Oct 11, 1975 - Junior hospital staff contract. Mr J G W FEGGETTER ... is the wish of the majority of the junior staff ... Dr R B WOODD-WALKER (Essex County.
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remunerated by existing contracts or other arrangements) may be paid specifically for the actual operative procedure only.4 (For those unfamiliar with the documents concerned, in brief this latter reference states that the surgeon's fee relates to the operative procedure only and must be paid to the actual operator, subject to certain exceptions concerning trainees under direct supervision.) We therefore have situations where for a lesser amount of work a registrar or senior house officer in gynaecology or surgery will be paid more than twice the fee of a consultant anaesthetist. We regard these arrangements as unfairly discriminatory against the service specialty and degrading to the status of the consultant anaesthetist relative to a registrar or SHO in other specialties, and ask that the negotiators reconsider these matters to amend the inequity and to ensure that the relative fees more accurately represent the amounts of work which the remuneration relates to and the grade of the practitioner. It is suggested that other anaesthetists who do not favour these arrangements advise the Central Committee for Hospital Medical Services and their professional organisations of their disfavour. Our concern in this letter is solely with the relativity of the fees to the amounts of work and is not connected with concern5-7 over the sizes of the fees or the merits of the arrangements. C E BAPTISTE, D L LEAMING, ELIZABETH EVERITT, I M J MAIR,. E N S FRY, M MEHTA, P M MEHTA, J NEASHAM, G W KUVELKER, P T F NEWNAM, H L LEAMING, HAROLD G SAUNDERS, S J KALKETT.
Department of Anaesthesia, North and South Tees Health Districts of Health and Social Security, CMO 21/72. ing MD 14/75. Para 11 of HSC(IS) accompanying MD 14/75. Para 9 of HSC(IS) accompanying MD 14/75. Budd, D W G, British Medical Yournal, 1975, 3, 654. Powell, D E B, British Medical 7ournal, 1975, 3, 437. Douglas, C P, British Medical Yournal, 1975, 3, 437.
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2 Appendix to un-numbered HSC(IS) accompany-
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War service and pensions SIR,-One part of your report on the proposed arrangements to count war service towards pensions (20 September, p 720) makes bad reading. By making June 1950 the latest qualifying date for this benefit the Department of Health has been cynically brilliant. The date means that the vast majority of ex-service men and women who started their studies on their release from wartime service will be unable to benefit. What makes it even more brilliant is the fact that their contemporaries who started their medical studies straight from school and then entered the Services will be able to benefit under this regulation provided they entered the Health Service by June 1950. I do not think that those of us who volunteered for the Services straight from school have grudged our school contemporaries their five or six years' seniority in the profession and recognise that so far as careers are concemed they were wise to start their training straight from school, but this is a quite unexpected twist to the affair because there had at least been the prospect of redressing the financial balance pardy.
BRITISH MEDICAL JOURNAL
11 OCTOBER 1975
It is bad enough to have to pay heavily Jobs for women doctors for added years of pension to cover the SIR,-The experiences of Dr Eva Lester (20 deficit without this. A C CATTANACH September, p 700) are, sadly, far from unusual, except perhaps for her eventual sucNew Milton, Hants cess. Nevertheless, there is no systematic information on the availability of women London Weighting for GPs doctors for part-time work. Provision for training is nominal-for example, hospitals SIR,-I note with pleasure that doctors in are not allowed to advertise training opporthe hospital service are to be paid London tunities under HM 69(6). weighting as from 1 April 1975. This, I As a to a systematic survey I presume, will bring them into line with our would bepreliminary grateful if you would permit me, colleagues in local authorities, Govemment through your columns, to seek information service, and the armed Forces. Why then from women doctors who have had difficulty not general practitioners? in obtaining posts in hospital, general During the past 20 years or so as a London practice, or suitable any other branch of medicine. general practitioner I have attended many I would be pleased if any interested reader meetings and discussions at which this would contact me, by letter, to arrange an matter has been raised and invariably has interview in London or completion of a attracted 100%° support. Surely this matter brief questionnaire. should be raised immediately with the Secretary of State, who I am sure must be RITA HENRYK-GuTT unaware of this anomalous state of affairs. Shenley Hospital, Shenley, K A E SPENCE St Albans, Herts London NW1
Points from Letters Junior hospital staff contract Mr J G W FEGGETTER (Royal Victoria Infirmary, Newcastle upon Tyne) writes: In response to your leading article (27 September, p 726) I must point out that although the BMA has reacted calmly to the Review Body's recommendations the response in this region has been one of bewilderment.... The new contract differentiates correctly between working and being on call and offers supplements A and B respectively. It then goes on to say that each will include an average amount of call out. The decision as to how many units of each a contract includes will depend on negotiation between the individual, his consultant, and the administration. It is obvious which way the administration will lean and it is inevitable that there will be wide variations in salaries for different posts. I have been in favour of the new contract since its inception, but the final result as awarded by the Review Body contains so many problems that I believe the present system to be the better and that this is the wish of the majority of the junior staff in this region.
Dr R A SMITH (Royal Berkshire Hospital, Reading) writes: You state in your leading article (27 September, p 726) that "one of the main objectives of introducing extra duty allowances and of their refinement into this new contract was to reduce the over-long hours by making the NHS pay heavily for them." In fact the NHS will now pay extremely cheaply for over-long hours. It will be far cheaper for them to have one doctor working 120 hours than to have three working 40 each. The incentive will be for employers not to fill vacancies or create new posts.... If we accept this pricing of the contract at 30 % we shall all be back to working one in two in a few years' time. ...
Colour disturbance as a symptom Dr P STONE (Leicester General Hospital, Leicester) writes: I was surprised to read of Dr G R Davies's surprise concerning the absence of Ishihara colour testing during school medicals (20 September, p 708).... I can recall having at least three school medicals, all in different health areas, and I have never been tested for colour defects.... Perhaps the time has come for an inquiry to be made into the standard and content of school medical examinations.
Incidence of pertussis Dr R B WOODD-WALKER (Essex County Hospital, Colchester) writes: With reference to the statement by the Joint Committee on Vaccination and Immunisation on whoopingcough vaccine (20 September, p 687), to what extent do the number of notifications of a disease parallel its actual incidence? None of the cases of clinical pertussis which I have recently seen as outpatients here were reported by their practitioner. Although not opposing the committee's recommendation, one might mistrust arguments based on such returns. A free service?
Dr A R BAILEY (London NI) writes: Dr N B Sprague's enjoyable Personal View (27 September, p 762) contains one extraordinary misapprehension. In comparing the cost of removing a fish hook from a patient's thumb in Britain, Canada, and the USA, he says "it would have been done for nothing in England." While the attitude of both suppliers and consumers is that our Health Service, which absorbs around 5 %. of the gross national product (about Elm a day), is free it will not be possible to allocate the dwindling resources in a satisfactory way....
