The BMA has raised three main concerns on the proposed changes to medical contracts a head of eleventh hour negotiations with the government.
In a message to BMA members at the weekend, Paul Flynn, chair of the consultant committee, said there were problems with the plans to scrap the weekend non-emergency opt-out; ensuring contractual safeguards to protect consultants’ working hours; and, additional payments for out of hours work.
It was revealed last week that the BMA and NHS Employers had held “exploratory” talks over restarting negotiations. These followed the health secretary Jeremy Hunt threatening to impose contract changes on doctors if progress was not made by 11 September.
In its weekend message, referring to schedule 3 paragraph six of the contract, the BMA said removal of the weekend opt-out, which the review body said was “not appropriate” and “highly unusual”, would only be accepted if sufficient safeguards were in place.
The S3P6 clause does not limit the delivery of urgent or emergency patient care at any time or day of the week. It is typically used to ensure that consultants are not forced to provide non urgent care at unreasonable times without mutual agreement.
This was a key topic for the consultant contract negotiations. The DDRB report suggests that while staff’s employment needs should be protected, S3P6 should be renegotiated and redesigned to reflect employers’ and patients’ needs.
The BMA is working to ensure contractual safeguards are fair to doctors, while sustainable for the NHS. The BMA will only accept a contract that we believe protects doctor welfare.
The union said contract negotiations stalled in October 2014 because it could not come to an agreement on contractual safeguards. The DDRB agreed in its report.
The BMA wants safeguards that will protect consultants in the event of the removal of S3P6.These safeguards included vital issues such as safe working hours, occupational health, prioritisation of emergency care and provision of supporting services and facilities.
The third issue concerns working unsocial hours, with the BMA believing doctors’ pay should reflect the challenges of doing so. The DDRB report said doctors’ ability to work late into the night safely may diminish with age.
The BMA is willing to negotiate new rates and times for unsocial hours work but is clear that enhanced rates should be paid for work undertaken in unsocial hours, and that further work is needed to agree what constitutes unsocial hours.
The review body said NHS Employers, which is negotiating for the government, needed to go further on safeguards and this could be a potential area for progress in future negotiations. Consultants would continue to have job plans agreed with their employer, which includes the ability for an independent appeal process.
Employers have suggested contractual guidance would mean a maximum 40 hour week and no more than one in 13 weekends at work.
The union told its members: “We want safeguards that will protect consultants in the event of the removal of [the weekend opt-out].These safeguards included vital issues such as safe working hours, occupational health, prioritisation of emergency care and provision of supporting services and facilities.”
Sara Hedderwick, the Deputy Chair of the UK consultant committee, said: “Jeremy Hunt’s vindictive and politically motivated attack on the professionalism of hospital doctors didn’t just anger doctors and detract from unanswered questions about the feasibility of a seven day NHS, it also distracted attention from other important proposed changes to consultants’ contracts.”