Government is accused of using clinical excellence awards as “a political bargaining chip”

The BMA has accused the government of holding off publishing the evaluation by the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) of the clinical excellence and distinction award schemes for consultants in the United Kingdom because the association won’t “roll over and agree” with the government on its pension reforms.

The DDRB’s report is due to make recommendations on whether there should be an application round for new national clinical excellence awards in 2012, after the Department of Health recommended that no new awards should be allocated this year (BMJ Careers, 4 Jun 2011, http://careers.bmj.com/careers/advice/view-article.html?id=20003224). The government has yet to confirm whether local or national awards will in fact go ahead this year, delaying the awards rounds for 2012.

“I think it’s absolutely disgraceful that the government is using the understandable anger of doctors about the attacks on their pension scheme to effectively say to people, ‘It doesn’t matter how hard you work or how well you achieve your objectives for the health service, we’re not going to recognise that,’” said Mark Porter, chairman of the BMA’s Central Consultants and Specialists Committee. “The government sees consultants’ reward for achieving excellent things for patients as something appropriate to use as a political bargaining chip.”

The DDRB submitted its recommendations on reform of the award schemes to the government last July, but the government has yet to publish the report.

The BMA’s consultants committees for England, Wales, Scotland, and Ireland have all lodged requests under freedom of information legislation with their respective governments seeking to obtain a copy of the report but have had their requests rejected. The Welsh consultants committee is now appealing this decision and could take the issue to the information ombudsman to force the Welsh government to make the report available.

Earlier this year the BMA warned that local awards are being delayed by the government’s refusal to confirm whether awards would take place in 2012 (BMJ Careers, 18 Feb, http://careers.bmj.com/careers/advice/view-article.html?id=20006703).

NHS Employers has now advised that employers should prepare for a 2012 round of local clinical excellence awards, despite no word from the government as to whether employer based or national awards will go ahead.

However, employers should not launch the local application process until the status of employer based awards for 2012 has been clarified, the organisation says. Trusts that have already begun an awards process should not progress beyond the receipt of applications, it adds.

If national awards do go ahead this year, it is unlikely that the application and adjudication process will be completed in time for awards to be allocated within the 2012 calendar year. Should the allocation of awards be delayed, it is unclear whether the awards will be backdated to the point at which awards should have been given had the process run to timetable.

The uncertainty over the 2012 round is causing much disquiet among consultants and could affect doctors’ financial planning, said Paul Flynn, deputy chairman of the BMA’s consultants committee. Doctors nearing retirement could be particularly hard hit, because whether or not they get an award will affect their final salary on retirement and the level of pension benefits they receive.

“There’s a lot of uncertainty at a time when consultants are feeling particularly hard done by, through the reduction in the number of awards that will be available at national and local level and in terms of the changes to their pensions and the pay freeze that they’ve had longer than anyone else in the NHS,” said Dr Flynn. “I think it’s increasing consultants’ general anger and disenchantment with the government.”