Dear All
Peter Hawker came to Cornwall 2 weeks ago to sell the contract to us.
Fairly lively debate, best turnout of consultants I have ever seen. No-one
came to his aid.
A few of the issues plus my comments
1. OUT OF HOURS WORK
The offer of 3-8% suppliment for on call is derisory and penalises those on
high intensity rotas.(You will get about £50 more per night worked if you
work a 1 in 16, rather than a 1 in 4)!!
The statement that work out of hours takes 1st priority of a consultants
time is not true. The 1st 3 hours will count as a 4 hour session, but as
initially only ONE such session is allowable the any other out of hours work
will not be recognised (deja vu UMT).
P Hawker said there was a choice between higher overtime payments and lower
salaries:
The argument that to properly recompense for out of hours work would result
in lower salaries overall is invalid, the govt can hardly reduce our
salaries to reflect this because we are currently not being paid anything
for on call/ out of hours work (excepting the temporary intensity
suppliments).
PH said GP's were set to lose money by dropping out of hours care:
Likening our contract to the new GP contract is invalid, their starting
position was to be contracted to 24 hrs care and to move down from this,
moreover we are in a much stronger barganing position, can you see a
deputising agency providing cover for A/E, ITU, the cardiology, surgical,
paediatric or any other take you care to think of?
I am not aware of a vast pool of under employed specialists ready to step in
to take over out of hours care.
The BMA position should be that consultants work 40hrs + a week, you want
them in more at night/WE you will have to pay for it untill such time that
there are enough trained consultants to cover all the work. The Govt want it
both ways.
2. NORMAL TIME WORKING HOURS
PH said that this was to recognise work done in the evening, post op WR,
over run clinics etc. If this was the case then it would be reasonable to
agree that up to (say) 8pm any session started after 2pm could be extended
up to 8 pm and paid at day rates pro rata for the hours worked. Any session
starting after 6pm should be paid at enhanced rates.
The Govt are desperate to announce ahead of the next election that the new
NHS will provide the service of convenience that pts want; evening clinics
etc (good), A/E Consultants on the shop floor evenings and weekends (good),
at no extra cost to the Taxpayer (good). The only small fly in the ointment
is that it is you and me who will be providing this and missing out on going
to our childrens school plays, socialising etc, and not be financially
rewarded at enhanced rates for unsocial working.
The Govt (according to PH) will not agree to enhanced rates.
3. PHASING IN PAY AWARDS
PH Says that the govt will not move senior consultants straight onto the new
bands (I got the impression that he sympathised with them). Why? The bulk of
the changes to the contract will be implimented immediately. This is work
the contract now, get paid later, or if you are close to retirement work it
now, never get paid.
4. PAY RISE
Tempting on the face of it, not so goog after reading the small print. The
treasury are not famous for largesse. Remember that of each £1 they allocate
50p goes straight back in Tax & NI.
5. REDUCED WORKING HOURS
The BMA have not won anything that the govt would not have had to deal with
anyway on the European working time directive.
6. BIG SALARIES FOR WORKING MANY SESSIONS
a) We will ultimately not get paid for more than 48 hrs (10 + 2 sessions:
see 5), the work load is not going to get less, clinical work gets priority
(good), so we will end up doing appraisal, admin, clin governance ,
answering complaints etc, etc for nothing (as per now).
b) The DOH has yet to decide how to allocate money to trusts,it is likely
that trusts will be capped, they will not be in a position to pass on the
cost of us all getting these extra sessions that we (already) work on to the
treasury.
7. PRIVATE PRACTICE
The 7 year ban on PP was always a nonsense, the only people to take this
seriously was the BMA.
The 'victory' in fighting this is illusory.
8. TAKE THE MONEY AND RUN
We would be abandoning those at the start of their careers and throw away
all their negotiating strengths for the future.
9. THE START OF SOMETHING BETTER?
The Govt have got what they want, they will not be in any hurry to move
forward.
IN CONCLUSION
We are not going to take action such as striking BUT the govt need us more
than the BMA seem to appreciate, they are desperately worried about the real
cost of out of hours care and the effect that it would have on the service
if out of hours work were to count as work done (for the EU directive),
given their failure to train enough consultants to do the work demanded.
Paul
-----Original Message-----
From: Doc Holiday [mailto:[log in to unmask]]
Sent: Monday, September 02, 2002 23:50
To: [log in to unmask]
Subject: Re: Contract suggestions
I just thought I should share this with the list:
I read out most of the new consultant contract proposals to a handful of
non-medical friends of mine at a recent BBQ (yes, do pity me!). I lied a bit
in telling them what it was (more of that later). These friends are all in
their late 30s to early 40s and are a building contractor, an accountant, a
solicitor and two insurance execs. 4 are UK-born, one a recent arrival from
South Africa. They have all been well-informed by myself and our common
medical friends over the years and they know quite a bit about what A&E and
the NHS are all about.
