Hi, sorry to bring politics back to this forum but the BMA has not give us
much time, we need to think fast.
I just enclose a copy of an e-mail posted in the BMA contract forum by
someboby signing as AATHOW. It deals with a few interesting points:
BMA SPIN DOCTORS
Not content with avoiding ?renegotiations? with John Reid because he did
not like it and agreeing his ?tweaks? to the 2002 Framework in a few July
days, our negotiators are now trying to portray this deal in the best
possible light.
It is a betrayal of the aspirations of the consultant body as expressed at
the 21st May LNC representatives meeting, who stood firm against local
deals and wanted a good new national contract.
In the New 2003 National Consultant Contract for England - a Summary by the
BMA?s Consultants and Specialists Committee CCSC September 2003 on the BMA
website, Key New Features are put forward as part of an ?improved offer?.
KEY NEW FEATURES
* - ?There is a clear full time commitment of 40 hours per week ( or less
if some work is in premium time) - any additional work must be by agreement
and paid for.?
Our present contract is based on a 35 hour week.
The guidance issued on the BMA?s CD-ROM states in the section on How to
review yourworking hours (Hospital Doctor 15 May Page 2) * ?Make a claim.
You can then either make a claim for extra notional half days to have this
extra work paid for, or seek to agree with the trust a reduction in
workload down the minimum commitment of ten notional half days (35 hours) a
week.?
How is increasing our basic working week by 5 hours a step forward.?
Radiographers do a 35 hour week. Other NHS staff a 37 hour week.
* - ?any additional work must be by agreement or paid for?
Is not that what trade unions are for? Most other unions achieved this
principle in the last century.
The BMA argue that consultants work many unpaid extra hours. Why is this?
It is because up to this May there was no determination by the BMA to make
sure our present contract was honoured.
Acceding to a longer working is sheer capitulation. What is to stop it
happening again ? Presumably the BMA is relying on management. A dubious
hope !
* - ?No discrimination between new and existing consultants?.
In last year framework, established consultants were only to be asked to do
7 programmed activities( PA)s of direct patient care, and new consultants 8.
On the present contract, there are only 5 to 7 fixed sessions and the BMA
advice was strongly against agreeing to more than 7. This horrible
compromise whereby everyone would have to do 7.5 patient contact PA is
being dressed up as non-discriminatory. !
The fact is that 7.5 patient contact sessions is alot more work, not
withstanding all the claims that you can write your letters and attend MDMs
in this time.
* - ?Job plans drawn up by agreement, with a clear appeals mechanism?
This is dangerously misleading.
In the new nhs contract (england) September 2003 Para 7.1 it states ? You
and your clinical manager will seek to reach agreement in the scheduling of
all activities. We will not schedule non-emergency work during premium time
without your agreement?
So there is an explicit agreement about Out of Hours work, but not one for
basic hours. The strong implication is that non-emergency work during basic
hours can be scheduled without your agreement. Sure the manager will seek
to reach agreement with you, but say they do not? After all, the trust has
to move over to 7am to 7 pm working.
When your next appraisal/job plan review comes up, the matter would be
raised again. If you still did not cooperate, you could forfeit the next
pay increment as ?performance at job plan review informs pay progression?.
Also in order to achieve pay progression you would have to show that you
had ?worked towards any changes identified as being necessary to support
achievement of the organisation?s SERVICE OBJECTIVES in the last job plan
review?. (F/work P24). As pointed out by a leading member of CCSC in July
2002, ? However, the 3 month maximum wait will soon be upon us as a
priority target and will be written into job plan objectives...... The
Trust will.... refuse to pay porgression because you have some 3+ month
waiters? ( Paul Miller as quoted 22.7.03 on doctors net ?Please think
carefully about this deal? )
PERFORMANCE RELATED PAY IS THE FIRST MECHANISM BY WHICH MANAGEMENT WOULD
ENFORCE ?AGREEMENT?.
In the new contract, pay increments from the date of appointment would no
longer be automatic but performance related. The BMA Summary does not make
this clear.
What could the consultant do.? Appeal to the Medical Director. Then go
through the appeals procedure which is said to be ?robust?. It consists of
three people, the Chairman nominated by the employer, one representing the
consultant and one from a list approved by the BMA/BDA with the Strategic
Health Authority. The latter could be replaced at the consultant?s request.
