Doctors' leaders warn of patient-care cuts: A health minister says extra costs in NHS salaries must be met by 'efficiency gains'. Celia Hall reports

Doctors' leaders warned yesterday of cuts in patient services because of the Government's insistence that rising National Health Service costs and elements of salary increases must be met by 'efficiency improvements'.

The British Medical Association also believes that the Department of Health is speeding up its intention of devolving the next round of pay arrangements to local hospital trusts.

The BMA has obtained a letter sent last week by Gerald Malone, the Minister for Health, to all Tory MPs providing 'factual information' which he says they may find helpful if approached by doctors, nurses and other NHS employees, over pay.

The letter reminds MPs that the BMA is campaigning against local pay determination and that nurses are also campaigning for their own pay claims for next April.

In the current year, 1994-95, he says that NHS purchasers are required to produce efficiency savings of 2.5 per cent to meet increases in hospital activity. Pay increases for doctors and nurses which came in six months ago were largely funded by additional money awarded to the NHS. But Mr Malone says that 'any excess' - those costs not met by improvements - must 'be met by additional efficiency gains', adding: 'The past performance of the NHS suggests that this is well within its grasp.'

The letter has fuelled BMA determination to fight the plans for local pay arrangements. James Johnson, chairman of the BMA consultants' committee, said yesterday: 'The whole thing is a complete nonsense. There seems to be an assumption that unlike everywhere else, the NHS is not affected by inflation. Costs rise in the NHS just the same.

'Every year we do more work for less funding. All that happens is that the system becomes more and more broke and hospitals go more and more into debt.

Savings have been made but we are now pared to the bone. To suggest that more activity is all due to efficiency is a pretence. The managers have to massage the system more and more. What happens is that we do lots and lots of cheaper operations and fewer big expensive ones. This looks good on the books, more patients have been treated and everyone goes away happy. This can only go on for so long. Patient care is suffering from so-called efficiency savings.'

Doctors' and nurses' pay has traditionally been arranged through review bodies that make national recommendations to the department which has normally acceded to them.

Mr Malone's letter says this year the department's evidence to the review bodies urged them not to recommend an across-the-board increase 'but instead to give a strong steer to the continued development and implementation of local pay arrangements by leaving employers with maximum scope for local action'.

A BMA spokesman said it believed this indicated that local pay arrangements would be brought in swiftly rather than using a gradual process with the larger percentage of pay awards continuing to be administered centrally. 'We think there has been a real shift in their plans,' he said.

The health department has told health service finance managers, in advance of next month's Budget, that for 1995- 96 there will be no cuts to their resources in real terms.

Suggested Topics
Start your day with The Independent, sign up for daily news emails
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksAn introduction to the ground rules of British democracy
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
SPONSORED FEATURES
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: Administrative Assistant / Order Fulfilment

£14000 per annum: Recruitment Genius: An exciting opportunity to join a thrivi...

SThree: Trainee Recruitment Consultant

£18000 - £23000 per annum + Uncapped OTE: SThree: Trainee Recruitment Consulta...

SThree: Trainee Recruitment Consultant

£18000 - £23000 per annum + Uncapped OTE: SThree: Trainee Recruitment Consulta...

Recruitment Genius: Production Operative

£13000 - £17000 per annum: Recruitment Genius: Due to a period of sustained an...

Day In a Page

Refugee crisis: David Cameron lowered the flag for the dead king of Saudi Arabia - will he do the same honour for little Aylan Kurdi?

Cameron lowered the flag for the dead king of Saudi Arabia...

But will he do the same honour for little Aylan Kurdi, asks Robert Fisk
Our leaders lack courage in this refugee crisis. We are shamed by our European neighbours

Our leaders lack courage in this refugee crisis. We are shamed by our European neighbours

Humanity must be at the heart of politics, says Jeremy Corbyn
Joe Biden's 'tease tour': Could the US Vice-President be testing the water for a presidential run?

Joe Biden's 'tease tour'

Could the US Vice-President be testing the water for a presidential run?
Britain's 24-hour culture: With the 'leisured society' a distant dream we're working longer and less regular hours than ever

Britain's 24-hour culture

With the 'leisured society' a distant dream we're working longer and less regular hours than ever
8 best children's clocks

Tick-tock: 8 best children's clocks

Whether you’re teaching them to tell the time or putting the finishing touches to a nursery, there’s a ticker for that
Isis profits from destruction of antiquities by selling relics to dealers - and then blowing up the buildings they come from to conceal the evidence of looting

How Isis profits from destruction of antiquities

Robert Fisk on the terrorist group's manipulation of the market to increase the price of artefacts
Labour leadership: Andy Burnham urges Jeremy Corbyn voters to think again in last-minute plea

'If we lose touch we’ll end up with two decades of the Tories'

In an exclusive interview, Andy Burnham urges Jeremy Corbyn voters to think again in last-minute plea
Tunisia fears its Arab Spring could be reversed as the new regime becomes as intolerant of dissent as its predecessor

The Arab Spring reversed

Tunisian protesters fear that a new law will whitewash corrupt businessmen and officials, but they are finding that the new regime is becoming as intolerant of dissent as its predecessor
King Arthur: Legendary figure was real and lived most of his life in Strathclyde, academic claims

Academic claims King Arthur was real - and reveals where he lived

Dr Andrew Breeze says the legendary figure did exist – but was a general, not a king
Who is Oliver Bonas and how has he captured middle-class hearts?

Who is Oliver Bonas?

It's the first high-street store to pay its staff the living wage, and it saw out the recession in style
Earth has 'lost more than half its trees' since humans first started cutting them down

Axe-wielding Man fells half the world’s trees – leaving us just 422 each

However, the number of trees may be eight times higher than previously thought
60 years of Scalextric: Model cars are now stuffed with as much tech as real ones

60 years of Scalextric

Model cars are now stuffed with as much tech as real ones
Theme parks continue to draw in thrill-seekers despite the risks - so why are we so addicted?

Why are we addicted to theme parks?

Now that Banksy has unveiled his own dystopian version, Christopher Beanland considers the ups and downs of our endless quest for amusement
Tourism in Iran: The country will soon be opening up again after years of isolation

Iran is opening up again to tourists

After years of isolation, Iran is reopening its embassies abroad. Soon, there'll be the chance for the adventurous to holiday there
10 best PS4 games

10 best PS4 games

Can’t wait for the new round of blockbusters due out this autumn? We played through last year’s offering