Aneurin Bevan famously said that in order to create the NHS he had been forced to "stuff doctors' mouths with gold". Sixty years on and new figures released by the National Audit Office have revealed that, in order to reform it, his political successors have had to do the same thing.
Over the last nine years the pay of hospital consultants has risen by 68 per cent – the largest rise of any NHS staff member including managers. Even after allowing for inflation the average consultant is £28,000 better off than they were in 2000, with an annual salary of £120,900.
In comparison nurses have seen their salaries rise by 36 per cent over the nine years since 2000 – a £1,700 real-terms increase. Even hospital managers have not done as well, with an average salary last year of £47,900 – less than half that of consultants.
The consultants' pay bonanza came in the main as a result of a new contract they signed with the Government in 2004. The contract was meant to improve NHS practices while making consultants work longer and more productively. But, after a series of concessions, the contract was watered down. The consultants kept their money, but a report by the heath think tank the King's Fund found little evidence of improvements in services offered to patients.
The figures show that, in 2000, the mean earnings of a consultant were £71,900. But by 2009 this figure had risen to £120,900 – an average yearly increase of 5.9 per cent. In contrast, across the whole of the pubic sector salaries rose over the same period by 4.5 per cent. For the private sector the rise was 3.7 per cent.
Staffing accounts for around half the total NHS budget and about 70 per cent of hospital costs. The Office for National Statistics recently estimated that productivity across the NHS as a whole fell by 3.3 per cent between 1995 and 2008, an annual average decline of 0.3 per cent. This was partly due the huge influx of new money in the early 2000s.
Dr Paul Flynn, deputy chair of the BMA's consultant committee, denied that consultants had benefited disproportionately. He said he did not recognise the Government's figures and claimed that much of the financial benefits of the consultant's contact had been offset by recent pay freezes.
"Many consultants are actually worse off now than they were before the contract," he said. "We had a pay freeze imposed a year before the rest of the NHS and before that we had a number of below-inflation rises. We simply do not recognise the figures from the department."
Mr Flynn added that productivity was difficult to measure. "I work in keyhole surgery and we now do hysterectomy operations which allow patients to leave hospital the next day. The operations take longer – but they are better for the patient and save on hospital bed space.
"However the raw productivity statistics just show the surgeons doing fewer operations. You have to be careful how you judge these things."
The report from the NAO warned hospitals were not doing enough to curb consultants' "lifetime" bonuses, which can see them earning thousands of pounds a year on top of their salary. These sums are paid out every year even if they no longer carry out the work for which the money was initially paid. They are included in the figures for consultant earnings but not in their published salary bands.Reuse content