The two tier syndrome behind waiting listsBMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7283.427 (Published 17 February 2001) Cite this as: BMJ 2001;322:427
Article contained numerous inaccuracies
- M Pringle, consultant (firstname.lastname@example.org)
- Queen Alexandra Hospital, Portsmouth PO6 3LY
- Department of Psychiatry, St George's Hospital, London SW17 0QT
- Parkplace Health Centre, Darlington DL1 5LW
- Oxford deanery general surgical higher surgical training scheme
- Royal Berkshire and Battle Hospitals NHS Trust, Royal Berkshire Hospital, Reading RG1 5AN
- 6 Bingham Avenue, Poole, Dorset BH14 8NE
- Hill House, Lerwick, Shetland Isles ZE1 0EL
- Pinderfields Hospital, Wakefield WF1 4DG
- St Michael's Hospital, Bristol BS2 8EG
- Center for Bioethics, University of Pennsylvania, 3401 Market Street, Philadelphia, PA 19104, USA
EDITOR—How can the BMJ publish an article that is full of statements about the NHS and doctors that it must recognise as untrue?1
Light suggests that surgeons and anaesthetists are short changing the NHS. However, independent studies show that most consultants work well over their contracted hours.
Light suggests that consultants control the waiting lists to increase private practice, but waiting lists are mainly a resource problem in a state funded system. To get rid of waiting lists the NHS needs more doctors and more infrastructure or an insurance based system.
Light points out that by working one day a week in the private sector surgeons can double their NHS income. This surely reflects the way that successive governments have failed to maintain the consultant salary and have continued to exploit the medical profession. Doctors would be well rewarded in any other walk of life. There are no perks in hospital medicine—no company cars, bonuses, share options, or private health insurance.
Is it right that senior consultant surgeons should get a maximum of £63 000 a year from the NHS (minus £6000 if they do private work) because they work for a state monopoly employer whereas the prime minister's wife, a lawyer, earns over £200 000 a year? Many consultants do private practice because they enjoy it, but many do it to maintain the reasonable standard of living that they feel they have earned and that their peers enjoy. Is it right that many doctors feel they have to do private work?
The BMA calculates that if the present NHS consultant salary was equivalent to that 20 years ago it would be 50% higher than it is now. How do you decide consultants' salary? By seeing what their market value is and looking at the pay of other comparable …
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