BMJ  2004;329:1343 (4 December), doi:10.1136/bmj.329.7478.1343

Letter

Reforming the consultant contract again?

Applied in partnership, the contract works for both consultants and patients

The first 150 words of the full text of this article appear below.

EDITOR—Maynard and Bloor show no benefit of financial incentives, rather their limitations, divisions, and distortions, with regard to the consultant contract.¹ Most recent changes in health have not been driven by such incentives.

Overall, 85% of consultants have signed up to the new contract. Surveys show that a third are already seeing improvements. Monitoring will indicate where adjustments are needed, but there is no planned revision.

The contract gives transparency and ability to manage performance. Trusts that have negotiated job plans, including objectives and supporting resources, in partnership with consultants reflecting the number of programmed activities required will see this to the benefit of patients and consultants. To omit proper job planning misses a fundamental feature of the contract

There is little evidence of support for fee for service payments. Consultants realise the limitations, as shown by the refusal to bow to pressure from the last health secretary.

. . . [Full text of this article]

Royal Berkshire Hospital, Reading RG1 5AN jonathan.fielden@rbbh-tr.nhs.uk

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