Letter: NHS merit awards

Sir: Comments on reforming the system of consultant distinction awards on the grounds that they are handed out secretly on the "old boy network" are wide of the mark.

As a trust chief executive, now retired, I played some small part on a C Awards committee. I was always impressed with the thorough and fair way in which applications were judged, it being open to all consultants to bid for the limited number of awards available.

It should be remembered that only about one third of consultants at any one time receive an award, the majority a C. Relatively few A and A+ awards exist and it is only these which double or nearly double salaries. Indeed, one of the "achievements" of the NHS as a monopsonist employer has been to depress medical salaries relative to other countries with more diverse healthcare systems. British taxpayers can rest easy in the knowledge that they get a good health service on the cheap.

How else should awards be decided other than in private? Many people's pay is decided confidentially, yet only in the case of consultants is this regarded as somehow reprehensible. Involving patients in the judging process has all the hallmarks of a popularity contest.

JOHN O'BRIEN

Morpeth, Northumberland