NHS 'must get tough on consultants'

Doctor in a hospital in Gloucestershire MPs have called on the NHS to get tough with consultants

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Failings in care in England can be directly linked to the NHS's inability to properly manage hospital consultants, MPs say.

The warning was made by the Public Accounts Committee after it studied the impact of a new contract in 2003.

The MPs said problems with working hours and bonuses worked against the interests of patients - and urged the NHS to get tougher on doctors.

But the criticisms have been rejected by the British Medical Association.

The cross-party group found that since the contract was introduced a decade ago, pay had risen by between 24% and 28% for the 40,000 consultants working in the NHS.

'Barbed rhetoric'

It also noted the deal had allowed doctors to refuse to work during evenings and weekends, prompting trusts to fork out up to £200 an hour in overtime payments or rely on locums, which was not good for continuity of care.

And it highlighted the bonus system - known as clinical excellence awards - which was being given to 60% of consultants despite it being aimed at rewarding those who perform over and above what is expected.

The report was also critical of the way consultants were being managed - nearly half of trusts were not assessing if consultants were meeting their objectives.

Start Quote

This nonsense highlights how badly consultants' performance is being managed”

End Quote Margaret Hodge Public Accounts Committee

It concluded the failure to implement a proper culture of performance management was a "crucial factor" in poor standards of care, such as that seen at Stafford Hospital.

Committee chairman Margaret Hodge added: "This nonsense highlights how badly consultants' performance is being managed."

Gill Bellord, of NHS Employers, said: "The report raises some important issues about care for patients, which are of increasing concern."

She said the organisation had begun talks with the BMA about what changes needed to be made, adding: "It is time to refresh the contract."

But Dr Paul Flynn, the BMA's consultants leader, said: "The barbed rhetoric is particularly unhelpful at a time when we are trying to come up with some broad principles for potential negotiations.

"Doctors are crucial to innovation in the NHS, and their work not only improves quality, but also frequently saves taxpayers' money."


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  • rate this

    Comment number 344.

    Totally agree with 269. It is a scandal that consultants are paid by us the taxpayers to train, they then hold on to a NHS post meanwhile making themselves rich by charging a fortune privately. They use NHS hospitals and NHS operating theatres for their private patients. It has to be stopped. Other professions do one job - a police officer gives all his time to the public, no private jobs.

  • rate this

    Comment number 312.

    The consultants I know are so exhausted they are switching to part-time jobs. There's a huge shortage of consultants in some specialities e.g. A&E.

    I think they should be training much more doctors in the UK. There's a chronic shortage of UK-trained doctors in the NHS.

  • rate this

    Comment number 203.

    I was a receptionist in out-patients in a private hospital where the Consultant-who was meant to be on call at the NHS hospital- was doing his private clinic.During a break he was talking his Registrar-in the NHS hospital-through a C-Section.I often had calls from irate NHS receptionists and secretaries as to the whereabouts of their bosses.The entire system needs overhauling.

  • rate this

    Comment number 190.

    My heart bleeds for the medical posters on this board; health care is not a 9-5 job; you know that when you take up the call to the profession; unfortunately, career professionals & the rest of society are only interested in the pay & perks rather than the vocation!

  • rate this

    Comment number 186.

    As an NHS consultant I have just finished a weekend on call in an intensive care unit. I worked 10 hours in the hospital on both saturday and sunday and got telephone calls all night, both nights - above what I am paid to do. I didn't see my family and am exhausted. My wife (who is in the non-medical private sector) cannot believe I have to work so hard. There is a disinformation campaign afoot.


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