Milburn allows hospitals to impose pay deal rejected by consultants

Hospital truths will be allowed to impose controversial new pay and conditions on their consultants, the Government announced yesterday.

Consultants voted by two to one last October to reject a contract proposed by the Government and negotiated with the British Medical Association. The BMA then called on the Health Secretary, Alan Milburn, to re-enter negotiations but he refused.

Yesterday, Mr Milburn pressed on with his original pay deal, saying he would allow it to be implemented locally.

Hospital trusts in England can now individually introduce the new NHS contract for consultants, the Government said.

Under the plans, hospitals will be allowed to offer new incentives including a "fee-for- service" scheme, to reward those who do extra work.

Mr Milburn is desperate to get the doctors signed up so that they can deliver the Government's promised improvements to the NHS. Fears that managers could compel them to work outside normal hours was one factor behind the consultants rejecting the contract.

The BMA reacted angrily to the announcement. "Local implementation is the issue on which we have had most protests. It is not what consultants want," a spokeswoman said.

Paul Miller, chairman of the BMA consultants committee, said all meetings with the health department had been called off in protest at the move and industrial action was now on the agenda. "This demonstrates once again that the Department of Health has no interest in engaging in constructive talks."

John Hutton, a Health minister, said the contract was "basically sound". He added: "It was and is a contract that will fairly reward consultants properly for the excellent and complex work they do and properly address issues of workload and quality."

Some doctors thought the contract would force them to work weekends and evenings but the Government had made it clear this was not the case, he said. "We will now go further by asking local NHS trusts to make clear that if they and their consultants decide to implement the contract locally, they will not schedule non-emergency work at weekends or in the evenings without the agreement of individual consultants.

"I hope this removes one important barrier that some consultants have said stands in the way of them accepting the new contract," he said. "We have listened to what consultants have to say. We now need to make progress on reform."

The incentive schemes would involve annual bonuses for consultants who achieve agreed performance levels.

Mr Milburn is writing to all consultants and specialist registrars in England setting out the Government's decisions.

Ministers also attempted to sweet talk GPs with a new guarantee inserted in their contract to ensure no family doctor would lose money under their complex pay deal worth an extra 33 per cent to practices over three years.