Review body considers pay for performance

BMJ 1994; 308 doi: (Published 12 February 1994) Cite this as: BMJ 1994;308:435
  1. L Beecham

    Doctors in the NHS will receive a pay rise of 3% from 1 April, but their review body, which advises the prime minister on pay, says that it supports performance related pay. In its 1994 report, which was published last week, the review body acknowledges that there will be a shift towards pay being determined locally. But it says that it is essential that “the concepts of performance related pay, local productivity bargaining and efficiency savings . . . be clarified before the departments get into serious discussions with the professions.” The secretary of state for health, Mrs Virginia Bottomley, said, “I afford the highest priority to the early introduction of arrangements which will link a significant proportion of pay increases from next year to the performance of staff achieving improvements in local services.” She said that the Department of Health was already developing guidelines for NHS trusts and other units on local pay bargaining.

    Speaking for the BMA, the chairman of its council, Dr Sandy Macara, said that he was sceptical about the proposal. “Patient care in the NHS has been well served by the current system of nationally determined rates of pay,” he said. Dr Macara is also worried about the government's decision to fund the awards from gains in productivity. He fears that this could affect patient care.

    In its evidence to the review body the BMA pointed to the drop in recruitment, the deteriorating position of doctors relative to other professional groups, falling morale, and increased workload to support its claim for an 8.5% increase.

    Although the review body acknowledges that general practitioners “have worked hard to make the new contract a success,” it says that this has been recognised in increased remuneration. The secretary of the General Medical Services Committee said that the committee will consider these comments “very carefully” at its next meeting. Some of the increases for NHS doctors are set out on p 478.

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