CHOICE Health secretary admits clinicians unpopular with patients may lose their jobs

Published: 03/11/2005 Volume 115 No. 5980 Page 8

Hospital doctors could be laid off if they do not attract enough patients, health secretary Patricia Hewitt confirmed last week.

Questioned by health select committee MPs about the government's patient choice policy, Ms Hewitt said hospitals could lay off medical staff who were not getting enough patient referrals.

Conservative MP for Guildford Anne Milton asked if the government would be prepared to step in if patients were consistently choosing to go to one doctor over another at the same trust.

Ms Hewitt said it would be for 'the management of the hospital to draw the necessary conclusions and either find a way to improve the service or do something else'.

Asked whether this would mean going as far as sacking doctors, Ms Hewitt said trust management 'would need to look at whether there was an issue about clinical quality or patient experience, how this doctor was treating patients and what was causing the problem'.

'Ultimately if that could not be improved, then yes, you might well decide that you are no longer able to employ that individual.' NHS Confederation chief executive Dr Gill Morgan said that if referrals were not coming through for specific consultants, trust managers should look at the reason for that and try and resolve the problem.

However, Dr Morgan admitted that, as 'good stewards of tax-payers money', managers would have to question the demand for particular services and whether it was appropriate to employ particular individuals.

British Medical Association consultants' committee chair Dr Paul Miller said that it was 'quite obvious that there are people in the Department of Health who are only just realising the consequences of the policy they have put in place'.

'It all very well saying things like this, but the government put excess capacity in the system, so it is beyond question that many clinics will suffer a drop in referrals. This will lead to destabilisation and the closure of some units'.