Published: 19/09/2002, Volume II2, No. 5823 Page 4

The new consultant contract may be imposed if a ballot next week rejects the deal negotiated by the Department of Health and the British Medical Association, as is now widely feared.

A contract framework, delivering around 20 per cent extra pay for many consultants, was agreed between the DoH and the BMA in June. The BMA has spent the summer trying to persuade consultants that they should vote to accept the proposals, principally through a national series of roadshows.

But these have revealed high levels of disenchantment with key aspects of the deal, including evening and weekend work being paid as part of the standard week.

An indicative ballot will be held from next Friday (27 September), in which both consultants and specialist registrars will be able to vote.

The BMA's central consultants and specialists committee will decide what to do with the result towards the end of October.

The vote will be broken down into the four constituent countries of the UK and it is thought likely that Scotland will vote to accept the contract.

The BMA's Scottish consultants' committee and the Scottish Executive's health department issued a document last week aimed at calming fears of Scottish consultants over the deal.

Negotiations to produce something similar for England are still ongoing.However, HSJ sources in both the government and medical circles are currently expecting England to vote against.

There is widespread understanding that if this happens, the government could decide to impose the contract in its current form.

Senior HSJ sources said possible options include withdrawing any concessions made to the BMA and then imposing the contract, allowing consultants who wanted it to adopt the contract or leaving managers to negotiate arrangements locally.

Consultants have expressed anger at the idea of the contract being imposed. But a member of the contract implementation team said that all these options are considered feasible.

CCSC member Dr Ed Borman, who has presented the BMA's case for the contract at 10 roadshows, said: 'As it stands at the moment, it is unlikely it would be passed by either [consultants or registrars].

'Could we renegotiate? I do not think that is a feasible option. The DoH could say 'that is as far was we want to go' and they could offer it to anyone who wants it.'

British Association of Medical Managers chief executive Dr Jenny Simpson said elements of the contract could still be implemented if the ballot rejected the current deal.

She said: 'I imagine there would be scope about how we could bring about the same effect. A lot of trusts already have a very strong appraisal and job review process.'

Royal Shrewsbury Hospitals trust medical director Dr Ashley Fraser, who sits on the contract implementation group, also told HSJ it was feasible the contract could be imposed or offered to individuals, as consultants could stay on their current contracts.

A DoH spokesperson said: 'We have negotiated and agreed the framework for the new consultant contract with the BMA. We remain committed to the contract, and await with interest the outcome of the BMA referendum.