A proposal to dismiss doctors and nurses who refuse to accept changes to their pay and conditions as a way for trusts to save money has been condemned by the BMA.
According to the Sunday Times newspaper, a document has been drawn up by 19 NHS hospital chief executives in the south west of England that proposes various hard hitting measures to save money in order to maintain patient care while meeting the government’s mandatory efficiency savings.
One proposal is to terminate the contracts for thousands of doctors and nurses who refuse to accept changes to their salary and work conditions and possibly to re-hire them under new arrangements.
The new terms proposed include pay cuts of up to 5%; ending overtime pay for nights, weekends, and bank holidays; less holiday leave; longer shifts; and cutting sick pay rates.
The document leaked to the Sunday Times comes from what the newspaper calls a consortium set up by 19 NHS organisations outside of normal NHS structures, which hopes that by working together, all organisations will help find ways of saving the money they have to.
Overall, the NHS in England has to save £20billion by 2014-15.
The changes could affect 60,000 health professionals – half of whom are doctors – and apply to anyone earning over £21,000 a year. The document describes the option of dismissing and then rehiring staff on different conditions as a “last resort”.
The document is quoted as saying: “Acting in unison… in a way which has not been undertaken previously demonstrates both the seriousness of the situation and the collective resolve to achieve long-term change.”
A BMA spokesman said any such attempt was the wrong way for trusts to try to make efficiency savings.
“Doctors raised concerns at the BMA's recent annual meeting about the potential development of a sizeable 'pay cartel' of NHS employers in the south west of England - and the wider issue of more isolated attempts at applying local terms and conditions for NHS staff,” said the spokesman.
“This is not how successful and sustainable efficiencies are going to be achieved - effective recruitment, retention and movement of doctors across the UK is essential.
“We understand that in these tough economic times, savings do have to be made. The focus should be on NHS staff and managers working together to find more efficient ways of working and of shaping services, while improving or at least maintaining quality.”
Labour's shadow health secretary Andy Burnham told Sky News the Government had lost its grip on NHS finances and to propose making staff redundant was “sheer madness”.
“What we're seeing here is increasing signs of an NHS in distress. [It's] a chaotic approach really, to managing these cuts,” said Mr Burnham.
“This really is no way to go about things. It's in open defiance of the Deputy Prime Minister who has said there won't be regional pay in the national health service.
“We are seeing a crude, random approach to efficiency savings in the NHS. We have the sheer madness today of this talk of making staff redundant in the south west.”
A Department of Health spokesperson said: “NHS providers have long had the power to employ staff on such terms that they consider appropriate, including under the foundation trust laws passed under the previous government. This means employers are free to negotiate any changes to national agreements directly with staff locally or their representatives.
“We would expect NHS employers and trade unions to work together to ensure the national Agenda for Change pay scheme remains fit for purpose.”