Thank-you for that. Are you also willing to be specific about what there is in
the new contract which will give you "scope to improve my situation by local
variation or interpretation" and I mean specific, hours on shop floor per day,
timetables, ability to do other than face to face things with patients and
when to have lunch.

>>> Andrew Hobart 09/18/03 09:52pm >>>
I will vote YES.
If the majority vote no the alternatives are a national program of
sustained industrial action or locally negotiated contracts.
I do not believe that there is a critical mass of consultants (ie 60%
plus of all consultants not just 60% of those voting in a ballot)
willing to take industrial action of a type that will actually hurt the
government for the 3 to 6 months that I believe that the government will
hold out for.
There is no prospect of a third nationally negotiated contract without
sustained industrial action.
The BMA conduct regular surveys and focus groups and they will not try
and go for industrial action unless they know there is real support for
it. There are lots of pissed off consultants but this is a lot different
from a critical mass of consultants willing to take industrial action.
I do not think the BMA will go for industrial action and the HCSA has
far to few members to be able to exert any real pressure.

The effect of a rejection therefore will be that the government will
instruct Trusts to offer the latest contract locally or to negotiate
local contracts. I believe that a significant number of consultants will
accept the new contract.
Remember that even under a Yes vote current consultants can stick to the
current contract (except in Wales where if accepted their new contract
will be compulsory).
Look at the numbers who voted YES to the version we rejected last year.
They are not going to go on strike are they?

SO the questions I ask myself are -
If we vote no will we get a better Nationally negotiated contract. I say
NO.
If the current offer better than the current contract. If so would I
accept if offered locally? I say YES.
The effect of my personal judgment is that I would prefer to be working
locally on a contract which is the new national contract than to be
working locally on a contract which has no national standing.

There is quite a lot in the latest version which gives me scope to
improve my situation by local variation or interpretation. I think I can
make it work for me, so I will vote Yes.

Andrew Hobart







-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of John PASKINS
Sent: 18 September 2003 17:19
To: [log in to unmask] 
Subject: Re: Consultant contract

Is there anyone planning to vote YES and willing to share that with us?

>>> BINCHY Dr J, A&E Consultant 09/18/03 04:05pm >>>
I'll also be voting no for the following reasons:
    1) 14% increase in contracted hours from 35 to 40
    2) 20 years service to reach top pay band. With all due respect to
elder
colleagues, Consultants probably do most clinical work in their first
10yrs.
Just because one has been doing the same job for longer doesn't mean one
should be paid more. Senior Consultants have the option of discretionary
points or management payments to enhance their salary.
    3) Derisory on call payments. The present contract allows you to
assign
NHDs for on call duties in your job plan. Most job plans allow at least
one
NHD. A NHD is about 9% of salary. I'm on a 1 in 4 and stay in late.
Therefore
I rarely get called  back. Under the new contract I'll get a 3%
supplement for
this. That's a 66% drop.
    4) This contract does nothing for people working in acute
specialties.
Time and a third for working after 7pm and at weekends is insulting.
Young
doctors will vote with their feet and go into GP land or cold
specialties. 
    5) Pay progression dependent on being a good little doctor, not
rocking
the boat and meeting government and management targets.
 
    I could go on but I've work to do.
 

-----Original Message-----
From: Steve Meek [mailto:[log in to unmask]] 
Sent: 17 September 2003 21:52
To: [log in to unmask] 
Subject: Re: Consultant contract


I shall also vote no.
As Andres says, managers and thus also the politicians will control us
via
threat of witholding pay progression, making us prioritise according to
targets rather than clinical need.
There are 'specialty specific' reasons I won't vote for it and I'd like
the
views of others on this.
Like many other places, We in North Bristol do weekday late and weekend
shifts, rewarding ourselves with compensatory days off - not
overgenerously,
around time and 1/2. We have developed the rota and managers have
concurred
(though taken little interest). Why would I want to sign a contract that
reduces this to time and a third? The weekends are punishingly hard. It
doesnt
take a great leap of imagination to see the situation where failure to
slog
through the minors relentlessly enough leads to a ticking off and
failure to
meet one's target and so no pay progression.
What do those others who work shifts think? 
I really cant see any advantage for us or patients in this contract. I
fear
that there will in fact be a yes vote, as some are simply resigned to
it, and
others feel they have made their principled stand and now want to just
take
the money and have a quiet run up to retirement.
I'm not sure about industrial action. We are still seen by even the
broadsheets as greedy, lazy fat cats who obstruct modernisation, sadly,
though
virtually every new idea the government has come up with in emergency
care was
given to them by consultants. Until public opinion has been swayed (God
knows
how, with the BMA as our trusty sword), industrial action would be
disastrous.
Steve Meek
Frenchay

"Andres I. Martin" <[log in to unmask]> wrote:

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


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