The BMA blog

Archive

Syndication

Tagcloud

active transport air pollution bahrain ballots banding bma council bma council chair bma council chair mark porter bma medical ethics bma membership bma parliamentary unit bma regional services board of professional activities board of science cannabis careers certificate of completion of training child and teenage health child healthcare class a drugs class b drugs class c drugs climate change clinical commissioning group clinical commissioning groups clinical directors clinical excellence awards clinical leadership clinical performance cocaine competition complaints conservative party consultant contract consultants consultants committee consulting patients contracted hours contracts cycling diet disability drug dependency emergency care england european working time directive food food safety and standards foundation programme funding general medical council general practice general practioners committee general practitioners committee gmc gp health and social care act health and well-being health policy and economic research unit healthcare spending healthy eating her majesty's revenue and customs heroin hours of work human rights illegal drugs industrial action international committee international development it junior contract junior doctors junior doctors committee labour party leadership liberal democrat party mass media medical education and training medical students medical students committee modernising medical careers nhs nhs care nhs employers nhs pensions nhs reform nhs supplies nhs system reform noise pollution northern ireland on call rotas out of hours services out of hours work out-of-hours work patient choice pay pct peadiatrics and child health pensions pensions committee performance postgraduate deaneries poverty procurement professional activities public health raising concerns rationing reconfiguration reconfiguration and integration revalidation review body on doctors' and dentists' remuneration science and public health scotland scottish national party scottish parliament study leave substance abuse targets tax tooke inquiry training waiting lists water pollution welsh gps committee west midlands westminster parliament whistleblowing

Fair for doctors, good for patients

Posted on 1 February 2013 by Mark Porter  2 comments

This week, I spoke at an event called Better Contracts, Better Care. The event was hosted by NHS Employers and provided an opportunity to put forward doctors’ views on the recent proposals to change the junior doctor contract, and to review consultant excellence awards and terms and conditions

I spoke about doctors like Hamish Brown, a consultant breast cancer surgeon at City Hospital in Birmingham. He was part of a team that redesigned their breast care service, reducing the average stay for women from five days to one, saving £300,000 a year and increasing patient satisfaction.

I spoke about junior doctors like Elizabeth Meredith, a core medical trainee, who helped instigate a project to improve the process for admitting GP referrals to the acute medical unit bringing about earlier assessment, and treatment of acutely unwell patients.

I made it clear to employers that doctors can help drive up quality while saving money and improving the patient experience. However, I also stressed that this is becoming increasingly difficult as we are faced with the biggest structural reorganisation of the NHS since its inception, a multi-year pay freeze, the introduction of revalidation, the reform of medical education and training and  of course, major changes to public sector pensions that have hit doctors hard.

The government has set out its proposals to change the junior doctors’ contract, along with consultant excellence awards and terms and conditions. Rather than simply respond to its proposals, I set out our agenda by highlighting our concerns about the quality of training, working hours, the erosion of professionalism and clinical autonomy and the importance of supporting and rewarding innovation.

We are living in a tough economic climate but I was robust in my insistence that any changes to doctors’ contracts must not be approached as a cost-cutting exercise. We have not made any decision to negotiate changes to junior doctors or consultant contracts. However we are willing to have exploratory talks with NHS Employers so that we can carefully consider their proposals before making any decision to move to contract negotiations.

Your views will be central to our decision making process as the proposed changes could have a huge impact on our working lives. So read the information on our website to get an understanding of what is at stake and give us your views. Would you make changes to the current contracts? Where do you stand on seven day working debate? Do you think training should be part and parcel a new juniors’ contract?

Let us know what you think.

Mark Porter is chair of BMA council



Posted in:  Contracts

Tags:  junior contract consultant contract nhs employers contracts

Comments

  • Douglas Newton

    5 February 2013

    This is a further step in the journey started in 1974 by Jim Bramble, establishing a link between doctor's pay and time.Successive junior contracts, and the 2003 consultants contract have moved the profession into line with every other profession, where worked time is basis of all contracts, both long and short term. Every change in contract has lagged behind the reality of working many more hours, particularly at weekends, than were contracted for. The time for further change has probably arrived. For decades, the Employers agonised over the possibility that on-call doctors might not actually be working. Now, in the current NHS on-call for all grades means being at the coal face. For consultants this means many more hours than the 2003 contract.
    There are three issues of evidence base:
    1. Working excessive hours leads to impaired performance
    2. Less than 24h 7 day service has poorer outcomes
    3. NCEPOD evidence on night surgery (this needs to be revisited.)
    After all the gov sniping about pay and productivity we are back on the moral high ground when it cimes to negotiation

  • Neelam Dugar

    23 February 2013

    I agree that medical practices have significantly changed even over the last 10years that I have been consultants.

    On-call workload in many specialities for consultants is so busy that it can no longer be regarded as "on-call". However, it is expensive & inadequate to reclassify them as shifts.
    Diary based "workload" for on-call needs clear definition.
    11h continuous rest in 24 hour period should be available to all employees without them being penalised.

    Safe workloads for emergency work, inpatient scheduled work & outpatient scheduled work must be defined by BMA working with Colleges.

  •  
  •  

Have your say

Want to comment on something you have read or share your views with others?

ArrowEmail us

Changes to junior and consultant contracts

The government wants to discuss changes to the pay and employment conditions of consultants and junior doctors

ArrowFind out more and share your views