The NHS Contract Proposals

The profession and others are currently debating and preparing to vote on the proposed new NHS Consultant Contract. FIPO has not taken any stance on this believing this to be a matter for individual consultants. The new contract will be primarily a NHS issue and FIPO accepts and encourages a fully responsible approach by all NHS consultants to their NHS commitments.

However, there is no doubt that if the contract is accepted there will be gradual but definite impact on private practice. It is clear that some insurers and hospital providers are seeing this issue as a watershed in their relationships with the profession and are considering alternative working arrangements with consultants. It is possible that consultant employment by private hospitals become a reality. At the moment this applies, to a variable extent, only to the service specialities such as radiology and pathology and then only with regard to fee charging.

The concept of formal employment of consultants by private hospitals in a number of different specialities (including anaesthetics and surgery) would move the present “fee for service” situation to an HMO (Health Maintenance Organisation) service. This would result in diminished choice for patients and inappropriate restrictions and clinical controls on treatment as seen in the United States where this type of system has run its course and given rise to widespread dissatisfaction.

October 2002