Bonus payments given to thousands of doctors on top of their six figure salaries are to be slashed as part of a Government clampdown.Most hospital consultants currently receive an annual merit award, which gives them up to £76,000 on top of an average salary of £110,000.

Once a medic is on the scheme, they almost always stay on it for life, with the fund counting towards their pension.

In August, Health Secretary Andrew Lansley ordered an overhaul of the whole system, which has just paid more than 1,700 doctors more than £45,000 each, on top of their salaries.

Now medics have been told that until this review reports, the fund for all new payments made by local hospitals will be cut by more than 40 per cent. Meanwhile, the number of new awards made by the national part of the scheme has been halved.

While maximum levels remain the same – at £76,000 for those who get a payout from the Department of Health, and £35,000 for those rewarded by their local hospital, the pot will be shared among fewer medics.

New figures show that this year, 300 consultants received a “platinum” award of £75,800 in bonuses. Another 623 took home “gold” rewards of more than £55,000, and 847 were given more than £46,000.

Consultants have been given rewards above basic salary ever since the NHS was created in 1948.

But they have become more contentious since a new contract, introduced in 2003, increased the average salary by one third, to £110,000, as working hours fell.

This year, more than half of consultants received some sort of merit payment, under schemes set up to reward those who have made outstanding contributions to patient care or research.

The British Medical Association is threatening to take legal action over the new cuts, which will take effect in April.

The chairman of its consultants committee, Dr Mark Porter, said ministers were sending out an “appalling” message to the NHS.

The union has written to Mr Lansley, objecting to the latest changes, and is exploring whether legal action can be pursued.

Dr Porter told The Sunday Telegraph: “This is a really appalling way to treat doctors.

“We understand that there is a difficult position with public spending, but to specifically hit out at those doctors who are performing at the highest levels – those who go the extra mile – and decide to take investment from them, sends out a terrible message.”

Alan Maynard, Professor of Health Policy at York University said the Government was right to attempt to clamp down on a scheme which he described as “extraordinarily generous and poorly policed”.

He said: “These payments are supposed to reward particular excellence, and supposed to be subject to regular review.

“In fact, once an award is made, it is almost always for life, and these sums augment doctors’ pensions by an enormous amount.”

Emma Boon, from the TaxPayers’ Alliance, said that while consultants did an important job, the increases to their incomes in the last decade had been “astonishing”.

She said: “We need to ensure value throughout the NHS, and that means we can’t afford to sustain payments at these levels. Though doctors deserve decent rewards, we should be careful not to overcompensate them for the work they do.”

The Department of Health said the changes reflected the “challenging financial environment” the NHS was working in.

A spokesman said the Government wanted to reward those who went beyond the call of duty, and said the best consultants would still receive awards.

From: http://www.telegraph.co.uk/Bonus-payments-to-doctors-on-six-figure-salaries-set-to-be-slashed

NICE the killer quango wants to waste taxpayers money by suggesting that the NHS should bribe fat people to lose weight and smokers to quit, and give children toys for eating their fruit and vegetables.The Killer Quango- the National Institute for Curbing Expenditure (NICE) was set up in early 1999 by the labour Secretary of State for Health Frank Dobson and has since condemned hundreds of cancer sufferers to early deaths and blighted thousands to painful existences by restricting payments- creating postcode lotteries for health care.

Now during the credit crunch nice want to waste millions of taxpayers pounds bribing people when earlier pilot studies showed that there were high drop out rates and up to 80% failed to reach their targets.

The advice, which will be published by the National Institute for Curbing Expenditure, has been greeted with anger by critics who claimed such “bribes” were draining the public purse of money which could be better spent elsewhere.

The study examined a series of schemes, including one in Kent which pays dieters up to £425 for losing weight and another in Scotland which gives pregnant women shopping vouchers worth up to £650 for quitting the habit.

It also looked at programmes in Oxford, Manchester, London and Bangor in Wales, where schools have been given toys such as juggling balls, stickers and pencils to children who have eaten their fruit and vegetables.

Fiona McEvoy, from the TaxPayers’ Alliance, said state funds should not be used to pay people to change their lifestyles,

She said: “Bribing people to lose weight or quit smoking is nothing but a quick fix which patronises the individuals in question and drains much-needed money away from the public purse. At a time when cancer drugs are being denied to sufferers due to lack of funds, many will be disgusted to learn that NICE are considering such a costly approach.”

Other schemes examined in the report include a pilot in Manchester which rewards overweight parents for walking their children to school.

As part of a £30m project, supermarket points are given to unfit people who attend keep-fit classes, weight loss clubs or go for a run in the park.

Overweight people gain credit points they can cash in for groceries just for turning up, with extra rewards depending on how much weight they lose.

