Plans for a new package of rewards for NHS consultants, designed to reform the way the service delivers patient care, have been announced by the Health Secretary, Alan Milburn.The proposals follow the rejection by consultants of a new contract of employment negotiated between the Government and the British Medical Association. The measures have been greeted with caution by the BMA but welcomed by the NHS Confederation which represents health service managers. In a letter to some 40,000 consultants and Specialist Registrars Mr. Milburn says the Government intends to introduce the package from April this year following a short period of discussion with representative organisations.

“This package is designed to recognise and reward those consultants who do most for NHS patients. Local NHS employers will be able to choose how best to use the resources I am committing to reward consultants, reform working practices and improve patient services,” Mr. Milburn writes.

“In keeping with our programme of devolution to frontline services there will be maximum local flexibility but it will always be a something for something deal. As a result more NHS patients will be able to benefit from more of the valuable time and expertise of NHS consultants,” he goes on.

In response Dr Paul Miller, the newly elected chairman of the BMAconsultants’ committee, said, “I am encouraged that the door is open fortalks and that the Health Secretary has recognised that we share a common agenda in wanting to improve and modernise services and in rewarding those who work hardest and most intensively for the NHS. However, the Health Secretary’s plans for local incentives do seem to be very strongly tied to Government targets and consultants are very wary of having clinical care dictated by political priorities. I will be arguing strongly that preserving the national character of the NHS is best achieved by national agreement on a national contract.”

Alastair Henderson, policy manager for the NHS Confederation, who was on the negotiating team, said, “We believe that the NHS will think this is a positive package of measures which should help trusts improve services locally for the benefit of patients and also improve the rewards to consultants for the work they do. ”

Meanwhile UNISON highlighted the proposal for the longest-serving consultants to be offered the chance of sabbaticals and called for this to be extended to all health workers. Karen Jennings, the union’s head of health, said: “Unfortunately it is not just senior consultants who feel the strain working in the NHS – this applies to nurses, paramedics, porters, cleaners and the rest of the health care team.”