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Is doctors' self interest undermining the National Health Service?

BMJ 2007; 334 doi: http://dx.doi.org/10.1136/bmj.39098.405602.BE (Published 01 February 2007) Cite this as: BMJ 2007;334:235
  1. Laurence Buckman, general practitioner
  1. 1Temple Fortune Health Centre, London NW11 7TE
  1. l.buckman{at}ntlworld.com

    Recent newspaper headlines have suggested that doctors' pay is responsible for the financial crisis in the NHS. Alan Maynard argues that financial and other self interest is endangering the service, but Laurence Buckman believes the remuneration is justified

    The NHS is its staff. Europe's largest employer spends the bulk of its money on those who deliver health care to UK patients. The small amount that is doctors' pay could not undermine the NHS, when the total number of workers is so large.

    Without adequate pay there is no morale. Demanding and receiving proper pay and conditions is everyone's right, even in the public sector. This is not self interest. Self interested doctors would go and work elsewhere. Reward, including non-cash benefits, in the NHS is less than that in the private sector for equivalently weighted jobs, and NHS professional pay was less than that of almost all other Western health services for many years until 2004.

    Doctors' pay has been maintained irregularly since the Doctors' and Dentists Pay Review Body was created to advise governments 46 years ago. Periods …

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