President's view: Health budgets the central issue

Each of the key issues facing health services has budgetary constraints at their heart, says HCSA President Professor Ross Welch

As the dust has settled on the election, pressure has grown on two important fronts – both for a review of the overall spending package available for health services and social care, and also for an end to the years of so-called “pay restraint” which has seen NHS staff across the board handed real-terms wage cuts.

This is not before time. There is deep concern at the impact of decisions over pay on retention and recruitment of hospital doctors, as well as the support teams around us.

The latest findings of the annual British Social Attitudes survey suggest that the wider public share these concerns, with 83 per cent of respondents calling for “more” or “much more” to be spent on the NHS even if that requires greater taxation.

In England, meanwhile, the dominant policy buzzwords remain sustainability and transformation.

There are increasing voices warning that these plans are driven by the demand for cost-cutting rather than local service need.

Royal College of Physicians president Professor Jane Dacre was among those describing huge variance in the application of plans regionally and warning that many had sizeable funding gaps with, “to put it mildly, aspirational plans” to bridge them based on service reductions.

STP groups have leapt into existence and are beavering away trying to decide where the next NHS reorganisation is going. Mostly these meetings are avoiding speaking to those of us who actually work day to day in the service, as that would only cloud their decision-making, but I predict confidently that it will result in job losses, service reductions and more bureaucracy.

For our part, HCSA will continue to press the case for proper resourcing and recognition for clinical teams in our hospitals.

Most members will have seen the Hospital Manifesto that we produced following the announcement of a snap election.

As we enhance our policy function we shall seek to advance and influence on the many issues affecting hospital doctors and their patients, and seek your individual views where possible.

Whether it is in the negotiating room or wider public discourse, I am determined that the HCSA’s role as an advocate for hospital doctors shall grow ever greater.


Here's to a new era of partnership

When HCSA secured national bargaining rights in England for all grades of hospital doctors back in January, we had hoped that this would mark the establishment of a united front in negotiations to ensure that the greatest possible number of hospital doctors were properly represented in talks.

In the first few days of the new year I wrote to then BMA President Mark Porter and Keith Brent, chair of the Central Consultants Committee, extending filial greetings, offering to meet and wishing that the New Year would be a good one for all medics.

The email, although read, was not acknowledged. Sadly, this set the scene for the months that followed.

We have since taken part in the ongoing consultant contract negotiations, where a sizeable portion remains undecided.

However, these have so far taken the form of parallel meetings between ourselves and the BMA.

The entrance to BMA House in London features a wall-sized graphic bearing the slogan “doctors working together.”

We remain hopeful that these words will be put into practice when it comes to joint negotiations in future.

Rest assured that HCSA intends to press hard on behalf of consultants and will be fully consulting members on the detailed outcome of contract negotiations.


New focus on trainees' interests

Foundation trainees became the latest grade eligible for HCSA membership following a rule change passed by our AGM at the end of April.

Although there are currently no direct contractual negotiations relating to the trainees, there is still discussion ongoing, mostly through Health Education England.

We have also been closely watching the progress of Dr Chris Day’s case and its implications on whistleblowing protection for hospital doctors (more on page 4).

As the HCSA evolves we are keen to bring more doctors in training into our decision-making structures. Every one of the 13 UK constituencies that make up the association has a reserved seat for doctors in training and non-career grade practitioners.

I would encourage those of you who wish to play a more active role in building the HCSA of the future to express an interest via your National Officer or by contacting our head office.