Views And Reviews

From the senior staffs conference Consultants will not tolerate performance related pay

BMJ 1994; 308 doi: (Published 18 June 1994) Cite this as: BMJ 1994;308:1643

“The introduction of performance related pay will put consultants in the thrall of managers and of their political masters,” Mr Stephen Brearley, a consultant surgeon in east London, told the annual conference of senior hospital staff last week. The meeting decided overwhelmingly that it would not tolerate such a “discredited and demotivating” practice, and the chairman of the Central Consultants and Specialists Committee, Mr John Chawner, will write to all senior hospital doctors spelling out the implications if the scheme were introduced. They will be asked to lobby their local members of parliament.

There were no speakers against the motion. Mr Chawner called the long term effects incalculable. Recruitment would be affected and there would be different salaries in different parts of the country, signalling the end of a national health service. In his opening speech the CCSC chairman said that the Department of Health had no idea how a scheme would work, but any proposals would be resisted. “They are bad from the point of view of motivation in an already profoundly demoralised workforce, bad from the point of view of a huge waste of public money, and bad above all because the proposals will make it even more difficult for us to treat our patients in a proper professional manner.” It was difficultto see how the review body system, which had served the profession and the health service well, could continue. Furthermore, the cost of devolving settlements to NHS trusts was enormous.

Mr Chawner did not believe that doctors would take industrial action if differential pay was introduced. But he believed that many would look carefully at the extra hours theyworked for nothing. On average senior hospital doctors work about 50 hours a week but are paid for between 35 and 38 1/2. This unpaid work amounted to …

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