MSPs criticise rise in NHS consultant bonuses

News comes at time when A&E departments are stretched. Picture: Greg Macvean
News comes at time when A&E departments are stretched. Picture: Greg Macvean
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THE NHS is paying out almost £40 million a year in bonus payments to leading medical staff at a time of intense pressure on services, The Scotsman can reveal.

Consultants are taking home payments of up to £75,000 a year through the system of “distinction awards” and “discretionary points”, on top of annual salaries of up to £102,000.

Nicola Sturgeon said she would get payments under control but they have increased

Jim Hume

The payouts went up by almost £700,000 in total across Scotland last year, figures obtained under Freedom of Information laws have shown.

When she was health minister in 2010, First Minister Nicola Sturgeon pledged to bring bonuses for top medical staff under control and is now facing calls to explain the rise. Although “distinction awards” have come down, in line with Ms Sturgeon’s pledge, other “discretionary” payments by health boards have soared by more than £3.5 million.

The increase follows another stretched winter period for Scotland’s NHS which saw many patients left waiting for hours in extremely busy Accident & Emergency departments, while waiting times targets were regularly missed.

Consultants can expect to earn a basic salary of £76,000 to £102,000, depending on their level of seniority. Many already supplement this by doing operations in the private sector.

Liberal Democrat health spokesman Jim Hume said: “It is right that we reward exceptional performance and that is what we get from doctors in our NHS on a daily basis. But as with any other area of public spending, SNP ministers need to be transparent about pay awards. Nicola Sturgeon said she would get payments under control but they have increased. She needs to explain why.”

Conservative health spokesman Jackson Carlaw said: “This is yet another example of Nicola Sturgeon pledging one thing and delivering quite another. Patients will question whether or not this is the best use of significant NHS funds.

“Consultants of course are highly skilled and valuable, but they are also well remunerated.”

The biggest payouts were in Greater Glasgow and Clyde where £12.2m was paid out in 2013-14, up by £500,000 on the previous year, while £6.6m was paid out in Lothian.

Consultants across Scotland benefited from five-figure payouts. In Grampian, 53 consultants enjoyed distinction payments last year ranging from £31,959 to £75,899, the figures reveal. In addition, 228 consultants in the North-east received discretionary payments ranging from £3,204 to £25,632.

In Lanarkshire, nine staff received distinction payments ranging from £63,194 to £21,066, while 193 got discretionary payments of up to £25,632.

The Scottish Government last night insisted the payouts were not bonuses.

A spokesman said: “NHS consultants can receive discretionary points – local awards – for their contributions to professional excellence.

“The Distinction Awards Scheme is frozen in Scotland and no new awards have been allocated since 2010-11. The value of the awards is also frozen.”

A spokeswoman for the British Medical Association (BMA) said the payments were needed to attract the “brightest and best” and are an important part of consultants’ remuneration.

She said: “Distinction awards and discretionary points are given to consultants over and above what they would do for their contracted work.

“For distinction awards, that’s producing or conducting research which has a real benefit for patients. They promote excellence, they promote doctors going that extra step beyond their job to provide patient care and make patient care better.

“They’re an important part of the NHS remuneration package.”

She added: “Our medical academics are telling us that since the government froze distinction awards in Scotland three years ago, it has had an effect on doctors looking to come to Scotland who would be conducting world-leading research.

“It is part of doctors’ remuneration packages and they are for extra work over and above what they would be doing routinely.”

She said discretionary points are under control of local health boards, where they feel doctors “deserve that additional reward for the work that they are doing”, such as driving change or improving patient care.

Pressure on the NHS intensifies as budgets are squeezed and demand soars. Hospitals aim to see 95 per cent of all patients within four hours in A&E departments, but this target was widely missed this winter.

The ageing Victoria Infirmary in Glasgow was among the hospitals under fire after it emerged in December that some patients spent the night in a cold room after wards filled up and waits in A&E stretched beyond 12 hours.

Greater Glasgow and Clyde said in order to warrant a discretionary point payment, consultants must demonstrate an “above average contribution” in teaching, research or the management and development of the service. A spokesman said: “To attain the maximum of the discretionary point scale, consultants will be expected to have demonstrated an outstanding contribution to services.”

The payments are not automatic and do not reflect seniority, but do take into account contributions to “professional and multi-disciplinary team working”.

Distinction awards are awarded by a special advisory committee and have been frozen since Ms Sturgeon unveiled plans for a crackdown in 2010. But the subsequent fall in these payments has been outstripped by a significant increase of £3.5m in the discretionary payouts in the past two years, according to the figures obtained from Scotland’s 14 area health boards.

Jim Crombie, Chief Officer of NHS Lothian Acute Services said: “NHS Lothian wants to attract the very best clinical professionals to care for patients and many of the UK’s leading doctors work here. Doctors’ terms and conditions are set nationally. This includes the discretionary points system which recognises the contribution made by senior doctors to improving services for patients.

“We award the minimum number of discretionary points each year, as required in the national guidance issued by the Scottish Government.”


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