Nigel Hawkes, Health Editor
Win a fitness package worth more than £3,000
A pay deal that gave hospital consultants a salary increase of 25 per cent left them working shorter hours and treating fewer patients, the National Audit Office has found.
It says that the consultants deserved more money, but it was regrettable that the public and the NHS had not seen benefits in greater productivity and better services.
The contract, agreed in 2003, cost £715 million in the first three years — £150 million more than the Department of Health estimated. In that time the average consultant’s pay rose to £110,000 a year while the average number of hours worked fell from 51.6 a week to 50.2.
Although there was an 11.3 per cent increase in the number of consultants working in the NHS in the two years after the agreement, the amount of consultant-led activity increased by only 4 per cent.
“The bottom line is that the Department of Health has increased consultants’ salaries without demonstrating any extra productivity in return,” said Edward Leigh, MP, chairman of the Commons Public Accounts Committee, to which the audit office reports.
“This is one more example of weak financial management by the Department of Health. It drove through the new pay deal with scant regard for proper evidence and solid financial forecasting.”
Sir John Bourn, the Comp-troller and Auditor-General and head of the National Audit Office, said: “Consultants deserve to be paid properly for the work that they do. However, the new contract was introduced to benefit not only consultants but patients and the health service in general.
“Although a new contract was needed, it is regrettable that the costs are higher than expected and that we are not yet seeing any clear evidence of improvements in productivity or services for patients.”
In negotiating the contract, the department used out-of-date information on the hours that consultants actually worked. In spite of evidence that the average was between 50 and 52 hours a week, the department worked on the assumption that it was 47 hours.
It then agreed a contract with the British Medical Association that was based on an average of 43 hours a week. In fact, consultants continued to work much longer hours than these, and under the new contract were paid for them. As a result, the contract cost £150 million more than the department expected.
Lord Hunt, the Health Minister, said: “The new arrangements reward and incentivise consultants who make the biggest contribution to service delivery and improving health services. This has helped us to recruit and retain highly skilled consultants, historically a challenge for the NHS. We now have low vacancy rates — fewer than 2 per cent — and more than 10,000 more consultants working in the NHS than when the Government came to power.”
Andrew Lansley, the Shadow Health Secretary, said: “This confirms that the Government simply didn’t understand what consultants were doing before they made assumptions about the new contract.”


Life's been a blast for the baby boomers but how does it really feel now that they are 60? Two writers square off
Industry sectors news at a glance. Interactive heatmap, video and podcast
The inside track on current trends in the charity, not for profit and social enterprise sectors
Read our exclusive 100 Years of Fleming and Bond interactive timeline, packed with original Times articles and reviews
Everything the Business Traveller needs to know to make a better trip
Shortcuts to help you find sections and articles
05/2005
£13,500
08/2008
£109,950
2006
£10,750
Great car insurance deals online
£Excellent+ executive benefits
Torres and Partners
London
£49,229 - £62,035 pro rata
Charity Commission
London/Liverpool/Taunton
Alstom Power
Europe
Six Figure
Rolls Royce
Midlands/Europe
From £89,950
Great Investment, River Views
Special Offers now available
New Year in the USA!
.
Cruise the Islands of Hawaii - Pride of America
List your property with two leading travel websites
Great travel insurance deals online
Contact our advertising team for advertising and sponsorship in Times Online, The Times and The Sunday Times, or place your advertisement.
Times Online Services: Dating | Jobs | Property Search | Used Cars | Holidays | Births, Marriages, Deaths
News International associated websites: Globrix | Property Finder | Milkround
Copyright 2008 Times Newspapers Ltd.
This service is provided on Times Newspapers' standard Terms and Conditions. Please read our Privacy Policy.To inquire about a licence to reproduce material from Times Online, The Times or The Sunday Times, click here.This website is published by a member of the News International Group. News International Limited, 1 Virginia St, London E98 1XY, is the holding company for the News International group and is registered in England No 81701. VAT number GB 243 8054 69.
Under European law, we can only work 48 hours a week - even if we in fact work more.
We used to be paid for 37 1/2 hours a week, now we get paid for more or less what we work (on paper).
Every working hour is "micro-managed". So operations, ward rounds, clinics, etc, are all packaged and boxed into nice pre-determined timetables, which includes reams of extra paperwork, also timetabled. Can't see patients during a paperwork session, now can we? That's the way the goverment want us to work, so they can feel in control.
