HC Deb 21 February 1975 vol 886 cc546-8W
Mr. Onslow

asked the Secretary of State for Social Services how many RHAs have made payments to hospital consultants on acount of overtime so far this month; what are the sums involved in each area; and what has been the source of the funds involved.

Mrs. Castle

Hospital consultants do not have a specified number of hours of attendance or duty: their contracts are normally for a programme of responsibilities. Consultants' representatives have publicly stated that they regard their contracts as open-ended, and have given evidence to this effect to the Doctors and Dentists Review Body.

In the case of whole-time consultants there is no limitation on the hours of duty required. Consultants with "maximum part-time" contracts are permitted to do private practice in recognition of which they receive only nine-elevenths of the whole-timer's salary. A statement by the Joint Consultants Committee in 1961 indicated that a health authority could expect as much from"— a consultant on a maximum part-time contract as on a whole-time contract".

For part-time consultants, the terms of service provide that employing authorities should make a general assessment, in terms of notional half days and fractions thereof, of the average time per week required by an average practitioner in the grade and specialty to perform the duties of the post, a notional half day being regarded as the equivalent of 3½ hours". The proportion of the whole-time salary payable to the part-time consultant depends on the number of notional half days so assessed, but the consultant's contractual responsibility is to perform the duties of the post, and is not normally limited to any particular number of hours.

It follows that no question of "overtime" arises, nor of payment being made in respect of it, and any consultant who fails to carry out the full range of duties for which he has contracted irrespective of the time it takes is in breach of contract.

The Government and health authorities have an overriding obligation to ensure that the essential needs of patients continue to be met. In cases where it has been clear that a consultant would cease to play his full part in meeting those needs unless he received extra payments, health authorities in eight regions have, in the interests of patients, had to make some extra payments to consultants who have demanded them. Such payments have totalled about £12,500, the cost falling on health authorities' revenue alloca- tions. No use has been made of the British Medical Association's or the Hospital Consultants and Specialists Association's agencies.