Views And Reviews

From the medical academic conference Performance related pay is strongly opposed

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6944.1642 (Published 18 June 1994) Cite this as: BMJ 1994;308:1642
  1. L Beecham

    Medical academic staff believe that the proposal to introduce performance related pay into the NHS and the academic sector would be demotivating, divisive, and destructive. At their annual conference on 6 June they called on the BMA to oppose it. The chairman of the Medical Academic Staff Committee, Dr Colin Smith, a senior lecturer in medicine in Southampton, said that he could see no reason for the continuation of the review body system if performance related pay was implemented and warned that the whole system of a national pay award for doctors could be destroyed. Although some speakers at the conference thought that the proposal was inevitable, the chairman of the BMA council, Dr Sandy Macara, pledged to stop it. “We know that the secretary of state does not want it,”he said. “This will be a crunch fight, and it is a war which we intend to win.”

    The conference took its decision after Mr Barrie Brown, one of the BMA's provincial secretaries, gave a presentation on performance related pay. The proponents of the system maintain that it motivates employees; helps to recruit and retain staff; links work output and financial rewards; may effect a cultural change in the organisation; and improves an organisation's performance. The options were individual performance related pay, rewarding group performance by team bonuses or gain shares, or rewarding organisation performance by profit sharing.

    There was little evidence, Mr Brown said, that any system worked. Few of the organisations that had introduced it had evaluated it. Any system had to be judged on its effectiveness, economy, and equity. There was no evidence that it improved effectiveness or controlled the pay bill. Other factors, such as job security, influence, and good relations, motivated people as much as or more than pay. So far as equity was concerned …

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