NHS consultants launch proposals for new contract
BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7263.726/b (Published 23 September 2000) Cite this as: BMJ 2000;321:726
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This report repeats the statement that "consultants currently work an
average of more than 50 hours a week for the NHS, with one in three
routinely working more than 60 hours". It gives no source for this
information.
Can anyone tell me on what research this figure was based and how it
was calculated?
I have heard allegations that the figure includes double counting,
where a consultant is scheduled to run two clinics at the same time, one
of which is actually run by junior doctors on his or her behalf. This
sounds improbable, if only because if true it would be outrageous.
I have also heard, more credibly, an explanation that the figure is
not intended to be an estimate of clinical hours but includes management
time, attendance at professional conferences and other study etc.
If this is, indeed, the average number of hours actually worked by
consultants, it must have been reduced by the fact that many consultants
work part time for the NHS; how many hours does the average _full time_
consultant work for the NHS?
The government is right to address this issue, which has nothing to
do with consultants free time. The amount of work done by consultants on
the NHS has a direct effect on - indeed, is the main determinant of - the
demand for their private services. There is a clear conflict of
interests: if consultants increased the supply of their services offered
free at the point of delivery, they would reduce the demand, and hence the
price, for the same services offered for an open-market fee. They would
be altruistically reducing their own income. The vehemence of the BMA's
response may be connected with this fact.
Timothy James
Competing interests: No competing interests
Re: Clarification of figures necessary
Dear Sir
Consultants in our trust, as in others, recently completed a 4 week survey
of actual hours worked. This included administration time (essential for
the running of any clinical service) but did not include time on call,
study leave or attendance at conferences. For example a day spent at a
national conference, leaving at 6am and returning at 10pm would be counted
as 0 hours worked.
Full time NHS consultants in neonatology, paediatric surgery and
cardiology all worked at least 60 hours per week. The majority of my
colleaques in other specialties appear to work similar hours.
Mr James may feel that increasing consultants workload further has
nothing to do with our free time, we beg to differ.
Yours sincerely
Pamela Cairns
Consultant Neonatologist
St Michaels Hospital, Bristol
Competing interests: No competing interests