Doctors prepare united pay fight

Hospital consultants and GPs are planning to join forces on sanctions in their separate battles with the Government over proposed local pay arrangements and new payments for out-of-hours working.

If action by these two powerful groups of doctors goes ahead it would be unprecedented in the history of the NHS.

James Johnson, chairman of the British Medical Association consultants' committee, said yesterday: "I am now seeking a meeting with the GP committee to discuss linkage in any future action over the areas of concern facing GPs and consultants.''

The effect of action could be wide ranging, hitting the referral of patients to out-patient clinics and non-urgent surgery, and lengthening the waiting lists.

While the consultants' plans are advanced and details of sanctions are being worked out in detail, the GPs are still deciding on their course of action. However, the GPs' committee of the BMA has already indicated that its leaders should discuss with consultants how to co-ordinate sanctions.

Dr Ian Bogle, chairman of the GPs' committee of the BMA, said yesterday: "We are looking at a series of options open to us. We would be far happier not to fight the Government over out-of-hours working but it looks as if a fight might be on the cards."

On the question of a joint meeting with the BMA consultants to discuss complementary plans, he said: "We have not yet gone far down this route and we do not want to compound the situation. But the consultants are considering sanctions and we will have discussions on courses of action with our consultant colleagues if it becomes necessary." Mr Johnson, said the likely trigger was the report of the independent Doctors' and Dentists' Review Body on pay which is presently forming its recommendations to be put to the Government at the end of the month. It is expected to make recommendations on the introduction of pay determined locally at hospital trust level. It is less certain how far the Review Body will go on recommending changes to GPs out-of-hours pay.

Mr Johnson said: "If the Review Body was to recommend a one per cent rise nationally and one per cent to be determined locally that would trigger our sanctions. We would consider it as the imposition of local pay."

Hospital consultants have asked their sanctions committee to draw up plans which involve refusing to give any priority to the patients of GP fundholders and working only their contracted hours. It is estimated that consultants each put in 14 "good will" hours a week.

GPs have rejected Department of Health proposals on their out-of-hours working payments. The new payments amount to 2.8p per patient a week to provide 24-hour cover.