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Staff and Associate Specialists Committee Annual Report 2007

Download the annual report as a PDF here or by using the link on the right.

Chairman’s message

Welcome to the fifth annual report of the Staff and Associate Specialists Committee.

It is five years since SASC evolved from being a subcommittee of the Central Consultants and Specialists Committee (CCSC) to becoming a full BMA branch of practice committee in its own right. Despite being in operation for five years, SASC still feels like a ‘young’ committee. This is partly relative, in comparison with other long-established BMA committees, and partly because our full development has been somewhat delayed by the fact that our agenda and focus has been necessarily dominated by negotiations for the new contract for SAS group doctors. But as this process draws to an end, SASC has begun to turn its attention to wider professional issues.

As the Chairman of SASC’s Strategy, Policy and Procedures (SPP) Subcommittee, Greg Dilliway, explains on page 3, SASC has been hard at work trying to raise the profile of SAS doctors and to extend the sphere of influence of the committee and the doctors we represent in many areas. Of note has been our active engagement in the wider aspects of NHS reform. We have submitted evidence to a BMA Council Working Group on NHS Reform and have participated in a locally directed BMA campaign about the introduction of the second wave of independent sector treatment centres (ISTCs) and clinical assessment, treatment and support centres (CATSs) in the North of England. The aim has been to ensure that SAS doctors’ views are put forth and that our concerns, as clinicians, about the effect on patient care is made prominent. We are also working within the BMA to eradicate the negative effects of reform on our careers and to increase the positive opportunities that reform may offer us. We wish to provide SAS doctors with clear information and advice about adapting to, managing and benefiting from the changes to NHS structures and ways of working (please see page 9 for details).

The Postgraduate Medical Education and Training Board (PMETB) has now been officially active for almost two years. Despite the continued lack of SAS group representation on PMETB, SASC has established a good position of influence and a constructive relationship with PMETB officials. We have developed and established several BMA support mechanisms. For example, we have produced detailed guidance for doctors and BMA Regional Services support staff, as well as establishing the successful series of PMETB seminars. The seminars have helped PMETB to understand the problems with its systems.

SAS doctors continue to experience considerable problems with PMETB’s administration, despite the disproportionate increase in fees. We continue to receive complaints about the slowness of processing Article 14 applications for a Certificate Confirming Eligibility for Specialist Registration (CESR) and we will continue to press PMETB to improve its services during the coming year.

The optimism generated by the recommendations for introducing improved training opportunities for SAS doctors contained in the Modernising Medical Careers publication 'Choice and opportunity' has, sadly, abated. The disappointing reality seems to be that the only opportunities SAS doctors will have to continue postgraduate training will be locally negotiated top-up training secondments or formal re-entry to training posts in open competition with junior doctors (please see page 8 for details).

I had hoped that by now a new and better contract would have been implemented and that SAS doctors would at last have had some official recognition and fair remuneration for our skills, experience and the crucial care and support we provide to patients and the NHS.

The negotiations with National Health Service Employers (NHSe), which began in May 2005, have not been easy for a variety of reasons; not least because they have taken place within the climate of the NHS financial deficit where the success of previous BMA negotiations has resulted in the government using the media to blame the crisis on consultant and GP salaries. In their evidence to the 2007/08 Doctors’ and Dentists’ Review Body (DDRB), the Department of Health implies that each 0.5% rise in salaries could be translated into redundancy for as many as 1,200 qualified nurses, or 440 doctors or the cancellation of 18,700 elective procedures. This threat of redundancy, the shortfall in training posts and the general over-supply of doctors in the NHS make employment security for doctors a thing of the past. All in all, not a good environment within which to negotiate improvements to career progression and pay.

The official end of negotiations was 17 July 2006 at which time ministers declared NHSe’s remit to be over, regardless of whether SASC deemed negotiations to be complete or not. Despite this declaration, we continued discussions with the NHSe with the aim of trying to make the contract package as good as we possibly could wherever we possibly could. Despite our best efforts on behalf of all SAS group doctors, the final contract does not go as far as our aspirations at the beginning of negotiations, particularly when it comes to improving the career aspirations of SAS doctors.

The new chairman of negotiators, Ashok Pathak, gives a full update with further details on the contract and negotiating process on page 11.

This year’s DDRB recommendation offered a flat cash rise for SAS doctors of £1,000 for 2007/08. The rise has been implemented in full in Scotland. However, the departments of health of the other three nations did not accept the recommendation in full, choosing to stagger increases for those for whom this represents a more than 1.5% increase. This year’s pay rise therefore comes in at below the rate of inflation for all (please see page 13 for details). SAS group doctors did not receive an adequate pay rise in 2006/07 because the DDRB believed we would have a new contract with consequent pay increases on 1 April 2006. So, while the blame for NHS deficits continues to be attributed to doctors’ earnings, our salaries have effectively been cut.

So the SASC agenda continues to be a rollercoaster ride of negatives and positives and despite the year’s disappointments, we plough on with our hard work. Only through continuing our work, widening our sphere of influence and remaining committed to ensuring our voice is heard and acknowledged will we be able to prove that SASC is a major player within the profession and a major stakeholder in the NHS. This is the foundation from which we aim to be able to make improvements to the working lives and professional careers of SAS doctors and to ensure that the essential role we undertake in supporting the NHS and caring for our patients is not overlooked.

Mohib Khan
Chairman
SASC UK