So I'm afraid if you don't chose to be ill during one of our clinical sessions, it's outside our job plan.
Except - we're doctors. So we do what we have to, not what managers plan for us to do.
Good thing too, really, or the system would have collapsed by now. It's still running (just) because we do what is needed, not what the goverment thinks is needed.
Nick, Sheffield, UK
Alan Bond's comments are ill informed. Consultants in the NHS have always had, and continue to have, an obligation to provide round the clock emergency cover for patients. I can tell him from personal experience that consultants are increasingly involved in this type of work. The consultant contract does not include planned surgery or clinincs at weekends or in the later evening or night.
SC, Birmingham, UK
Why do the Government and people like Mr Bond (Lancaster) have so much of a problem with professionals being paid for the work that they do? For years huge amounts of work went unrecognised and unrewarded. Family time was neglected and many burnt out doctors have died within a few years of retirement - what a surprise after working twice the standard working week all their lives!! The current shambles of Government interference in patient care has left medical and nursing staff at breaking point. Current pay levels are only a small recognition of years of unpaid work- the audit office report simply concludes that the Government didn't know or appreciate how much work was being done.
P.S- I've worked every day for the last three weeks (weekends included) that's 243 hours or 83 hours per week. I get paid for 56. As a taxpayer I think I'm getting good value.
DMK, Belfast, N.Ireland
Well goodness me!
What is the use of having doctors if they only work city hours?
Perhaps we are being stupid by falling ill in the evening, or weekend, or, mercy me, in the night.
It is time that the overpaid doctors accepted that their professional status relies on the service they provide.
Thank heaven we have the talents of the para-medics and the ambulance service to save our lives during the doctor's 'lets play golf' time.
Alan Bond, LANCASTER, england
A legacy from bungling Alan Milburn who left mainstream politics 'to spend more time with his family'.
GPs and consultants have been laughing all the way to the bank since the implementation of Milburn's 'Action for Change' . Don't worry, the taxpayers' pockets are bottomless, are nt they ?
Rick, London, England
I worked as a hospital consultant in the UK for years: putting in 60 - 80 hours a week on the (A&E) frontline, in appalling conditions. Like most of my generation, I was certain that managers, ministers and health economists neither comprehended nor appreciated my workload or my input. Consequently, I was happy to escape to another jurisdiction as the Blairite exercise to micro-manage consultants began to bite. This political DisRespect campaign, carefully orchestrated by Alan Milburn and John Reid (remember them?), led to routine distrust and disbelief of consultants, all-round. So it comes as no surprise that those behind the rushed, imposed new consultants contract got it so wrong. Not only did they get a reduced output from better paid, strait-jacketed consultants, they also guaranteed that despondent senior doctors would have little interest in future invitations to go the extra yard. Truly, the Blairite chickens are coming home to roost.
LCL, Cork, Ireland
Why do doctors and consultants seem to think that they are a special case? I would be inclined to give Nurses a bigger pay-rise as they do the real hard work like caring for the patients while doctors and consultants seem to find time to work in the private sector before working in the NHS.Working less hours for more money brings in the greed factor with these people.
Tom Slattery, Paisley, Scotland
Let us be clear about this.
As with the GP contract, the Dept of Health underestimated the quality of work already being done by consultants. We were subjected to pernicious whispering campaigns & claims of consultants spending time on the golf course instead of seeing patients.
Well, the govt insisted on verifying the hours worked & imposed strict controls on local arrangements. They have sacrificed any goodwill extant & will have to muddle out of this on their own. But the situation is going to get worse because the current reforms still pretend that staff are not working to capacity. They will come a cropper but by then the culprits will have moved on.
Saleem, London, UK
Just another example of the stupidity of Gordon Brown, the fool just throw huge amounts of cash at the HNS with out any control over what it was used for. Now we have the highest paid (lazy) consultants on the planet and can't aford nurses.
Brown is to be the next PM, god help us! Roll on the next general election when we can rid this country of the whole sorry lot of them
D Case, Newquay, UK
Who on earth thinks that politicians make managers? Until you have a system, as in France, where the state pays the bulk of the cost of any treatment but the treatment is delivered by competing private sector companies this will continue. Tory, Labour or Lib Dem it will always be thus.
eddie reader, birmingham, uk