Consultants (Hansard, 29 October 2002)

§ 4. Mr. Chris Mullin (Sunderland, South)
What recent discussions he has had with representatives of the British Medical Association about the consultant contract; and if he will make a statement. [75352]

§ The Minister of State, Department of Health (Mr. John Hutton)
The Department agreed the framework for the proposed consultants' contract with the central consultants and specialists committee of the British Medical Association on 12 June. I last met representatives from the BMA to discuss the proposed new contract on 11 September.

§ Mr. Mullin
In the light of the apparent rejection by consultants of the contract negotiated on their behalf by the BMA, and endorsed by the BMA's annual conference, will my right hon. Friend assure the House that not one penny of the many millions set aside to implement the new contract will find its way into the pockets of those who refuse to co-operate in reducing waiting lists?

§ Mr. Hutton
Obviously, it would not be productive or useful for me to speculate on the outcome of the ballot. We shall have the result on Thursday. We have always made it clear that one of our principal objectives is to provide better rewards for consultants who make the biggest contribution to the NHS. That will remain the case.

§ Dr. Richard Taylor (Wyre Forest)
My impression is that dissent among consultants about the proposed new contract relates to lack of trust and, in many places, poor relations between managers and clinical staff. What can the right hon. Gentleman do to improve those relations?

§ Mr. Hutton
Again, I shall not speculate on the outcome of the ballot; we must wait and see. I believe that relationships between consultants and managers are pretty good throughout the NHS. If the hon. Gentleman wishes to draw to my attention specific examples of poor relationships, I shall be happy to examine them.

§ Mr. Bob Blizzard (Waveney)
Has my right hon. Friend read The Times report today that speculates that consultants are about to reject the new contract, which offers them a 15 per cent. pay rise? My constituents will be horrified that people who were trained through the public purse want to turn down a 15 per cent. pay rise, 671 are unwilling to join a national effort to reduce waiting lists and would thus let down the public whom they are trained to serve.

§ Mr. Hutton
I have a great deal of sympathy with my hon. Friend's point. It is worth reminding hon. Members that the proposed contract will be good for patients and the NHS. That is not only my view, but that of the hon. Member for Woodspring (Dr. Fox). The contract holds out the prospect of significant improvements for NHS consultants' terms and conditions of work, and I hope that we can take the matter forward positively.

§ Dr. Evan Harris (Oxford, West and Abingdon)
The impending rejection of the Government's new contract by current and future consultants is not because of money. Does the Minister accept that they are rejecting giving more power to the Secretary of State and managers, who would put political targets before clinical need? Are not junior doctors, who are currently exploited, rejecting a definition of a normal working week that includes working late in the evening and on Saturday and Sunday mornings?
If the Minister wants more consultant time, why does not he insist that the NHS creates more consultant posts and allows those on non-consultant career grades, the majority of whom are from ethnic minorities and stuck in such posts, to apply to be consultants? They have the skills to increase NHS activity.

§ Mr. Hutton
I am afraid that the hon. Gentleman is wrong in just about everything he has said. We are increasing the consultant work force in the NHS. When we came to office, there were 21,000 in England; there are now 26,000. We are taking a number of measures to improve the terms and conditions of all doctors in the NHS, but his position on all those issues is complete incomprehension of the need for reform. The need for reform here will be just as important on Friday—the day after the ballot result is announced—as it is today. There is a strong need to reform the consultants' contract. That is not only my view, but that of the BMA.

§ Mr. Dennis Skinner (Bolsover)
Does the Minister agree that, more than 50 years ago, consultants played a part in holding up the reforms of the Minister of Health, Nye Bevan? It seems that they are still at it. It seems rather odd that everybody else in the hospital has to sing to the same tune, yet consultants, who are making money on the side, seem to wield tremendous power. I say all that against this background: I have to go and see one in a month. I hope that the Minister manages to tell them that it is time they played the game.

§ Mr. Hutton
I have a great deal of sympathy with the points that my hon. Friend makes. I hope that the consultant who is seeing my hon. Friend voted yes to the new contract; otherwise, he might be in a bit of trouble.
I say in all sincerity to my hon. Friend, whom I hold in the highest regard, that the point that he addressed is fundamental, and there will still be an issue of accountability in the NHS, not only for managers, but for senior doctors. Those arguments about accountability to the taxpayer and to patients and the wider community in which we all live will be just as 672 pertinent the day after the BMA announces the ballot result on Thursday as they have been in the 50 years since the NHS was established.

§ Dr. Liam Fox (Woodspring)
But if the reports referred to are correct and the consultant contract is rejected, who will be primarily to blame?

§ Mr. Hutton
As I have said repeatedly, I will not speculate on the outcome of the ballot, but I would be interested to know whether the hon. Gentleman, whom I suspect hears the sound of a bandwagon rolling and now wants to get on board, has changed his view, which he expressed in June, that this is a good contract for the NHS.

§ Dr. Fox
We are touchy today. Although I accept that there are positive aspects to the contract for doctors and for patients, if there is a rejection, it will be of the contract's culture, not its substance. Doctors fear far greater interference in their clinical work, which is hardly surprising, given the Government's target culture. Despite all the Secretary of State's rhetoric, he has tried to micromanage the NHS from Whitehall, which has resulted in ever more administration and red tape as well as a distortion of clinical priorities. The rejection of the contract and the chaos that that may bring will be a direct result of the Government's approach to running the NHS. Does the Minister accept that, ultimately, the buck therefore stops with him?

§ Mr. Hutton
The hon. Gentleman, rather like the hon. Member for Oxford, West and Abingdon (Dr. Harris), is wrong on all those issues and all those counts. Interestingly, it appears that it is now the policy of Her Majesty's Opposition to set themselves against any national target for the NHS. They have collective amnesia on the other side of the House, because only last summer the hon. Member for Woodspring (Dr. Fox) and his right hon. Friends were committing themselves to national waiting time targets across the NHS. What does he want?