Bonus system for doctors is sexist and too expensive says Nationalist GP

Published on Thursday 28 May 2009 22:03

A BONUS payment system for senior doctors is out of control and should be scrapped, an MSP and former doctor said yesterday.

Nationalist MSP Ian McKee criticised the system of distinction awards for senior doctors and consultants for being sexist and too expensive.

Too often, he claimed, the awards are given to consultants for time serving rather than "going above and beyond the call of duty".

Dr McKee, a former GP, called on First Minister Alex Salmond to support major reform of the system that costs Scotland about 30 million a year. He was prom-ised that a review of the payments will be published shortly, at which point ministers will make a decision on their future.

But Dr McKee insisted that the only reason to keep the payments is because a similar system exists in England and Wales and scrapping them could affect recruitment.

There are currently three levels of distinction award – A+ giving a doctor an extra 74,768; A adding 55,098, and B 31,486.

Once an award is made it is permanently added to salary and boosts post-retirement pension payments. Even when an award is taken away the increase remains in the salary although consultants then have to forgo pay rises until their salary reaches the level it would be without the award.

"The system is out of control," said Dr McKee. "I think it should be abolished and the Scottish Government should open negotiations with the UK government to have them abolished both sides of the Border."

The awards are decided by a quango – the Scottish Advisory Council on Distinction Awards – and are meant to reward outstanding doctors. The committee is made up of health professionals and academics and in-cludes Chief Medical Officer Harry Burns as an ex-officio member.

Dr McKee's call has been backed by the Royal College of Nurses as bonus awards are only available for doctors. But the British Medical Association (BMA) has defended the awards. Dr Lewis Morrison, Deputy Chairman of the BMA's Scottish Consultants Committee, said: "The BMA does recognise that the Distinction Award System needs to be reviewed and we have provided the government with our views on how the system should be reformed to make the system fair and transparent.

"We should be encouraging innovation in NHS Scotland as the ultimate benefit is the improvement of patient care."

Dr McKee is also concerned that doctors in "Cinderella specialisms" such as old age and adolescent psychiatry, are unlikely to receive the awards. Just 1.5 per cent of consultants in the fields get one. But more fashionable specialisms such as respiratory medicine have a much better chance with more than a third of senior staff receiving an award.

Some 50 per cent of all consultants retiring hold one and this figure goes up to 78.6 per cent of all consultants retiring over the age of 65. However, just 13.5 per cent of consultants overall hold a distinction award. He also noted that while 18.6 per cent of consultants are women, only 14.7 per cent of awards go to them.