They made a few interesting observations. I admit that on a few points they
only commented after I specifically asked for an opinion, but I put no words
in their mouths:
- The language was "ominous" - it sounded as if the government was trying to
"take over" and control the profession. Some suggestion of an
"attempt to POLICE the profession".
- Very vague language when it came to any commitments other than the
consultants' ones. My solicitor friend said that it was so vague it was
could not actually be used as a basis for negotiations.
- Who are the "employers"? Were there any guidelines as to who was entitled
to be deciding on a consultant's next pay rise other than that they would be
office-dwellers?
- "Where is the bit about A&E?" - A literal quote. My mates thought this was
written for surgeons.
- They will be counting how many patients you see and paying you
accordingly. There is no currently implementable system to audit ANY
OTHER aspect of A&E work except its mere quantity. So the only goals
you could prove you have met are numbers... Who will be deciding on
these targets?
- Sounds like consultant on-call duties will be eliminated in A&E
departments with SpRs on call - the section on on-call duties states that
this would happen if consultants are "rarely" called upon to come in.
- That section also limits the budget to be spent on on-call pay as a
proportion (3.48%) of total consultant pay bill. This means that if this is
insufficient, the next step would be to to use preferentially those
consultants who are on a lower pay level to do on-call work, thus
reducing the bill by creating a lower rank of consultant. This could be
made to happen through a management decision, regardless of any
opinion consultants have on how this will affect their interrelationships.
- What happens to SpRs who, when it comes time for them to switch to a
consultant post next year, are above the £63,000 initial level?
- Many and repeated concerns expressed over how pay raises will be used as a
leash to tame consultants into just slogging for the NHS and not
having anywhere near enough time for any non-clinical activities. No
wonder the juniors want to vote on this, they said. They will be getting
zero training now if their consultants have to chase numbers.
- How can they ignore pensions? Who would be dumb enough to even look at a
contract without pension details, especially nowadays, with everyone trying
to find ways of avoiding paying what they had promised in terms of pensions.
- "Is private work illegal? They make it sound like a crime..."
- "Looks like doctors are never going to be finished with exams" -
referring to how each year consultants would have to jump through a
hoop of approval to just get paid their dues.
- "Watch out for stress levels"
I am cutting the list of points I noted at the time. There were a few more,
but I don't wish to make this e-mail too long. My lie? I told my friends
that this was the government's initial suggestion only. They were all
assuming that this was the point we will BEGIN to negotiate from. When I
told them this was the supposed outcome, they could not believe it.
But this possibly explains why they could not see anything positive here at
all. They actually doubted whether we should even begin to negotiate with
such a basis unless firmer language was used on the "employer's" side.
The only positive point noted, by accident, was that there will be many
jobs created by this. For each consultant's annual assessment, many
person-hours will need to be spent (I have personally added to this list)
- by someone to audit their performance figures and data
- by someone to collect that data and/or create systems for collecting it
- by someone to confirm that this is correctly collected
- by the conslutant, who will also collect the information to ensure he/she
is not being cheated
- by others who will report/spy on consultant's performance
- by as many people who would then have to sit and debate this each year
with each consultant over as many hours as it takes (and it would have to be
a significant number of people to avoid personal bias)
- by those who will review the inevitable appeals - likely to be near 100%
of those who are refused a raise
- by those who will have to porcess the mountains of paperwork
(Personally, I expect there would also be MANY resignations and transfers
resulting from pay raise refusals as well as legal actions very early on for
unfair discrimination)
They could not believe this was something MY elected representatives
were actually prepared to admit to. We got some paper (after the BBQ) and
did the math and they were actually laughing! The misleading way in
which figures were presented was so deceitful, they said, that it would not
be considered legal in any of their fields to put it down on paper. There
was an obvious attempt to "hide" the fact that a junior consultant grade was
being created, using, among other means, the working hour directives.
BTW, the BBQ was good...
_________________________________________________________________
Join the world's largest e-mail service with MSN Hotmail.
http://www.hotmail.com
----------------------------------------------------------------------------------------------------
The information in this e-mail and any attachments is confidential
and is intended for the attention and use of the named
addressee(s). It must not be disclosed to any other person
without our authority. If you are not the intended recipient, or a
person responsible for delivering it to the intended recipient or
are aware that this e-mail has been sent to you in error, you are
not authorised to and must not disclose, copy, distribute, or
retain this message or any part of it.
We sweep all outgoing mail for the presence of computer
viruses. However we cannot accept any responsibility for any
loss or damage to your systems due to viruses or malicious code
not detected.
The statements and opinions expressed in this message are
those of the author and do not necessarily reflect those of the
organisations within the Cornwall & Isles of Scilly Health
Community, which will not automatically take any responsibility
for the views of the author.
---------------------------------------------------------------------------------------------------
|