14.01.15
Consultants must lose their evening and weekend 'opt-out' – NHS Employers
The organisation representing NHS employers is urging an end to the veto that it says allows consultants to “name their price” for working out-of-hours, as well as extensions of the hours considered ‘plain time’, scrapping incremental pay progression based on time served, and the introduction of spot pay rates.
NHS Employers made the proposals in its submission to the Doctors and Dentists Review Body (DDRB).
It also wants major changes to the junior doctors’ contract, saying the ‘New Deal’ version is no longer fit for purpose. Pay needs to be fairer and more consistent, with an end to the “exceptionally complex” banding system, with pay related to levels of responsibility more than time served, and better incentives to encourage people into demanding specialist roles.
A new work scheduling process would handle working patterns and training to ensure a better and more consistent mix of junior doctors and consultants at different hours of the day.
Danny Mortimer, chief executive of the NHS Employers organisation, said: “For years these hospital doctors’ contracts have been problematic and every year it worsens. The current junior doctors’ contract was formed in 2000 and, while it’s frustrating that no change has yet been agreed, we can base this next step on years of constructive debate. I would urge all parties to consider the detail of our proposals and recognise how the improvements would benefit patient care.
“The consultant doctors’ contract has served the NHS and its patients for years, but key elements are increasingly unhelpful – especially the veto that lets consultants name their price for working out-of-hours.”
NHS Employers said: “The proposed changes aim to redistribute the money available for pay, in order to reward doctors equitably for the contribution they make and be cost-neutral to the NHS. They would support safe working hours and service delivery. They address current concerns that junior doctors need to be supported more effectively in their training and development during evenings and weekends. Flexibility of working hours would increase. Doctors would be protected during any transition.”
The British Medical Association (BMA), representing doctors, abandoned the negotiations in October 2014. It said that the “unreasonable demands from the government” could undermine patient safety, and said that was a lack of credible evidence on what was proposed. But it submitted evidence to the DDRB earlier this month saying: “Any new contract deal must be fair for doctors, good for patients and sustainable for the NHS.”
It wants guaranteed rest periods for consultants, is cautious though not opposed on seven-day services, it wants pay to reflect experience for junior doctors, and has “serious concerns that doctors could end up without fair reward for the intensity of work by junior doctors”.
The British Dental Association has also submitted its evidence, saying the continuing fall in dentists’ income “cannot continue”. It says: “There has been a drop of nearly 25% in taxable income for general dental practitioners delivering NHS care in England and Wales from 2006-07 to 2012-13…Morale in the profession is very low and particularly in comparison to the general UK workforce.”
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