Examination of Witnesses (Questions
200-209)
MR TERENCE
LEWIS, MR
ANDREW MORRIS,
MR NEIL
PERMAIN AND
MRS CHRIS
WILKINSON
21 JUNE 2007
Q200 Chairman: In relation to the
pay thing that you have just raised, when we were in Iraq last
we met a doctor who said if he left the following day he would
be paid double what he was being paid in Iraq, with all the difficulties
and danger there, if he went into the NHS. Is that about right?
We put that figure to the Minister of State and he thought he
recognised that.
Dr McKeating: There are certain
instances where you could do that. If you were a newly accredited
GP, for instance, depending on what practice you went into, you
could go out and earn a lot more. To be quite honest, military
doctors are quite a marketable commodity: they are well trained,
they are going to turn up on time, do the job, do what they have
to do. They are a very marketable commodity. You could envisage
a situation where somebody could go outside, more so in secondary
care perhaps with the inclusion of private practice.
Q201 Linda Gilroy: I think since
that remark you have been successful in getting a reasonable settlement.
It does not address everything but since a year ago there has
been some improvement, even though it does not meet the whole
gap.
Dr McKeating: Yes, certainly we
managed to narrow the gap last year but, unfortunately, this year
we got the standard public sector two per cent which effectively
starts to chisel back the progress we made the previous year.
Those figures I quoted initially are the differentials that we
believe we are still looking at after the admittedly good pay
rise that the Defence Medical Services achieved last year.
Q202 Mr Jenkins: They may have received
a good pay rise but nothing like the GPs in the NHS got, did they,
so how is a young GP going to explain to his family that he is
prepared to go away and serve with the military and earn 40,000
or 50,000, but as a GP in the NHS he could bring home £120,000
a year? If you have done all the figures, can you tell us what
the bill is to make sure that these people are compatible with
the NHS because I would love to know so that we can pursue the
MoD to see if we can bring them in line?
Dr McKeating: I am sorry, I do
not quite understand. Do you mean the overall costing of such
a pay rise?
Q203 Mr Jenkins: The bill that would
bring them into line.
Dr McKeating: No, we do not produce
such figures for the Government. We leave it up to the Government
to do that.
Q204 Mr Havard: I find what you say
very interesting. I was a trade union official for a number of
years so I understand exactly what you are doing, you put all
the factors in and you are bidding up the price, which is fair
enough, that is part of your activity, and it is part of the difficulty
as well as part of the solution. In the limited time I have got
available, in the evidence that you have given there are two elements,
this question about terms and conditions issues, as it were, and
whether or not people are discriminated against in their careers,
either by the fact that their training fades or they cannot do
the specialism they want to do and that side of it, discrimination
in the sense of over-use of them in a particular way, but also
direct discrimination, particularly in relation to Reservists.
You seemed to suggest, and some of the trusts were suggesting
earlier on, that because of more commercial arrangements within
the NHS, if you like, it was said directly, "I would not
employ them because they are a drag", that sort of pressure.
That was not directly what they said, I do not want to misrepresent
their argument. Are people directly discriminated against and
where is the evidence for that, or is the discrimination much
more related to this complex complexion of different elements
relating to training, pay, usage and so on? It is important. Is
there a difference as well between the full-time personnel who
you say are wanting to leave and the Reservists who increasingly
are having to be retained and recruited to fill in the difference
because of the gap?
Dr McKeating: In terms of Reservists,
the figure we had to April 2006 was 770 and they got 380 doctors,
so they are 50 per cent undermanned in the Reserved Medical Services.
If you look at the people leaving the Armed Forces it is very
interesting that the study that we did showed that only one in
ten who were leaving the Regulars would consider joining the Reserve
Forces. They will have some Reserve commitment on leaving the
Regulars but in terms of joining the Reserve Forces and volunteering
for Reserve Service, in other words joining the Royal Naval Reserve
or the TA or the Royal Auxiliary Air Force, only one in ten said
they would do that.
Q205 Mr Havard: But, as I understand
your study, that was much more related to their family issues
than it was any of these other issues about pay or training.
Dr McKeating: Coming on to the
Reservists themselves, we are getting some evidence, and certainly
I know of one senior Reservist Medical Officer who feels he was
very much disadvantaged by the Reserve Forces in terms of every
day that he took away to do his Reserve commitment he lost time
out for his pension and towards seniority and towards clinical
excellence awards while he was doing that. When we were coming
up to TELIC 1, the invasion of Iraq, he was spending a lot of
time being involved and feels he was very much penalised by his
trust for that.
Q206 Chairman: Does that system remain
the case?
Dr McKeating: It depends on the
trust. Certainly from my own experience with my own Naval Reserve
unit, we have one trust locally that is very supportive of Reservists
and they effectively get two weeks' paid leave a year to go and
do their training to keep themselves in-date for their Reserve
commitment, but we know other trusts are much less supportive.
It was very interesting to hear the gentleman from Plymouth's
comments. These trusts are becoming much more commercially savvy
and orientated and having a Reserve commitment in the future could
become something that might go against you when competing for
a job.
Q207 Mr Havard: So is the solution
to bid up the price for the individual or is it to give a countervailing
amount of money to the employer in order to avoid that problem?
Dr McKeating: If you are going
to have Reserve Forces you need to look after the employer as
well, especially if you are going to use them. You have to make
it so that first of all the individual does not lose out by volunteering
to serve their country and do these things. Certainly Reservists
do not do it for the money but what they do not want to do is
to lose out and when people approach them and say, "I have
looked at the Naval Reserve" and then find out they may have
to use their holiday to meet their training commitment or lose
out financially or may find they are being disadvantaged in some
way, we have to look after the employer as well and make sure
the employer is on board. Trusts are like different employers:
some employers are very supportive and other employers are not,
unfortunately.
Q208 Linda Gilroy: We have heard
some evidence from Service families that there can be difficulties
with registering on coming back from overseas. From the point
of view of your members, have you come across that at all?
Dr McKeating: Do you mean registering
with an NHS GP?
Q209 Linda Gilroy: Yes.
Dr McKeating: That is something
outwith our terms of reference, so I have no information on that.
I have done it myself and not had a problem, but that is anecdotal.
Chairman: Dr McKeating, thank you very
much indeed. Your session, as well as everybody else's session,
has been fascinating and very helpful indeed. Thank you very much.
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