The government has hit out at consultant "privileges" after rejecting a massive petition.
Nearly 200,000 people signed the on-line petition pressing for the resignation of health secretary Jeremy Hunt over his approach to doctors' contracts.
The petition, launched by Dr Ash Sadighi, called for Parliament to debate a vote of no confidence in the health secretary.
It stated: "Jeremy Hunt has alienated the entire workforce of the NHS by threatening to impose a harsh contract and conditions on first consultants and soon the rest of the NHS staff."
But an official response from the government accuses some consultants of charging employers "hugely expensive" payments of up to 200 an hour for working at nights and weekends.
The response says the consultant opt-out is a "major barrier" to introducing seven-day services.
It says that it hopes most consultants will be on new contracts by 2020, working across seven days, promising a "significantly higher" rate for working unsocial hours - and a 13 weekend a year limit on working.
The response says: "These new plans will mean that doctors working in some of the toughest areas in the NHS, such as A&E and obstetrics, will at last be properly rewarded and there will be faster pay progression for all consultants early on in their career.
"Under the new proposals, the highest performing consultants could be able to receive up to 30,000 a year in bonus payments, on top of their base salary."
It adds: "Of course, improving weekend care requires more than just ensuring greater consultant presence. That's why the government is also addressing issues such as access to weekend diagnostic services, provision of out of hospital care to facilitate weekend discharges, and adequate staffing cover amongst other clinical groups.
"But NHS leaders and the independent pay review bodies are clear that increasing the presence of senior clinical decision makers at weekends is vital, and that the consultant opt out remains a barrier to organising broader support services and staff rotas."
But the British Medical Association said the response failed to give answers to key questions about the project.
It said it had still failed to define which services needed extending to run over seven days.
Chair Dr Mark Porter said: “Doctors care for their patients every day and understand their needs, and have been explicit in their support for more seven-day hospital services. We have repeatedly called on the government to outline how they will fund and staff them, and yet neither we nor the public are any closer to finding out the detail of the government’s plans.
“It is positive that the government, in their response to the public petition, have listened to the BMA and recognised that improving weekend care requires more than just ensuring greater consultant presence. Just adding a doctor to a ward will make no real difference if the support is not there.
"But recognising this is not enough, we need the detail."
Nearly 200,000 people signed the on-line petition pressing for the resignation of health secretary Jeremy Hunt over his approach to doctors' contracts.
The petition, launched by Dr Ash Sadighi, called for Parliament to debate a vote of no confidence in the health secretary.
It stated: "Jeremy Hunt has alienated the entire workforce of the NHS by threatening to impose a harsh contract and conditions on first consultants and soon the rest of the NHS staff."
But an official response from the government accuses some consultants of charging employers "hugely expensive" payments of up to 200 an hour for working at nights and weekends.
The response says the consultant opt-out is a "major barrier" to introducing seven-day services.
It says that it hopes most consultants will be on new contracts by 2020, working across seven days, promising a "significantly higher" rate for working unsocial hours - and a 13 weekend a year limit on working.
The response says: "These new plans will mean that doctors working in some of the toughest areas in the NHS, such as A&E and obstetrics, will at last be properly rewarded and there will be faster pay progression for all consultants early on in their career.
"Under the new proposals, the highest performing consultants could be able to receive up to 30,000 a year in bonus payments, on top of their base salary."
It adds: "Of course, improving weekend care requires more than just ensuring greater consultant presence. That's why the government is also addressing issues such as access to weekend diagnostic services, provision of out of hospital care to facilitate weekend discharges, and adequate staffing cover amongst other clinical groups.
"But NHS leaders and the independent pay review bodies are clear that increasing the presence of senior clinical decision makers at weekends is vital, and that the consultant opt out remains a barrier to organising broader support services and staff rotas."
But the British Medical Association said the response failed to give answers to key questions about the project.
It said it had still failed to define which services needed extending to run over seven days.
Chair Dr Mark Porter said: “Doctors care for their patients every day and understand their needs, and have been explicit in their support for more seven-day hospital services. We have repeatedly called on the government to outline how they will fund and staff them, and yet neither we nor the public are any closer to finding out the detail of the government’s plans.
“It is positive that the government, in their response to the public petition, have listened to the BMA and recognised that improving weekend care requires more than just ensuring greater consultant presence. Just adding a doctor to a ward will make no real difference if the support is not there.
"But recognising this is not enough, we need the detail."
