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A way of aligning pay to performance and outcomes
| The first 150 words of the full text of this article appear below. |
The American economist Robert Solow argued that labour
markets "cannot be understood without taking account of the fact that participants, on both sides, have well developed notions of what is
fair and what is not."1 This may explain why many NHS
trusts in Britain have been reluctant to implement local pay mechanisms and performance related pay. As a result the creation of the NHS internal market has not led to a more efficient market for clinical labour. Indeed, opportunities have been missed
the recent review of
the distinction award system, for example, paid little attention to
incentives for efficiency.2 Nevertheless, the present
government is retaining the purchaser-provider split and is likely to
continue to seek efficiencies. With care and a common sense approach,
economics can contribute to the analysis and improvement of the
clinical labour market.
Some approaches to the analysis of labour markets reflect Solow's
common sense approach. Efficiency