In Newcastle, Bristol, Torbay, Manchester and Bury St Edmunds, those aged 16 to 22 are given subsidised gym membership if they visit at least once a week.

However, the report found limited evidence about whether the schemes make a difference.

In the Scottish antismoking project, for instance, the study acknowledged that four fifths of the women in the £43,000 scheme were smoking again within three months of giving birth.

The recommendations from NICE’s independent citizens council do not constitute its official advice to the NHS. Its board will launch a public consultation on the matter before considering the paper, which would inform future guidance.

However, the rationing body has already supported financial rewards for heroin addicts.

Originally NICE recommended that addicts who attended treatment programmes should be given the chance to win prizes, such as televisions and MP3 players.

The body dropped the idea following a public outcry but instead recommended that shopping vouchers worth up to £10 could be awarded to those who completed programmes, or showed they were clear of drugs.

NICE has been widely criticised for refusing to pay for dozens of cancer drugs on the grounds of cost. Medicines rejected include the drugs Avastin for advanced bowel cancer and Nexavar for advanced liver cancer.

Last year the institute fuelled controversy when it ruled marriage guidance counselling should be funded by the NHS, and supported the use of acupuncture for back pain, despite finding there was no good evidence it worked.

The report follows a three day meeting of NICE’s citizens council, where members were asked to vote about the use of incentives.

“More than 60 per cent said they were in favour of such schemes, as long as they were only used as a “last resort” and were not exchangeable for tobacco or alcohol.

Sir Michael Rawlins, the chairman of NICE said: “We clearly face several public health challenges in today’s society, some more obvious than others, and we must seek to improve these in ways that are likely to achieve the best outcomes to those affected.

“The majority of the council has voted in favour of the use of incentives under certain circumstances, but this clearly remains a divisive issue”.

Public consultation on the report starts today.

From:

http://www.telegraph.co.uk/NICE killer quango taxpayers-bribes-for-obese-and-smokers.html

Health Direct finds this new waste of taxpayers money a disgrace. Research in pilot studies has clearly showed that bribing people to lose weight and stop smoking DOES NOT WORK in the vast majority of cases.

On June 10, 2010 Health Direct published research :Nanny state cash bribes for good health fail three quarters of patients at http://www.healthdirect.co.uk/2010/06/nanny-state-cash-bribes-for-good-health-fail-three-quarters-of-patients.html

A Department of Health spokesman has already described them as an undesirable use of money and should only be adopted as a “last resort”.

If you would like to tell the killer quango NICE what you think of this scheme, comments should be sent to Clifford Middleton, Research and Development Project Manager at clifford.middleton@nice.org.uk by 5pm on Friday, 26 November 2010.

If email is a problem for you, please send your comments in a letter to Clifford Middleton at:

NICE,
MidCity Place,
71 High Holborn,
London WC1V 6NA.

Foreign nurses are receiving a crash course in euphemism after bewildered patients expressing the wish to “spend a penny” found themselves being escorted to a hospital shop.
Norfolk’s Queen Elizabeth hospital has organised special “adapting to life in Norfolk” sessions for Portuguese staff whose otherwise excellent English results in too-literal translations of everyday expressions.

Patients, particularly the elderly, face being met with incomprehension when complaining of “feeling under the weather”, suffering “pin and needles” or experiencing problems with their “back passage”.

Local expressions such as “blar”, meaning to cry, and “mawther”, meaning “young woman”, are also likely to see mystified nurses flicking in vain through conventional phrasebooks. The distinct Norfolk brogue provides another linguistic obstacle for the recruits hired by the Queen Elizabeth Hospital King’s Lynn NHS trust.

“One of the things people from overseas had difficulty with was our euphemisms such as ‘spend a penny’,” said a hospital spokesman. “In the past some of the new recruits from abroad, when patients used the expression, were taking people to the hospital shop.”

“They all speak exceptional English, but that doesn’t necessarily cover the type of English spoken in Norfolk. We have many different phrases and sayings in this part of the world. A lot of patients are elderly and use what can only be described as quaint phrases and descriptions, especially for body parts and common illnesses.

” The hospital has organised two-hour induction courses in dialect, idiom and colloquialism, covering phrases such as “spick and span”, “higgledy-piggledy”, “la-di-dah” and “tickled pink”. Other useful terms on the agenda are “jim jams”, “a cuppa” and “elbow grease”. Nurses are being asked to write down any confusing phrases they hear on the wards so they can be discussed in follow-up meetings.

Katherine Murphy, chief executive of the Patients’ Association, said the training would ensure “safe service” in hospitals. “Anyone working for the NHS – nurse, doctor, other healthcare professional, healthcare assistant – must be able to be understood by the patient and must demonstrate that they are safe to treat patients,” she said.