However, THE TRUST RETAINS THE RIGHT TO MAKE THE FINAL DECISION? (Heads of
Agreement July 17th 2003) This fact is not mentioned in the BMA?sSummary.
It simply states ?The panel makes a recommendation to the board of the
employing organisation.?
The Summary calls the proposed new appeals mechanism, ?clear?. Well Yes, it
is very clear. Management decides.
What is described here is an UNPRECEDENTED DEGREE OF MANAGEMENT CONTROL.
Management will dictate to us using the threat of withholding pay
increments and wielding the whip hand with appeals. This is true, despite
the hopeful statement in the Heads of Agreement July 17th,? The new
arrangements are emphatically not intended to diminish professionalism or
override clinical judgement.? Whatever the intentions, they will, of course
do just that, diminish professionalism and override clinical judgement.
Targets will rule the day.
Ian Bogle warned of this at the 2003 ARM. He said ?The suffocation of
professional responsibility by target-setting and production line values
that leave little room for professional judgement of individual doctors or
the needs of patients ?...... ?It will turn professionals into bean
counters answerable not their patients but to politicians, auditors,
commissioners and managers under pressure to deliver on edicts, priorities
and targets emanating from Richmond House.?
* - ?the job plan will define the resources needed to deliver agreed
objectives?.
Well it may define the resources. We can do that now. But there is no
guaruntee there will be the resources. Just try and get more secretarial
support, or more junior staff.
* - ?a greater proportion of the week, and all of the weekend, attracts
premium rates?.
This is spin for YOU WILL NO LONGER HAVE A 9AM TO 5PM WORKING DAY
and YOU WILL RECEIVE BASIC PAY IN UNSOCIAL HOURS 7am to 9 am and 5pm to 7
pm as there will be a system whereby basic rates are paid between 7am to 7
pm Monday to Friday, in which the trust will run shifts.
Changing the start and finish time of the trusts normal working day to 7 am
to 7 pm, would cause a huge deterioration in the quality of doctors working
and family lives. Having done years of one-in- two and one- in- three
rotas, are we seriously being asked to get up at 6 am in the morning to go
to work, and to contemplate a 3 pm to 7 pm shift, for basic pay?
One of the aims of the Framework 2002 was to ? to support more rational
planning of extra activity, for instance to help meet performance targets
for waiting. The aim should be to allow, wherever possible, for extra
consultant activity to be arranged on a planned basis and at normal
sessional rates, in preference to the ad hoc arrangements and premium
payments made for some current initiatives.? (Framework 2002 Page 13 Para
6) That sentiment still exists. So if you do an evening clinic from 5 to 9
pm, the first 2 hours are paid at basic rates, and only the second 2 hours
attracts time and a third treatment. Waiting list initiative lists, at
£500, would go.
Premium rates? You can hardly call time and a third, a premium rate. An NHS
pysiotherapist working in the hospital on Saturday, is paid time and a half.
* - ?Additional 2 days annual leave per annum ( after 7 years in post )?
Big deal.
We are supposed to applaud these ?key new features? as being so much better
than the June 2002 Framework. It just shows how aweful that was, that
anybody could boast of these ?key new features?.
THE NEW PROPOSED CONTRACT IS COMPLETERLY UNACCEPTABLE. We should vote NO.
Our leaders are so timid. They say ? If a ?No? vote: * Highly likely that
the Department of Health would go for local implementation * very unlikely
to be any further talks nationally; * only realistic chance of achieving an
alternative offer would be a sustained confrontation, including industrial
action.?
Have they chosen to forget the 21st May conference of LNC representatives?
What are they afraid of?
We just say No and stick to the present contract and stay national as we
did in May and June. We make the present contract work for us until such
time as we get a leadership which will forward a decent claim on our
behalf. Not just accept the DoH?s framework or tweak of a framework.
( NB The Welsh deal IS based on 9 to 5pm day. see Para 3.8 )
AATHOW
I do not agree with all the points raised in this e-mail, but I think is a
good starting point for a discussion in the list. Remember we got very few
days to decide something that is going to be with us for the rest of our
working life.
Andres
|
