Failing NHS consultants punished with pay cut

Eight hospital consultants have had their NHS salaries cut by up to £35,000 because they were not performing well enough to deserve bonuses.

Eight hospital consultants have had their NHS salaries cut by up to £35,000 because they were not performing well enough to deserve bonuses.

The eight had received distinction awards, which are made for "outstanding professional performance" and can double a consultant's salary. But the awards were withdrawn after a routine five-yearly review by a government advisory committee.

One of the consultants, none of whom has been identified by the committee, had an A-plus distinction award worth £60,460 on top of a basic, top-of-the-scale salary of £63,640.

A-plus awards are reserved for the top 250 doctors in the country. Most have an international reputation. The doctor picked out by the committee has had his or her A-plus award downgraded to a B award, worth £25,455 – a pay cut of £35,000. The remaining seven consultants have had their B awards withdrawn and have suffered pay cuts of between £5,000 and £25,000. The details are given in the report of the advisory committee on distinction awards, dated October 2000 but published last week.

No reason was given by the committee for its decision. A health department spokesman said: "There is guidance on the criteria consultants have to meet in order to maintain an award and if they don't meet the criteria they don't keep the award. It is perfectly fair."

The criteria include evidence of professional excellence, research and innovation, outstanding contributions to management, teaching, and good patient care.

The five-yearly reviews were introduced in the mid-1990s to counter charges that consultants were being given distinction awards – which could not be removed – on the "Buggins' turn" principle. Only 12 consultants have had awards withdrawn among the 3,000 who hold one.

White male consultants are favoured for awards over women and those from ethnic minorities. The proportion of ethnic minority consultants grew last year to 14.7 per cent of the workforce, but their share of the awards slipped to 7.7 per cent from 10.8 per cent in 1999.

The Department of Health highlighted instead the total number of ethnic minority consultants with an award, which, it said, had risen from 4.9 per cent in 1997 to 6.5 per cent last year. The Health minister John Hutton said: "The upward trend in the number of ethnic minority consultants holding awards is positive, although there is still a lot of room for improvement." A spokeswoman for the British Medical Association said: "That is seriously misleading. The health department is clearly manipulating the figures."

Women comprised 22 per cent of consultants last year and gained 16.5 per cent of the awards given in 2000, up from 13.7 per cent in 1999.

A health department press release highlighted this increase, noting that the number of women in receipt of an award had "risen by 19.7 per cent" last year. It did not say that, overall, women held 11.6 per cent of awards, half their proportion in the consultant workforce.

The advisory committee said in its report that it had made "real efforts" to identify good candidates from among ethnic minority consultants.

It added: "If [there is to be] further increase in the number of awards to be made to women and those from ethnic minority backgrounds, the [committee] will need to receive a greater number of nominations in support of them. Such nominations must, like all others, fulfil the published criteria."

Ministers plan to replace the national distinction award scheme which, together with a local bonus system of discretionary points, costs more than £170m a year for consultants.

Last year's NHS plan said the two schemes were "not sufficiently related to the NHS work these consultants undertake". It proposed a scheme which would increase the proportion of consultants with an award from a half to two-thirds.