Doctors' vote shows extent of frustration

Almost half of hospital consultants' representatives voted yesterday to explore ways of leaving the NHS and selling their services back, in an expression of frustration at the health service reforms.

Although the resolution at the annual meeting of the British Medical Association consultants' section was lost by two votes, 58 to 56, its chairman John Chawner said he was not surprised at the strength of feeling.

'Last year on a similar vote a very small minority were in favour. The fact that at this meeting virtually half are now wanting us to look at the alternatives is very significant,' he said after the meeting.

Mr Chawner supported the resolution, which asked his committee to 'explore the possibilities of consultants withdrawing their services from the NHS and contracting their services back. This has arisen out of frustration, innumerable frustrations occuring these days. It would be extremely unwise not to explore the possibilities.'

Dr Basil Hudson, of Derby, proposing the motion, said it was likely consultants would become unhappy working in a service in which commercial considerations were paramount. 'If that is the case they may have to consider withdrawing from direct employment and taking up as self-employed medical practitioners, offering their services to the patients.'

Speakers against the proposal said this would lead to the fragmentation of the NHS, to the eventual disadvantage of patients and doctors. Small, local arrangements would give NHS managers more power over their working practices.

Earlier, the consultants unanimously voted to oppose the 'doctrinaire' government decision to impose performance-related pay on them.

Stephen Brearley, of North East Thames, said it was a fundamental human right to have an unbiased judiciary and equally important for patients to expect an independent medical profession. 'The introduction of performance related pay would put consultants totally in the thrall of managers and of their political masters.'

He estimated that local pay bargaining based on four consultants taking four and a half days a year to negotiate in each of 400 hospital trusts would cost the NHS pounds 572,000.