Child heart surgeon faces cut in payoff

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A CONTROVERSIAL heart surgeon could have his pension drastically reduced amid government plans for a clampdown on the pay of medical consultants.

The Health minister, Alan Milburn, is taking legal advice in an attempt to lower the benefit enjoyed by James Wisheart,struck off after 29 children died at Bristol Royal Infirmary and four were left brain-damaged.

Mr Wisheart had been paid a bonus of pounds 54,910 on top of his pounds 57,800 NHS salary for his services to medicine which now counts towards his pension.

Mr Milburn will announce tomorrow a strict new system for awarding merit bonuses to consultants in a package that will greatly weaken the power of the medical establishment. The membership of the Advisory Committee on Distinction Awards, which has the power to award performance increases of up to 95 per cent to consultants, will be changed so that doctors lose their majority of seats on the body.

At the moment 25 of the 33 members of the committee are consultants, but Mr Milburn will propose that it be reduced to 14 members, only five of whom will be representatives of the medical profession. Eight of the new group will be from patient organisations and employers. The review by Mr Milburn will also propose more say for hospitals in the system of merit pay which costs the National Health Service pounds 104m a year.

Mr Milburn said that under the new system patients would have a considerable influence on how the extra pay was awarded. "The changes we are making will ensure the system is open, fair and subject to proper scrutiny. We will reward excellence, but we will ensure that the taxpayer does not end up rewarding failure." Consultants' basic salaries vary from pounds 44,780 to pounds 57,800, but their remuneration can be enhanced for "outstanding work of wider benefit to the National Health Service".

The latest figures show that about 12 per cent of the 25,619 consultants had received extra payments. Some 267 had received an increment of 95 per cent, which at the top band would yield earnings from the NHS of pounds 112,710. Around 920 received a bonus of 70 per cent and 2,042 got 40 per cent.

The Government's review of the system is understood to have been heavily influenced by the tragedies at Bristol Royal Infirmary.

The Health minister is determined to introduce a system in which the committee will be able to review the performance of consultants and withdraw merit pay for poor performance, improper conduct and other serious offences. Government officials yesterday were at pains to point out that the distinction awards should not be regarded as a right by the medical profession.

A spokesman for the British Medical Association said that the organisation did not oppose the principle of making the award of merit increases "open and transparent". The spokesmen said, however, that the BMA wanted to scrutinise the detail of Mr Milburn's report before arriving at a final conclusion.