BMJ  2006;332:1096 (6 May), doi:10.1136/bmj.332.7549.1096-c

Letter

Money for nothing, and your kicks for free

EDITOR—You know you've upset the profession when a local colleague stops you in the car park to say you've got it wrong. I merely suggested on a Scottish news programme that the general practitioners' pay rise was excessive and divisive.

We have seen record spending on health care—to catch up for years of the NHS underfunding.¹ We were the backward medical child of Europe, with our French, German, and Italian cousins enjoying much better health care. This of course was a complete false premise—merely doing more operations, having more specialists, and taking more medicines should not be confused with quality—but that's politics. More spending indeed runs the very real risk of overdiagnosis and unnecessary interventions. The NHS had for decades made the best of its lot—poverty giving it clarity and priority. We were well paid, with a generous pension, and we worked hard. Grumbling was a popular and enjoyable pastime.

Unfortunately, this government has squandered its cash. Wasted on "bling-bling" waiting list initiatives. A drug culture not only accepted but promoted. Negotiators impressed by the professional muscle and hard street talk shelled out big money for less work and no control over quality of care. A right rock and roll swindle. Now many trusts are in trouble, but wait until next year. Their financial wheels lashed by a 60% increase in quality point payments—the iceberg looms, the band is practising, but the lifeboats are missing.

Paying doctors more has no impact on patient care and may reduce the incentive for well paid professionals to do extra. We do need more doctors and nurses, but paying general practitioners £100 000 a year will attract only candidates motivated by status and financial gain. We need a return to some old fashioned ideals. Become a doctor because it's important, it's fulfilling, and it's a vocation. If lawyers, accountants, or even footballers get paid more, does it matter?

Sorry for the offence caused to the profession by such a radical suggestion—see you in the car park.

Glasgow G20 9DR destwo{at}yahoo.co.uk

---

Competing interests: DS is a public servant and a taxpayer.

References

1. Day M. Prime minister tells troubled trusts to "hold their nerve." BMJ 2006;332: 927. (22 April.)[Free Full Text]

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Relevant Article

Prime minister tells troubled trusts to "hold their nerve"

Michael Day
BMJ 2006 332: 927. [Extract] [Full Text] [PDF]

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