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ss triple helix - winter 2003,  The consultants' contract - Family friendly first

The consultants' contract - Family friendly first

Many people will find it hard to understand why hospital consultants in England and Wales should have rejected a deal promising a 20% rise in starting salary to new consultants and pay rises of 9 to 24% across the board. But the reality is that most doctors do not go into medicine for the money. Whilst no one would deny that consultants are generally on comfortable incomes, they do earn less than many equivalently qualified professionals in the private sector. Most doctors are motivated far more by the knowledge that they are doing high quality work. The government seems not to understand this.

It was unfair and disingenuous of health ministers to imply that consultants had rejected the contract because they were uncommitted to bringing down waiting lists and wanted to earn more money in private practice. Whilst this is undoubtedly true of some, the majority of consultants already work more hours for the NHS than they are paid, and the new contract would have disrupted team functioning and taken more evening and weekend family time from those who already have considerable out of hours work commitments, without necessarily delivering better patient care.

The contract considered up to 10pm at night during the week and up to 1pm on Saturdays and Sundays as normal working hours to be remunerated at normal rates of pay and many consultants were freshly concerned by a leaked NHS document to hospital managers urging them to push ahead with weekend and evening work and to only pay extra to the 'deserving few'. They feared that they would become the pawns of policies aimed more at fulfilling political targets than properly prioritised patient care.

The really urgent need is still for more consultants, and attempts to shift blame onto the medical profession when the reality is that the health service in this country remains amongst the most poorly resourced in Europe, will only succeed in fuelling more feeling that government and health managers are out of touch with realities at the coalface.

Britain has one of best-trained and committed hospital consultant work forces in the world. It would be a great tragedy if a heavy-handed approach by government led to an exodus of top consultants from the NHS. It would then be those least able to pay for good quality healthcare that would miss out. The government will make far more headway in negotiations if it seeks to listen to doctors and understand their concerns.

Christian doctors especially need to work hard at better communication with government and managers, and push for a contract that is more family-friendly and conducive to good patient care.
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