HC Deb 13 March 2001 vol 364 cc815-8
9. Mr. David Amess (Southend, West)

What representations he has received on the negotiations for new consultants contracts. [151957]

13. Dr. Julian Lewis (New Forest, East)

If he will make a statement on the recruitment and retention of consultants. [151961]

The Secretary of State for Health (Mr. Alan Milburn)

The Government's proposals for a new consultants contract were published last month. We are now in negotiation with the British Medical Association on our proposals and its own. In the meantime, the number of consultants in the NHS has increased by almost 3,000 since 1997. We are committed to further significant increases as part of the NHS plan. By 2004, there will be 7,500 more consultants working in the NHS.

Mr. Amess

I take all that with a pinch of salt. Surely the Secretary of State realises that, even by the standards of this deeply sinister, incompetent—[HON. MEMBERS: "Rotten Government"]—rotten Government, his policy on consultants contracts is wrong. Will he now undertake to look carefully at the evidence given to the Select Committee on Health, which showed that morale in our health service will plummet as a result of that policy? Will he undertake to stop his wicked attack on our hard-working consultants and realise that although we need more hospital consultants, we certainly do not need a Labour Secretary of State for Health?

Mr. Milburn

I know that the hon. Gentleman is parliamentary adviser to the Caravan Club—which probably explains why he is undertaking his political tour of Essex constituencies at the moment—but not everyone has the luxury of having two jobs at once. It is right that we correct this historic anomaly, and our proposals are designed to do something very simple indeed. The consultants contract has remained unreformed since 1948; it is about time it was changed. I want to put the NHS in a better position to compete for consultants valuable time, expertise and skills, for the benefit of NHS patients.

Dr. Lewis

Does the Secretary of State's policy not show that he thinks he knows a lot better than the founding fathers of the NHS, who recognised the problems that would be caused if consultants were forced into the NHS and not allowed to engage in private practice? What makes him think that he has a better solution to the problem, which is fundamentally the same now as it was when Aneurin Bevan and other Labour Ministers, who knew what they were doing, decided that the course that he proposes to adopt was totally wrong, counter-productive and would result in consultants being lost from the NHS?

Mr. Milburn

The hon. Gentleman is the oddest looking Bevanite that I have ever seen in my life; poor old Nye would be turning in his grave at the prospect of the hon. Gentleman supporting him. The contract has remained unreformed since 1948. It has remained as it was then for the past 53 years, and it has to change. The whole assumption behind the consultant contract has been that the best way for NHS consultants to get on is by opting out of NHS work. We must turn that on its head. There is a fair deal on offer for NHS consultants. We will pay them more for doing more NHS work, in exchange for which we expect them to do less private practice. We have proposed the deal, and we shall negotiate it.

Mr. David Hinchliffe (Wakefield)

The Health Committee's inquiry into consultants contracts was mentioned a moment or two ago. Does my right hon. Friend remember that during that inquiry, we received evidence that, in certain parts of the country, NHS waiting lists were being artificially lengthened to stimulate a demand for private consultations and private treatment? In the negotiations with the consultants, has that matter been considered?

Mr. Milburn

I understand that there are concerns about precisely those issues. Many patients find being confronted with such potential conflicts of interest extremely uncomfortable, but that is not the primary purpose of what we seek to do. Given that we have a limited number of NHS consultants—we shall have more in future—our primary purpose is to ensure that we get the maximum amount of NHS time from them. That seems reasonable; it is not a something-for-nothing deal.

We are seeking to pay NHS consultants more for doing more NHS work. They will receive an average of £10,000 a year extra when they start out as NHS consultants. They will have extra access to discretionary points and extra access to £20,000 worth of extra rewards in exchange for doing less private practice. That is the deal that we have proposed. It makes a fundamental break from what has gone before, but I believe that in the end, it will be welcomed not only by NHS consultants, but, most importantly, by NHS patients.

Mr. Dennis Skinner (Bolsover)

I wish my right hon. Friend well in his endeavours. Do we not all know that, contrary to what Tory Members have said, Nye Bevan wanted to do exactly what my right hon. Friend is attempting to do today? The money was not there then, but we have now got an economy that enables us to achieve what we could not do in the 1940s. My right hon. Friend should not worry when the Tories talk about doctors and consultants with more than one job, because nearly every Tory MP moonlights as well.

Mr. Milburn

My hon. Friend, as always, makes a very good point. I will not take much notice of what the Conservatives say, but of course we shall listen to what the consultants say. There will be a negotiation, and we have set out our position very clearly indeed. We shall negotiate on it, and I fully expect us to make progress.

Mr. Peter Lilley (Hitchin and Harpenden)

Although I accept that it is normally desirable to retain experienced and dedicated consultants in the NHS, will the Secretary of State set up an inquiry into why Mr. Lennox Kane, a consultant gynaecologist at Hemel Hempstead who had been diagnosed with Parkinson's disease, was allowed to continue operating? Will the inquiry investigate the complaints of 27 of his women patients about the treatment that they received? Will the right hon. Gentleman use his good offices to ensure that the chief executive and chairman of the health authority and the trust agree to meet the members of the action group that was set up to represent those patients before such an inquiry, not after, which is all that they have agreed to at present?

Mr. Milburn

The circumstances that the right hon. Gentleman describes are extremely disturbing. As I understand it, the trust is already reviewing the way in which the complaints were or were not acted upon. I promise him that I shall look into precisely the matters that he has raised with me.

Mr. Desmond Swayne (New Forest, West)

On 11 June last year, the Secretary of State told BBC television:

In most walks of life employees have got a choice haven't they about whether they work part-time or whether they work full-time … We are not going to deny that to consultants. Surely, why should we? It would be a pretty odd state of affairs if we said to highly trained consultants, some of the most expert people, professionals that we have in the Health Service, you are going to be denied a set of rights that everybody in the NHS has. Can the Secretary of State explain what change has brought about the pretty extraordinary state of affairs that we now find, or was that statement, like the concordats with the private sector, just part of the mood music? Is not the authentic Secretary of State the authoritarian that we see before us at the Dispatch Box now?

Mr. Milburn

Welcome to Health questions. The hon. Gentleman should read the Government's proposals.

Mr. Graham Brady (Altrincham and Sale, West)

Answer the question.

Mr. Milburn

If the hon. Gentleman will stop hollering, I will try to answer the question. If he calms down and keeps taking the pills, he will be fine.

If the hon. Member for New Forest, West (Mr. Swayne) reads the Government's proposals, he will see that there is perfect consistency between what was said then and what is being said now. We have made it perfectly clear that, in exchange for extra rewards, we will expect newly qualified consultants not to work in private practice for up to seven years. Following that seven-year ban, it will be perfectly permissible for consultants to undertake a limited amount of private practice. That seems to me to be the right thing to do. It is right for consultants, because it gets them extra rewards, and it gets NHS patients the extra skills, the extra commitment and the extra expertise that they need.