Public poll on doctors' pay scales backfires: BMA and minister claim victory

AN OPINION poll to test public support for continuing national pay scales for doctors backfired yesterday with the British Medical Association, which commissioned it, and the Department of Health both claiming victory.

The poll found that half supported the present system. Hospital doctors are strongly opposed to government plans to introduce some element of locally determined, performance-related pay in April next year.

Announcing the results, John Chawner, chairman of the BMA consultants' committee, said a 'considerable proportion' favoured the present system while Baroness Cumberlege, parliamentary under-secretary of state at the department, gave the opposite interpretation, saying 'a significant proportion' favoured local pay systems.

Salaried hospital and public health service doctors have their pay determined annually by recommendations made through the independent Doctors' and Dentists' Pay Review Body.

Consultants and junior hospital doctors are resisting the government plan, saying it is against the interests of patients and good medical practice. They fear local managers will introduce crude schemes measuring work by the numbers of patients seen.

'The department has not suggested a single idea as to how it might work in three months. They imagine managers will come up with some ideas,' Mr Chawner said.

Half of 2,000 people questioned by Mori wanted nationally-set pay scales to continue. Adults were asked to choose between one of five ways of paying doctors; 53 per cent chose a clear statement that the present system should continue; 19 per cent chose local pay settlements.

Lady Cumberlege said: 'I am sure that most people, if the issues were put to them in a balanced and fair way, would agree that there is sense in relating some element of what clinicians are paid to the quality of care they provide for patients.'

However, Virginia Bottomley, Secretary of State for Health, and Lady Cumber lege are intimating that local pay could be linked to the performance of hospital trusts rather than to individuals. Mr Chawner dismissed this. He said consultants were not considering industrial action but warned that any imposition of local performance-related pay scheme would destroy doctors' goodwill.

'Senior hospital doctors do 30 per cent more work than they are actually paid for. If a manager starts asking a doctor to prove he has done three-and-a-half hours' work in the clinic, and in fact he has done five hours, he is going to start saying he wants to be paid for those five hours. In such circumstances doctors would be bound to look at what they had been doing for nothing,' he said.

The BMA has calculated that this would add pounds 200m to National Health Service costs. In addition, a survey of junior hospital doctors has shown that each works on average four hours a week for which they are not paid. 'The Government risks losing this goodwill which in my view would be regrettable,' Mr Chawner said.

In June a proposal at a consultants' conference to resign from the NHS and contract back in was lost by a narrow majority of two votes.

The BMA says that the costs of developing local bureaucracies to handle pay bargaining and time lost to medicine through doctors having to negotiate would also be very large.

David Blunkett, Labour's health spokesman, called for a period of stability in the NHS. 'We need a period of common sense in the NHS rather than disruption and conflict,' he said.