Right of Reply: Dr Peter Hawker

The joint deputy chairman of the BMA's Consultants' Committee answers criticisms of consultants' pay
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The Independent Culture
THE MERIT award system for medical consultants has always caused controversy, even amongst consultants themselves.

The scheme, which was introduced by the Labour government in 1948, was and is intended to reward work of high merit and "to provide for a significant minority of consultants the opportunity to provide income comparable with the highest which could be earned in other professions". In short, to encourage those who might otherwise have left the National Health Service to achieve higher earnings, to stay in the service.

Today the average hard-working consultant can earn between pounds 44,700 and pounds 54,800 per year, a fraction of the earnings of senior members of many other professions.

A significant minority of consultants, who perform exceptionally high quality of work locally, or whose work is of major national or international significance, are beacons of excellence and enhance the reputation of the profession in British medicine. This excellence should be rewarded by a fair system of distinction payments. The Independent itself, (11 August) suggests that there should be larger incentives for those who are truly outstanding.

The BMA agrees that such a scheme must be fair and open, and that any imbalances or inequalities must be corrected. There must be further mechanisms for withdrawing awards when performance has fallen below acceptable standards.

However, the case for an open and fair merit award system remains as strong today as it was 50 years ago, and we will support the Government in its plans to reaffirm and reform the system to bring this about.

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