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EDITIONS
NHS reform Friday, 28 July, 2000, 11:52 GMT 12:52 UK
Doctors may fight NHS plan
Doctors
Consultants will be rewarded for doing less private work
Doctors look likely to resist government plans to change the way they work as part of the NHS reforms.

They have also criticised the timetable for reform and have accused ministers of deluding themselves and patients if they think some of the reforms can be introduced in just a few years.

Prime Minister Tony Blair unveiled the NHS national plan on Thursday, saying it would make the health service fit for the 21st century.

However, his plans could be derailed if doctors fail to cooperate fully with the modernisation programme.

The Kings Fund, an independent health think tank, warned: "The government knows that it will have to bring all health professionals, including doctors, with it if it wants to introduce these reforms."

Doctors are critical of plans to tighten controls on them, by curtailing their independence and tying their salaries to performance.

They include proposals to force all newly-qualified consultants to work solely for the NHS for their first seven years.

All consultants will be asked to sign new contracts which will reward those that give up private work.

Urgent talks

Dr Peter Hawker, chairman of the BMA's consultants' committee, said he would be seeking urgent talks with ministers.

"The proposals about changes to the consultant contract is couched in terms that belie a profound lack of understanding of the work consultants do.

"It raises a lot of questions, including those of fairness, that we shall want to explore urgently with the government."

But Dr Peter Fisher, president of the NHS Consultants' Association, criticised the BMA.

"It is rather disappointing that the BMA and others are seizing on changes to contracts as the key thing to the plan."

GPs, too, have been critical. Under the plan, their pay will be linked to the quality of their work rather than the number of patients they see.

They will be encouraged to sign a new contract which will make them salaried employees of the NHS, rather than self-employed contractors to the health service, as at present.


By pretending that they can do this in three or four years time, ministers are deluding themselves and the public

Dr Laurence Buckman, BMA

Any doctor who works alone, as opposed to those working in group partnerships, will be forced to become salaried. They will also have to meet strict quality measures.

Offended Dr Laurence Buckman, a senior member of the BMA's GPs committee, said doctors would be "offended" by some of the proposals.

"I think the plan is actually quite advanced and has a large consumerist agenda. However, some doctors will be offended by it.

"We don't need to have contractual change. This will make a workforce which does not have good morale develop even lower morale."

He added: "To force someone in the NHS to work in a different way is counterproductive and will just encourage people to quit.

"I am saddened that the government has seen it right to use a vindictive piece of statute to try and damage general practice." Dr Buckman said the some of the proposed reforms would fail to be introduced as planned because of a lack of NHS personnel.

"The government is stoking the expectations of patients. There are not enough people in the health service at the moment to make some of these reforms possible.

"By pretending that they can do this in three or four years time, ministers are deluding themselves and the public."

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