The NHS bonus scheme is being criticized. The scheme originated in 1948 when the NHS was created. They are available to consultants and are designed to reward excellence in research, teaching and, of course, clinical care. The bonus comes over and above the the basic salary - which currently stands at £89,400 on average - and for the top-performing doctors are worth an extra £75,000 a year. The consultants nominate themselves for the awards with a final decision being made by the local NHS trusts or, for the larger awards, a national committee. Once a doctor is awarded a bonus given they continue to get it in subsequent years. However, the awards are subject to five-yearly checks. However critics claim that the system needs overhauling as checks are not being carried out and any problem might mean that the money cannot be withdrawn even if performance deteriorates. For example, a doctor getting the top £75,889 award could get the gold star removed from the records, but would still be given the money each year.
Professor Alan Maynard, who specializes in health policy in York University said, “The system is archaic and it is about time it is reviewed…Once the doctors get these awards they effectively have them for life. The payments stop once they retire but they contribute to their pensions…It is going to be difficult for the Government to stop the payments altogether as doctors will put up a strong fight.”
Professor John Appleby, chief economist at the Kings Fund think-tank, also said, “these bonuses are out of step with how the NHS should be paying staff. They should be abolished…There is no evidence that they encourage the consultants to do any extra work - they are usually highly motivated individuals who will carry out research regardless of whether they get paid.”
Matthew Sinclair, Director of the TaxPayers’ Alliance, added, “Taxpayers will find it incredible that their money is being spent on bonus payments for doctors who aren’t even entitled to them…This makes a mockery of the whole point of these incentive payments and has clearly led to assessments under the scheme becoming pretty much meaningless. There is more and more evidence that there is huge waste in the NHS and the Government were wrong to ring fence its budget.”
Critics have called it as “lifetime bonuses.” The numbers getting them are rising year on year. Nearly 20,000 in England which is more than half the entire workforce get some form of bonus. This meant that the bill for the bonuses crossed £200m barrier last year.
The Ministers have tried to reform the bonus system previously. Seven years ago negotiations took place over the new contract but no significant outcomes have been reached. Health Secretary Andrew Lansley after the formation of the Coalition government pushed for a review of the system in England. Now the independent doctors' pay body is investigating the issue and will make recommendations next summer.
The British Medical Association however feels that bonuses are an important part of the overall pay system. A spokesman said, “In order to reward and encourage quality and innovation in the NHS, part of the funding for consultant pay goes towards award schemes… The BMA is happy to engage with the government review of the schemes that has already been announced. However, it is important to keep in mind that not all consultants receive an award, and fewer than 1 per cent receive the highest.”
A Department of Health spokesman in a statement said, “Anomalies like this are exactly why the Secretary of State announced a review into these awards. In future we want to see a much tougher approach, including withdrawing them from people who no longer display the quality of work that would merit an award now.”
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