Hospital doctors could refuse to take up consultant posts if ministers insist on introducing new working arrangements, the British Medical Association has warned.

Consultants could also decide to leave the NHS and to sell their services to hospitals instead through independent 'chambers'.

The warning came as the government continued to ignore the BMA's call to re-open talks on the new consultants' contract.

If Mr Milburn insists on going down this road we will set up our own chambers

Mr Paul Thorpe, BMA

It emerged on Saturday that Health Secretary Alan Milburn is to introduce a new grade of "junior" hospital consultant to take on the extra NHS work rejected by consultants in England in their ballot this week.

The move will reduce the amount of private practice work that NHS doctors can undertake in their early years after becoming a NHS specialist, the Financial Times reported.

Doctors voted by almost two to one against the deal in a UK-wide ballot organised by the BMA.

After the vote, Health Secretary Alan Milburn insisted the contract would not be renegotiated.

He also suggested the deal could be offered in some parts of the UK and by individual trusts irrespective of the vote.

Extra money

Prime Minister Tony Blair appeared to up the ante on Friday by suggesting that the �300m per year earmarked for consultants could now go to NHS managers.

In an interview with the magazine Health Service Journal, Mr Blair said: "We've got a very significant pot of money that could have gone to the consultants, but they've rejected the contract, so therefore we will have to look at how else we use that money."

Mr Blair said the funds set aside for the contract would be used to provide "very considerable leverage in the system one way or the other for managers to be able to manage more effectively."

But a senior member of the BMA told BBC News Online that doctors could go their own way if the government insisted on being "unreasonable".

Mr Milburn has refused to re-open talks

Mr Paul Thorpe, chairman of its junior doctors' committee, said many would refuse to take up consultant jobs if it meant signing up to the new contract.

"There are far more jobs than there are people to fill them even now. There is an easy solution to all of this. People will simply refuse to sign contracts."

The junior doctors who were eligible to vote in the BMA ballot were five to one against the contract.

Mr Derek Machin, acting chairman of the BMA's consultants' committee, warned the government against forcing new consultants to accept the contract.

"That would be unbelievably inflammatory," he told BBC News Online.

"They are the group that voted most resolutely against it and to ignore what that group said will really be asking for trouble."

Mr Thorpe suggested that many existing consultants were considering setting up in chambers, along the lines of barristers.

This would enable them to effectively sell their services to the NHS and to decide their own hours, rates of pay and other conditions.

"The British Medical Association and other organisations have already taken legal advice on setting up chambers," he said.

"If Mr Milburn insists on going down this road we will set up our own chambers."

Re-open talks

Mr Machin urged the government to re-open negotiations.

"It would be bizarre if the government has a desire to get a contract in which is similar to the one we negotiated," he said.

Meanwhile, members of the BMA's consultants' committee in Scotland are meeting to decide whether the contract should be introduced there.

The contract was narrowly backed by doctors in Scotland and Northern Ireland.

Consultants' representatives in Northern Ireland will decide their course of action next week.