LONDON (Reuters), Apr 20 - A 25% pay raise for hospital consultants over three years has failed to deliver improvements to patient services, the government's financial watchdog said on Thursday.
The National Audit Office (NAO) said a pay contract agreed in 2003 had not succeeded in improving the productivity of consultants -- fully trained specialist doctors mainly employed in acute or mental health hospitals.
It said in a report that England's 32,000 consultants were working the same or fewer hours for an average 23,000 pound jump in salary.
"Whilst the contract has the potential to improve management of consultant time, it has yet to deliver the full value for money to the NHS and the public that the Department of Health expected," the NAO said.
NHS consultants are now among the best paid in the world but the auditors found in a survey that many still felt their salaries were too low for the average 50 hours a week they worked.
The new contract was introduced after consultant pay fell behind that of comparable professionals, but at an average of 110,000 pounds a year they are still earning less than many doctors working in general practice.
In return for the extra pay, the contract introduced greater management control over consultants' time, with their week split up into three- or four-hour blocks of activity such as running clinics.
But the auditors found the introduction of the new contracts had been rushed, with little effort exerted to make the most use of consultants' skills.
They found that planning of consultants' work was largely based on what they had done the year before, rather than being a way of organizing their activities to improve patient services.
Local hospital managers had also booked consultants to do more work than anticipated, leading to cost overruns.
The Department of Health had to give trusts an extra 150 million pounds to cover the additional doctor salary costs, on top of the 565 million planned for the first three years of the contract.
As a result three-quarters of trusts told the audit office they were now planning to reduce the hours of work done by consultants.
Health Minister Lord Hunt said the new contracts rewarded consultants who made the biggest contribution to improving health services.
"This has helped us to recruit and retain highly skilled consultants, historically a challenge for the NHS," he said.
The British Medical Association, the doctor's professional body, said consultants' workload remained high.
"NHS trusts have deliberately cut back on activity in recent months to save money, despite consultants' willingness and ability to do more," said Jonathan Fielden, chairman of the BMA's Consultants Committee.
The NHS Employers body conceded the introduction of the contracts had been rushed but said many trusts were now in a position to use the agreement to improve patient services.
The Conservatives said the NAO report demonstrated Labour's poor management of the NHS.
"This confirms that the government simply didn't understand what consultants were doing before they made assumptions about the new contract," said Conservative Health Spokesman Andrew Lansley.
By Tim Castle
Last Updated: 2007-04-19 12:00:45 -0400 (Reuters Health)
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