Consultants negotiated a new deal

Trust managers were instructed to bring in the contract for NHS consultants by February.

However, the BMA says managers are unwilling to agree job plans because are they are reluctant to pay for all the hours senior doctors are working.

The new contract cannot by implemented until job plans are agreed.

Trusts are not willing to invest the money that will ensure hard-pressed patient services are kept going. Dr Paul Miller Q&A: Consultant contract

However, the BMA's claims have been dismissed by the NHS employers' organisation, the NHS Confederation, which claims solid progress is being made.

Dr Paul Miller, chairman of the BMA's consultants committee, said doctors across the country were increasingly angry and disillusioned at the delays.

He said: "Consultants stand ready to modernise and reform working practices for the benefit of the NHS patients.

"However, yet again we are prevented from doing so by the failings of the Department of Health and NHS trusts.

"The new contract was designed to finally pay consultants for all the work they do yet trusts are not willing to invest the money that will ensure hard-pressed patient services are kept going.

"They prefer to spend the taxpayer's billions on the ever growing armies of tick-box checkers and target monitors, many of whom interfere with the patient services that doctors and their teams are trying to provide."

Dr Miller said the government had pledged to fund fully the contract during negations last year.

Everybody wants to do this properly, rather than just quickly. Alastair Henderson

Consultants had only voted to accept the new deal on that basis, he said.

"If trusts fail to honour their side of the bargain they may lose the good will of consultants. We urge them to fulfil the commitment they made to us."

However, Alastair Henderson, acting director of the NHS Confederation, told BBC News Online that the BMA view was a "severe misrepresentation" of what was actually happening.

He said: "A lot of solid work is going on. The end of January was never an absolute deadline.

"Everybody wants to do this properly, rather than just quickly if we are going to deliver the right sort of benefits for consultants, NHS organisations and patients."

Long negotiation

The new contract was agreed last July after years of intense negotiation.

The original deal struck by BMA leaders was rejected by a grassroots ballot.

While many consultants stood to receive substantial pay rises under the deal, they were concerned about management interference, and being ordered to work extra hours without extra pay.

A revised package was finally accepted after the BMA secured a number of key concessions, including an assurance that clinical autonomy was not under threat.

In addition, it was agreed that the new contract would include a clause saying that consultants would only work evenings and weekends "by agreement".

Paul Burstow, Liberal Democrat health spokesman, said: "This contract process is still mired in delays and confusion.

"This means there is now a real risk that the NHS could face spiralling costs and a loss of doctor's time and goodwill.

"The government could end up with the worst of all worlds - higher costs and less consultant time with patients."