Speech from the Chairman of the
Central Consultants & Specialists Committee
Dr Paul Miller
Monday 28 June 2004
When I stood before you last year, we had just seen the departure of one Secretary of State and the arrival of another who began with the same unconstructive approach. We turned that around. We had prepared for months. Within two days we were in talks. Within two weeks we had heads of agreement. Within two months we had most of our new contract sorted.
We promised the profession that we could unite previous “Yes” voters and “No” voters, consultants and juniors. We did.
We promised the Secretary of State that we could find agreement. We did.
We promised our members that with their support, we would deliver for them. We did.
Last year I also spoke of developing a better relationship with Government and working with them over implementation of the Working Time Directive, Modernising Medical Careers and suspensions of doctors. We have worked with the Department and achieved results: joint guidance for agreed parts of Working Time Directive implementation, our own evidence to Europe on areas where we differed; improved, though not perfect, proposals for better training with Modernising Medical Careers; and new agreed procedures for suspensions, widely regarded as a big improvement on what existed before.
We have communicated massively with members, through letters, documentation, guidance, web sites, e-mails and hospital visits. We have established in a short time a reputation for listening to our members, strongly representing their views and aspirations and, most importantly, delivering workable results. Not just over our contract, but in broader professional and NHS issues.
In many trusts, the contract has been implemented well and relatively smoothly, if a little slowly. And, to remove any doubt, it has certainly been implemented best in trusts where relationships are good and true partnership implementation has been possible. Many consultants are now receiving the improved pay or shorter hours they deserve. The credit and thanks for this is owed to many people. To consultants as a whole, for their unity in defeating unworkable local contract proposals. Great credit is due to the original negotiating team who did much hard work and now deserve their thanks. Special appreciation is due to Nizam and the second team who took over in such a difficult situation and prevailed. And most of all, we owe huge gratitude to all our CCSC staff who have worked unstintingly for consultants and sustained us through the difficult times. The unions involved in Agenda for Change must be very jealous of the quality of our professional negotiators.
We have in the past been very critical of unhelpful Government targets, set by politicians. I want to speak in favour of one such target. That is the target for implementing our contract by the end of January 2004. Not a single trust achieved it. Then, the Minister for Health wrote out telling all trusts to implement by the end of April. Very few achieved it. I ask you to name me any other target twice ordered by the minister where failure to deliver has been tolerated. Where trusts are not delivering fair implementation, it is now time for those responsible for that failure to be replaced by individuals who can succeed.
What does the next year have in store? Much work on fair contract implementation, without doubt, and improvement where implementation has happened badly. However, we will be looking to work with Government on patient choice, to get honest implementation given our experience of patient priorities distorted by A & E 4 hour wait targets; waiting lists being corruptly fiddled; PCTs being bullied into contracts with Treatment Centres they neither want nor need. Choice must not become an excuse to force patients to travel just to join the shortest waiting list. Patients do deserve choices and these are best expressed in partnership with their GP, as a free and informed choice.
The agenda for IT implementation in the NHS in the coming year will be massive. Yet consultation with clinical users is scarce to non-existent. History is littered with brilliant ideas that failed because the clever inventors were answering the wrong question.
The NHS is at a crucial moment. Some say you can see the end of the NHS from here, that the future is private. But never doubt that it only takes a few good people to bring major change-it’s the only thing that ever has. And healthcare for the patients of our country is too important to leave to politicians and their advisors. As we move on from our contract we must encourage, motivate and inspire consultants to recapture the NHS. To take the agenda and shape it for patients not politicians. Excluding consultants nationally or locally results in bad decisions and unworkable policies for patient care. Now that we are properly recognised contractually, it is time to seize the initiative in patient care at all levels. Nationally, we will provide leadership. Consultants have proven to be excellent innovators, developing new treatments, new ways of working with patients. We know what works. Government, talk to us, we can make the difference you need. Locally, consultants must reassert their influence: challenge decisions that are not in the best interests of patients and clinical services; get involved with management even if you are not a clinical or medical director; teach the NHS to tell the truth. For years now, they have failed patients by not involving us. That realisation is growing. Nationally and locally, NHS managers realise they need us. Change your approach, change the NHS, change your lives.
Consultants, your time is now.
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