Private chambers plans sent to doctors

Consultants rejected a new contract last year

The British Medical Association has issued doctors with a document that gives advice on how they might go about quitting the NHS.

The move comes as doctors' leaders crank up pressure on ministers to come up with a good deal on pay and conditions for hospital doctors.

At a special meeting last month BMA leaders gave ministers three months to re-open talks on a new consultant contract.

It is not surprising that consultants are starting to discuss the idea of leaving the NHS and setting up chambers more seriously

Dr Paul Miller

They voted to ballot members on industrial action if negotiations had not resumed by then.

The discussion document, Alternatives to sole NHS employment, concludes that moving to full-time or part-time self-employed status would be a viable option for some consultants.

It also provides a step-by-step guide on how doctors could set up lawyer-style private chambers.

Dr Paul Miller, Chairman of the BMA Central Consultants' and Specialists' Committee (CCSC) said: "The majority of consultants work full time for the NHS and, in an ideal world, would probably want to continue to do so.

"But they do feel very frustrated at the relentless workload in the NHS and by the feeling that their time is never their own.

"The fact that the Secretary of State for Health, Alan Milburn, is refusing to return to the negotiating table and develop a contract that is good for doctors, the NHS and patients, means that it is not surprising that consultants are starting to discuss the idea of leaving the NHS and setting up chambers more seriously."

US model

The BMA document argues chambers could contract to provide services at an NHS hospital trust, at primary care premises, at a private hospital or from premises owned and operated by the consultants themselves.

The idea is a red herring

Department of Health spokesman

In the USA it is common for specialists, such as radiologists to own their own equipment and/or hospitals.

But the document also warns that doctors who leave the NHS to work in a private partnership, company or chambers arrangements would have to leave the NHS pension scheme.

BMA leaders struck a deal with ministers over a new contract for consultants last year, but members then rejected it in a nationwide vote.

Doctors were concerned that it gave NHS managers too much power.

Ministers have said the contract can be introduced by hospitals locally, where there is enough support from doctors.

They have so far refused to enter into new talks.

A Department of Health spokesman dismissed the concept of private chambers.

He told BBC News Online: "The idea is a red herring."

He added the contract that was offered to consultants would have a 10% pay uplift over three years, and meant an overall average increase of 22% over that time.

"Consultants have a choice to make. There is the option of the new contract. Or they can stick with the existing contract or choose the local incentive scheme."