I am responding on behalf of my right hon. Friend the Prime Minister to the report by the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) “Review of compensation levels, incentives and Clinical Excellence and Distinction Awards schemes for NHS Consultants”. The report has been laid before Parliament today (Cm 8518). The report was to all four UK Health Departments. I am grateful to the chair and members of the DDRB for their report.
The recommendations in the report are wide ranging. As well as making recommendations on a new approach to national and local awards, it suggests the contract needs to recognise different stages in a consultant career by introducing a break point in the pay scale and a new principal consultant grade, that would cover up to 10% of the consultant work force at any one time.
The report sets out the case for change and the Government accept the key principles underlying the report. In particular, we agree that clinical excellence awards should recognise current not past excellence and that there is a compelling case for changes in the consultant contract. Local NHS organisations need to have a consultant contract that meets their needs and is fit for purpose for the future.
I recognise that there may be some concerns within the medical profession over the report. The Government are therefore committed to work with the profession on these recommendations with a view to reaching agreement with doctors’ representatives on how they should be implemented.
I am particularly mindful of the position of doctors who hold current pensionable and consolidated awards and on the impact of the DDRB’s proposals for national awards on the most senior doctors including clinical academics. It will be important to ensure that their reward packages remain competitive so that we continue to recruit and retain the most able consultants in the UK and provide appropriate incentives to encourage clinical excellence and innovation; not only in patient care but also in medical research and teaching.
The Government do not necessarily accept that consultants should be prohibited from holding awards simultaneously in the old and new schemes. This will depend on the final scheme design and should be considered as part of transition planning to ensure that all consultants retain appropriate incentives for continued excellence while avoiding paying twice for the same activities.
I am also prepared to consider the issue of pensionability of future awards as there is nothing inherent in a career average pension scheme that prohibits this. I therefore believe that longer-term national awards can remain pensionable. I would also be prepared to consider affordable proposals on pensionability of future local awards.
In advance of these discussions, we intend shortly to launch a specific consultation about discontinuing two anomalies in the current schemes.
We wish to work with the profession and employers to ensure that pay arrangements for doctors are affordable and sustainable in the long term. We will therefore also be seeking to agree changes to doctors’ contracts to better support seven-day working in the NHS. A move to seven-day working must be approached alongside better availability of community services and primary care. An NHS fit for the future needs to be delivering the same quality of service at the weekend as it does during the week and pay arrangements need to reflect this.
We are also today publishing a report commissioned from the NHS employers organisation by the four UK Health Departments on the junior doctors’ contract. The incentives in the current contract operate in a way that militates against the best quality training and restrict the service contribution made by doctors in training. We therefore wish to agree changes to ensure pay arrangements for juniors are also fit for purpose.
I am ambitious to see early progress on implementing these changes. I would wish to see a heads of agreement reached by the spring of 2013 on changes across both contracts with the intention of implementation beginning from April 2014. With the agreement of the devolved Administrations, this will be taken forward on a UK-wide basis, while respecting any differences arising from devolved responsibilities.
Copies of both reports are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office. The report on the junior doctors’ contract has been placed in the Library.