comment: Trusts find ways to introduce the consultant contract locally

Published: 24/04/2003, Volume II3, No. 5825 Page 15

The government talked tough when consultants voted to reject their new contract last autumn. As doctors' leaders muttered about strike action, ministers made it clear there would be no renegotiation and trusts could implement the deal locally.

Five months on, they are still talking tough. Trusts will be able to implement the contract 'where there is a high level of consultant support to do so'. Or they will be able to use the money that would have funded the new contract for local incentive schemes.

The Department of Health made it clear this week that trusts following the first route will not be able to force consultants to work evenings or weekends (news, pages 6-7).

Health minister John Hutton insists this clarifies the existing position; doctors' leaders describe it as a 'significant concession'.

Trust managers must decide whether the new contract offers real benefits for their organisation. The incentive schemes certainly look like an attractive alternative, as they potentially open the way for payment by results and radical changes in working practices.

The British Medical Association's consultants' committee has, unsurprisingly, reacted furiously, walking out of negotiations and muttering darkly, again, about industrial action. There is every sign that the government will continue to hold firm.

Given the implications of what ministers are now proposing to let local trusts do, the consultants may regret voting down the national deal. Managers should seize the opportunities on offer.