Government makes U turn on private practice ban

The UK government has been forced to backtrack on its commitment to ban newly qualified NHS consultants from working privately for at least seven years after qualification.

As part of a new consultants' contract, launched last week at a BMA conference in London, the heavily criticised ban on private practice outlined in the government's July 2000 NHS Plan will be abandoned (BMJ 2001; 321:317). Several changes in the pay structure and working practices of consultants will be implemented in its place.

“The government has had to face the most phenomenal climb-down in medical negotiations for a long time,” says Peter Hawker, chairman of the BMA's consultants committee, who referred to the new contract as a “BMA victory.” But he warned that compromises have had to be made.

With respect to private practice, for example, consultants in their first seven years will now be required to offer two extra sessions of four hours, on top of their normal 10 sessions, to the NHS before they can do any private work, and the more senior consultants will have to offer one session. The BMA has also accepted the government's move to impose tighter controls of consultants by NHS managers.

However, the overall deal is good enough to persuade most newly qualified consultants to work full time for the NHS, according to Peter Hawker, and will offer consultants some control over their workload.

The new contract, which will come into effect in April 2003, is the first renegotiation of the consultant contract since the NHS was set up in 1948 and will now be sent to all 26000 UK consultants for approval. The new starting salary for newly appointed consultants will be £62000 ($92000; €97000), rising to a maximum of £82250.

Key changes include a substantial rise in salary, as well as payment for currently unpaid emergency work and for duties such as teaching, continuing professional education, management, and audit.

“All supporting activities will now be valued and paid for as part of the core contract,” says Dr Hawker. Under the new contract, consultants will be paid for any work done outside the core working week of 10 four hour sessions. There will be a 20% increase in starting salaries for new consultants, and the most senior consultants could be earning in excess of £90000 by 2005—a proposed boost that is “long overdue,” says the negotiating panel. (See News Extra at bmj.com)

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Dr Peter Hawker believes that the deal is good enough to persuade most new consultants to work full time for the NHS