital in Crewe.