Costly NHS contract 'not benefiting patients'
Think tank says NHS consultant contract is not value for money
Wednesday, 10, May 2006 12:00
The new contract for NHS consultants has cost £90 million more than originally planned but has failed to have any noticeable effect on patient care, a new report finds.
Independent think tank the King's Fund says the contract has failed to deliver its aims of making England's top hospital doctors work more effectively, or ensure they put the NHS before their private patients.
At a time of mounting NHS deficits and subsequent job cuts, the report says patients are not getting value for money for an increase in consultant salaries rise of 36 per cent since 2001, to £69,298 a year.
However, the British Medical Association (BMA), which represents doctors, disputed the findings, saying the study looked at only five NHS trusts, all in London, where there had been particular problems in implementing the contract in 2003.
It insisted consultants still do a lot of unpaid overtime, adding that to blame the financial crisis on the NHS on their increased salaries was an "easy option".
The Department of Health (DoH) also said that while it would take time to realise the "full benefits" of the new scheme, there had already been a "dramatic impact" on the way managers and consultants work together, which was key to efficient services.
According to the report, attempts to improve planning in consultants' workload have been "mainly an exercise in filling forms", while a lack of national guidance has stopped NHS managers getting the full benefits from the changes.
King's Fund chief executive Niall Dickson insisted he believed consultants should be paid well for the work they do, and said the new contract had brought transparency.
But he said: "The government promised that this contract would also bring benefits to patients and so far that does not appear to have materialised.
"This is a limited study and these are early days but it raises profound questions about the effectiveness of the deal and what now needs to be done to ensure that it delivers greater productivity.
"Now more than ever, as the NHS finds itself under severe financial strain, there is an imperative to show that patients are getting value for money from reforms taking place in the health service."
But Paul Miller, chairman of the BMA's consultants' committee, said the blame for the NHS funding crisis "lies with an incoherent and inconsistent health policy, riddled with errors and misjudgments", rather than inflated salaries.
"Where trusts implement the contract in partnership with their consultants they see clear benefits for the trust, consultants and most importantly patients," he said.
For her part, the DoH spokeswoman said NHS pay reform had been "a significant success story", helping to recruit, retain and motivate record numbers of staff, and said trusts were becoming "more proactive" in planning consultants' work better.
"To ensure that patients get as much access to consultants in the NHS as possible, the new contract requires that consultants should offer up any additional capacity to their NHS employer before undertaking any private work," she added.
"This is part of the annual job planning arrangements and ensures the NHS gets the maximum access to consultant's time."