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Time to move forward, says consultant leader, after doctors vote yes to contract
Press release
20 October 2003

In the ballot consultants and SpRs* in England were asked the question: Do you want to have the option to take up the new 2003 national contract negotiated between the BMA and Department of Health in England?

Dr Paul Miller, Chairman of the Central Consultants and Specialists Committee (CCSC), said today: “This is a much improved contract to the one offered last year and I am pleased to see that most of my consultant and junior doctor colleagues share this view. This result also gives a clear ‘yes’ to a national contract as opposed to local deals.

"It has been a long and difficult journey getting to today’s result. I know that this contract is not perfect but it is a good contract and it will improve the working lives of most consultants in England. Also it is important to remember that the contract is a starting point and we will continue to work hard to enhance it in the coming years.

"It is time for consultants to move forward from any divisions or conflicts over the contract. We now need to begin the hard work of implementing it so that every current and future consultant benefits to the greatest extent possible.”

The breakdown of the ballot, conducted by ERS (Electoral Reform Services), is as follows:

• 20814 consultant votes were recorded, a 69.6% turnout of the potential vote of 29,000
• 12636 (60.7%) consultants voted yes
• 8178 (39.3%) consultants voted no
  
• 3090 SpR votes were recorded, a 37% turnout of the potential vote of 8,500
• 1711 (55.4%) SpRs voted yes
• 1379 (44.6%) SpRs voted no
  
• An amalgamated majority of 60% (14347) consultants and SpRs voted “yes” in the ballot

• The question for SpRs (the most senior grade of junior doctors) in England was as follows:

• Contract negotiations in the devolved countries:

• Please find a factsheet on the consultant contract in England attached.

• Around 29,000 consultants in England have been sent ballot papers

• As the next generation of consultants, specialist registrars would have to be employed under the new contract, and are also eligible to vote
• Around 8,000 specialist registrars have been sent ballot papers

• The current contract has been largely unchanged since it was negotiated in 1948. It relies heavily on consultants working above their contracted hours because of their dedication to patients
• Research has shown that most consultants devote over 50 hours a week to the NHSⁱ
• A new contract framework was negotiated in 2002, but was rejected by consultants by a majority of 63% to 37% in a turnout of 74%
• In July 2003, the BMA and the Department of Health resumed talks on the contract. The discussions focused on six contentious areas, resulting in significant improvements to the deal:

• Under the rejected contract, existing consultants would have had to offer an extra session (four hours) to the NHS before being allowed to do any private practice
• New consultants who qualified after the contract had been introduced would have had to offer two extra sessions
• Under the new deal, all consultants wishing to do private work without prejudicing their NHS pay progression would have to offer no more than one session in addition to the basic working week of 40 hours. There is no differential treatment between new and existing consultants

• Consultants were concerned that they would be forced to work at evenings and weekends, often to do routine work that would allow managers to meet government targets.
• Under the new deal, all non-emergency work at evenings and weekends would be by agreement only

• Consultants were concerned that only work before 8 am and after 10pm on weekdays, and after 1pm on weekends, would attract out of hours rates of pay
• Under the new deal, consultants would be paid at time and a third (or sessions would be reduced from four to three hours) for all work at weekends, and all work before 7am or after 7pm on weekdays

• Under the old framework, pay progression was at the discretion of managers, and there were concerns that it could be linked to government targets
• Under the new deal, pay progression would be clearly linked to agreed job plan objectives, and it would be normal for consultants to progress up the pay scale

• Consultants were concerned that managers would be able to impose unreasonable job plans
• There was no national agreement on an appeals process
• Under the new deal, the job planning process is to be undertaken with a partnership approach and would be supported by a fair and balanced appeals procedure

• Under the new contract there is a basic working week of 40 hours (ten sessions of four hours). In order to practise privately with no effect on NHS pay progression, consultants would have to offer one extra four-hour session for the NHS

• The existing consultant pay scale starts at £54,340 p.a. and goes up to £70, 715.
• The new basic pay scale would start at £65,035 and go up to £88,000 (an increase of around 20%)
• However, increases for individual consultants will vary according to their seniority
• Increased funding to implement the contract means consultants’ average lifetime earnings would increase by 15%
• Final salary pensions would increase by around 24%
• A greater proportion of the week, and all of the weekend, would attract premium rates of pay
• Consultants would also have the option to undertake additional programmed activities
• Under a new Clinical Excellence Awards scheme consultants showing the greatest commitment to the NHS would be rewarded

• The results of the Scottish ballot will be announced on 24 October
• The Welsh ballot opens on 29 October and closes on 12 November
• A date for the ballot in Northern Ireland has not yet been set