Views And Reviews

Can performance related pay work in the health service?

BMJ 1994; 308 doi: (Published 25 June 1994) Cite this as: BMJ 1994;308:1722
  1. S Vallely

    Reviewing workload statistics for our department a couple of weeks ago I was not surprised to find that last year we performed almost twice the number of radiological examinations recommended by the Royal College of Radiologists. Since 1990 our outpatient workload has increased by 48%, our inpatient workload by 13%, and our accident and emergency work by 6%. Similar figures could be quoted by most other consultants in the health service. I asked a member of the NHS Executive what effect this workload would have on my remuneration if performance related pay for health care professionals was introduced. The reply came “That is a matter for local negotiation.” “What factors will determine performance related pay for doctors?” “A matter for local negotiation,” was the predictable retort.

    Consultation is taking place between the executive and the profession and implementation is reported to be as early as September 1994. What is clear from the answers to my questions is that central guidance on the implementation process is likely to be couched in the vaguest possible terms with ample scope for local interpretation.

    Do doctors have anything to fear from the introduction of performance related pay? If a fair, clearly constructed, centrally guided process …

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