POLITICS

Whenever I consider the burdens of other people's jobs I think how daunting it would be to fly a 747 full of passengers across the Atlantic or - playing God in a different way - how scary to do brain or heart surgery where a slip may be fatal.

Actually, the sheer noise of a class full of six-year-olds puts me in awe of primary school teachers, too. But neither they nor pilots were the subject of the Commons health select committee's quickie (three-week) investigation into consultants' contracts under the shop stewardship of Wakefield's Labour MP, the bearded ex-rugby player, David Hinchliffe.

'Plea to ban consultants from private sector work', was the Telegraph's headline; this on the strength of the report's 60th and final paragraph. It urged ministers to 'make it a long-term objective that consultants in the NHS do not undertake private practice'.

The stated reason for this is sheer inequity, the notion that Keith with a 'non-urgent' heart condition should wait nine months for his op (the example cited) while approximately 45 people who can find£10,000 for the same op at the same hospital will jump the queue. It is part of what the committee calls the 'perverse incentive', by which it suits some consultants with private practice to force patients to 'go private'. Or at least that's the theory, though the committee admits it is what Scots lawyers call unproven.

What I say is, good on you, Keith, you've saved yourself 10 grand at some inconvenience but no risk. Mr Hinchliffe, however, is a Dobsonian enemy of private medicine, and most of his committee is Older rather than Newer Labour.

They had little difficulty in unearthing lax auditing of consultants' time, confusion over the way full and part time contracts work, anomalies and divergent management practices in different trusts. 'We could find no explanation for that,' is a recurring comment.

You may care to know that the most common reason for consultants failing to do their fixed NHS sessions was said to be that most are 'off doing some management meeting' - that is, not on the golf course or in Harley Street. You may also enjoy learning that the average consultant's NHS earnings are around£68,000 and that, of the two-thirds who also do private practice, average earnings in 1999 ranged between£7,572 for pathologists to£75,413 for - yes, you guessed - plastic surgeons.

I am all too aware that, in writing this article, I am a journalistic consultant engaging in part-time private practice. Though I am doing it at dawn and in my own time I am wary of attacking medics who (like me) feel their employers get their money's worth.

That seems to have been the view of the two Tory MPs, Simon Burns and David Amess - both Essex men - who voted against para 60.

I'm told that Dr Peter Brand, the Lib Dem MP-GP from the Isle of Wight, might have done so had he not arrived at the committee too late to take part; as we noted in this column last week, his party health spokesman, Nick Harvey, is now working closely with Minister Milburn on the NHS national plan, due around 26 July.

Labour's GP on the select committee, Dr Howard Stoate, was also well aware of the dangers which Nye Bevan understood when he engineered the famous ('I stuffed their mouths with gold') compromise in 1948: that of driving consultants out of the NHS when there was (and still is) a shortage of key specialists.

In effect, the report urges gradualism: independent management of NHS waiting lists, better monitoring and a move over time to replace part-time with fulltime contracts. So will Alan Milburn and John Denham rush to embrace the Hinchliffe doctrine? I think not. The brutal truth is that the NHS is entering a phase of closer co-operation with the private sector and cannot afford to pay its senior doctors private-sector rates, let alone French or German ones.

Mr Denham is already engaged in a tricky negotiation with the consultants over the terms and salaries in their contracts. Like the Bristol baby scandal, the Hinchliffe report may be a useful weapon with which to beat them ('any more trouble from you, my good man, and I'll let Hinch off his leash'), but not much more. As my man on the inside track admits, 'the truth is we still get our doctors cheap'.