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EDITIONS
Saturday, 2 November, 2002, 14:14 GMT
'Junior consultants' role proposed
NHS consultants at work
Consultants have threatened industrial action
A new grade of "junior" hospital consultant could be introduced to help the NHS take on extra work and reduce waiting lists.

The new grade was reportedly suggested by health minister Alan Milburn, as the row between the government and consultants continued.

The row began when consultants in England rejected a new government contract which would reward more flexible working practices with more money.

The "junior" grade could effectively reduce the amount of private practice work NHS doctors can undertake in their early years after becoming an NHS specialist.

It is likely to run into fierce opposition from the British Medical Association, and from junior doctors nearing the end of their training, who have long been against the idea of a "sub-consultant" grade.

Health Secretary Alan Milburn
Mr Milburn could try to force changes through
Mr Milburn was also reported to be looking at restructuring the incentive payment system to provide greater rewards for specialists who work in the new grade.

The BMA warned of industrial action if the government tried to force the new grade upon doctors.

Trevor Pickersgill of the BMA told BBC News 24: "Of the doctors in training to be consultants in the NHS, 84% of them rejected this contract - that's five to one against it.

"If this grade was brought in and imposed, it would be those doctors that would be expected to fill it. They would not do so.

"I can foresee very clearly at the next junior doctors' committee meeting in six weeks' time, calls - if this is true - for industrial action."

Scotland meeting

The BMA had already warned that hospital doctors could refuse to take up consultant posts if ministers insist on introducing new working arrangements.

Consultants could also decide to leave the NHS and to sell their services to hospitals instead through independent 'chambers', it said.

Meanwhile, members of the BMA's consultants' committee in Scotland are meeting to decide whether the contract should be introduced north of the border.

The contract was narrowly backed by doctors in Scotland and Northern Ireland.

Consultants' representatives in Northern Ireland will decide their course of action next week.

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The BBC's Richard Lister
"At the heart of the battle is how long consultants spend with NHS patients rather than private ones"

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