The BMA is to review its recent negotiations with the government over doctors' contracts. The organisation was severely embarrassed when members rejected proposed contracts negotiated by the BMA for GPs and consultants.
The review process, “Learning the Lessons,” will look at three contracts negotiated by BMA craft committees in the past four years, for consultants, junior doctors, and GPs. Announcing the details of the review, the BMA said that “notwithstanding the outcomes of the negotiations, the BMA has recognised there were problems in each.” The BMA will report the review's findings in January 2004.
The contract negotiated by the BMA's General Practitioners Committee was overwhelmingly rejected this May after the BMA sent out an income “ready reckoner” to enable GPs to calculate their future revenue under the new arrangement. Whereas the agreement had been touted as offering an average 33% increase, 70% of doctors using the ready reckoner found they would make less money than before.
Support for the contract among members collapsed, and a vote was postponed while the Department of Health and the BMA negotiated a “minimum practice income guarantee” which promised that no GP would lose money under the new formula. The contract was eventually approved by a wide margin in June.
The history of the consultant contract has been even more fraught with acrimony. Last October, members voted by two to one to reject the contract negotiated by the BMA's Central Consultants and Specialists Committee, leading to the resignation of the committee's chairman, Peter Hawker, and the election of the more outspoken Paul Miller.
The committee then sought to renegotiate the contract, but Alan Milburn, then health secretary, refused, suggesting instead that consultants make arrangements with their local employers. Consultants began to speak of industrial action. After the arrival of John Reid as health secretary after Alan Milburn's resignation (for reasons unrelated to the contract negotiations) negotiations were restarted. Differences over working hours have been partly resolved, but no date has been set for a vote on a revised contract.