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03.11.14

Government asks pay review body to look into doctors’ contracts

The government has asked an independent pay review body to consider recommending changes to consultant and junior doctor contracts, the first step in a process that would allow the government to unilaterally impose the body’s recommendations on the medical workforce.

Contract negotiations between the British Medical Association and NHS Employers broke down last month after 18 months of talks. The BMA team walked away over fears over inadequate safeguards against excessive working hours, saying that “the government has been increasingly focused on achieving political priorities”.

Now health minister Dan Poulter MP has written to the independent Doctors and Dentists Review Body (DDRB) it to consider recommending changes to the medical contracts to “better facilitate the delivery of services seven days a week, in a financially sustainable way”.

Dr Poulter asked it to “make observations” on contractual reform to deliver seven day services as well as examining possible changes to the Clinical Excellence Award Scheme. He wants the DDRB to consider all the evidence relating to the talks and make recommendations for doctors in England by next July.

This could result in substantial proposals from the review body to amend the terms and conditions of the medical contract, with the government having the power to implement any recommended changes without consulting the medical workforce.

The BMA said it welcomed the opportunity for the DDRB to demand the kind of credible evidence and modelling that doctor negotiators had called for during 18 months of talks on contract changes for UK doctors in training and consultants in England and Northern Ireland.

However, it stressed that the review body’s independence must be respected and it must not be used to deliver the government’s political priorities.

Devolved-nation administrations will make their own decisions about what happens next for their doctors.

BMA council chair Mark Porter said the association had been clear throughout negotiations that it supported more services being available over seven days, with urgent and emergency care being the priority for investment to ensure patients had access to the same quality of care all week.

However, he stressed the government failed to produce any credible evidence of how this would be resourced and how doctors and patients would be protected from the impact of long hours.

Dr Porter said: “While we have made clear that we remain committed to reaching an agreement which ensures the future of safe patient care and safe working conditions for doctors, it comes as no surprise that the government has now chosen to refer this issue to the DDRB.

“Throughout the negotiations, we have emphasised that the necessary safeguards for patients and doctors are critical to any new contract.

“We will be reiterating this in our evidence to the DDRB and we expect the government’s submission to demonstrate how they propose to provide additional services safely and fairly with the present workforce.

“It is vital if we are to have a contract that is good for patients, fair for doctors and good for the NHS that the DDRB listens to the doctors who already care for patients at nights and weekends, about how to make that care better and more consistent.”

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