Doctors should get less for overtime, suggests Streeting

Wes Streeting and Labour have promised an extra 40,000 appointments and procedures every week - Andrew Fox

Wes Streeting has suggested that doctors should be paid less for overtime.

The Labour shadow health secretary wants consultants’ pay to be capped at time and a half for working extra shifts.

Labour has promised an extra 40,000 appointments and procedures every week should it win Thursday’s general election.

It hopes the additional two million appointments a year will bring down the 7.6 million-strong backlog that a Labour government would inherit.

The majority of the extra slots are expected to be at evenings and weekends, but paying doctors to work the extra hours at premium rates could mean that costs spiral.

The British Medical Association (BMA), the doctors’ union, recommends that consultants charge up to £161 per hour for extra day work and £269 per hour for nights, including evenings, about three times their contracted rate.

But Mr Streeting would only give hospital trusts the funding to pay staff 1.5 times their usual rate. The final rates will continue to be agreed locally between hospitals and consultants, who could refuse to take on the work, but the proposed figures would undercut what doctors have typically been paid for extra work.

Labour has committed to deliver an extra £1.1 billion to fund the drive to cut the NHS backlog, but Mr Streeting warned that hospitals unable to deliver its targets would not get a share of the extra money.

“If we win the election [we’ll try] to give trusts and integrated care boards the freedom and flexibility to work out how best to deliver those appointments at a local level, because it will look different in different places,” he told the Health Service Journal.

“What we’re not prepared to do is throw good money after bad. People will get the money in order to deliver the appointments. If they say they can’t deliver those appointments, then they won’t have the money.”

The BMA has also questioned whether consultants will be incentivised to carry out the extra work, including because of fears the pension lifetime allowance may be reinstated, which was capped at just over £1 million.

Prof Philip Banfield, the BMA council chairman, told the Telegraph: “Doctors, just like patients, want to see waiting lists brought down. The reality for Mr Streeting, if his party is elected, is that he must engage with doctors to make this plan work.

“By addressing not just pay but also burnout and other obstacles such as pensions taxation that prevent doctors taking on extra work, we should be able to make rapid progress. We will be keen to work with whatever government is elected on Thursday to negotiate the practicalities that would enable this to happen.”

Independent think tanks have said Labour’s aims were laudable, but that industrial action remained a significant barrier if there is to be progress on tackling the waiting list.

Sarah Woolnough, chief executive of The King’s Fund, said weekend and evening appointments were “a good idea” but “scaling this up will rely on having enough NHS staff to take on the extra shifts – not a given when so many report high levels of stress and burnout”.

She said it would “almost certainly require a swift resolution to ongoing industrial action”.

It comes with junior doctors on strike for the 11th time in 16 months, with consultants charging premium rates to cover their shifts.

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