Doctors pay rises slammed by MPs

22 Nov 07
MPs have criticised the new NHS consultants' contract, which has allowed doctors' earnings to soar while their productivity has fallen.

23 November 2007

MPs have criticised the new NHS consultants' contract, which has allowed doctors' earnings to soar while their productivity has fallen.

In a report published on November 22, the Commons Public Accounts Committee found that consultants' pay rose by 27% over the first three years of the deal – far higher than the Department of Health's 15% prediction.

The contract was introduced in October 2003 and was the first major overhaul of consultants' terms since the NHS was formed in 1948. Ministers wanted it to give NHS trusts greater control of senior doctors' workloads.

The contract was aimed at halting consultants' drift towards private practice, increasing their productivity and extending patient services with more time spent on direct clinical care.

The PAC said: 'The department underestimated the cost of the new contract by at least £150m… NHS trusts failed to set a cost envelope and clinical managers agreed hours of work based on historical patterns of working, which they could not afford.'

Consultants' productivity – expected to increase by 1.5% a year – had actually dropped by an estimated 0.5% in the first year, and consultants were 'now working fewer hours than they did under the old contract', the MPs found.

The proportion of time they spend on direct clinical care 'has not reached the expected 75% level, and NHS trusts have not used the contract to extend patient services, such as providing out-patient clinics at the weekend', the report says.

PAC chair Edward Leigh said: 'Anyone who is puzzled how large quantities of money can be poured into the NHS to so little effect should examine the example of the new contract for consultants.'

But Dr Jonathan Fielden, chair of the British Medical Association's consultants' committee, said the 2003 contract recognised 'how hard consultants are working'.

'The productivity definition used by the PAC is based on an outdated model of consultant working and uses output measures which have no relation at all to quality of patients' outcomes,' he said.

Alastair Henderson, deputy director of NHS Employers, said he recognised concerns over the contract's implementation, but added: 'The committee's stark conclusions don't acknowledge the radical cultural change inherent in the contract and therefore the time required to deliver its full benefits.'

PFnov2007

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