But Fiona McEvoy, of the Taxpayers’ Alliance, resorting to idiom herself, said it was “using a sledgehammer to crack a nut”. It made more financial sense for foreign nurses to pick up local phrases “from hearing them used and being advised by peers”, she said.

From: http://www.guardian.co.uk/foreign-nurses-taught-english-euphemisms

An investigation found that 320 hospital, ambulance and health authority chiefs are paid more than David Cameron’s annual salary of £142,500.
The report comes as the health service faces cuts to frontline services to reduce the deficit. Of those 58 are paid more than £200,000 a year. Financial experts described the salaries as “unsustainable”.

The number of high-earners has increased 50-fold since Labour came to power in 1997. Prior to that only six NHS officials were paid more than John Major, who then earned a salary of £101,557.

The highest paid was Ian Miller, Interim Director of Finance and Investment for South East Coast Strategic Health Authority, who earned £310,000 for nine months work from April 2009 to January 2010.

His salary – which would be £400,000 per year – would pay for up to 14 nurses.

Meanwhile Ron Kerr, Chief Executive of Guys and St Thomas’ NHS Foundation Trust, earns the second-highest amount with £270,000.

Some health executives also receive additional bonuses such as leased luxury cars that cost more than a nurses salary of £20,000 a year.

The survey looked at 172 acute hospital trusts, 11 ambulance trusts and the ten regional strategic health authorities.

In total 734 staff earned more than £100,000 per year according to available records.

Matthew Elliott, chief executive of the TaxPayers Alliance, said: “It’s shocking that pay in some parts of the NHS has now reached these stratospheric new heights. It simply isn’t sustainable.”

Anthony Marsh, chief executive of West Midlands Ambulance Service NHS Trust, earns £232,000 – more than 14 times the salary of some ambulance drivers.

Pay does not appear to be linked to performance. Martin Yeates, former chief of Mid Staffordshire NHS Trusts, which runs Stafford hospital where 400 died due to inadequate care, earned up to £160,000 a year before he left.

Meanwhile the Department of Health said it was “committed to cutting NHS management costs” and planned to reduce them by 46 per cent in the next three to four years.

From: http://www.telegraph.co.uk/More-than-300-NHS-executives-have-a-larger-salary-than-the-prime-minister

The Department of Health has spent almost £500 million on management consultants, including deals with firms which have hired senior Labour figures and high ranking civil servants.The disclosure of more than 100 contracts worth a total of £470 million last night engulfed the labour Government in accusations of “cronyism”.

Among those recruited by the favoured firms are a former health minister, an ex-adviser to the health secretary and a senior Whitehall official responsible for encouraging private sector involvement in the NHS.

Doctors’ and nurses’ leaders expressed concern over the use of resources which could have paid for more than 60,000 hip operations, or the annual salary of 22,000 nurses.

Critics also said the revelations indicated that the “revolving door” between the labour Government and its favourite consultant firms was spinning ever more quickly, with former senior politicians, officials and advisers linked to companies profiting directly from the policies they had introduced.

Lord Warner, a Labour peer, who was a health minister until December 2006, now acts as an adviser to PA Consulting group, which received £4.9 million from the Department of Health (DoH) in 2007/8.

Until last December he also advised Deloitte, which received almost £3 million in the same year.

Since resigning as a minister in 2006, the peer has also registered interests working for six other health care, technology and IT firms.

Matthew Swindells, policy adviser to then health secretary Patricia Hewitt between 2005 and 2007, who was earning £195,000 at the DoH, is now group managing director for health at Tribal, which earned more than £2 million from the department in 2007/8.

KPMG, the finance firm, secured £4.9 million in the same year. Last month the firm announced the appointment of Mark Britnell, currently on gardening leave from his £235,000 role as DoH director general for commissioning.

The civil servant was responsible for a policy to encourage more private sector involvement in the health service. He drew up plans which allowed a shortlist of firms – including KMPG – preferential access to lucrative NHS contracts.

Under rules intended to reduce conflicts of interests, Mr Britnell has been told that he cannot lobby the Government for his first nine months in his new job.

Other figures to have crossed from Government to private sector firms which won the management consultancy contracts include Sir Michael Barber, who was Tony Blair’s chief adviser on delivery – focusing on education and health – from 2001 to 2005.

Since September 2005 Sir Michael has been a partner at McKinsey, which was paid £9 million for management consultancy services to the DoH in 2007/8.

Lord Birt, the former BBC director general, was Tony Blair’s strategy adviser from 2000 to 2005. In 2006 he was appointed as an adviser to Capgemini UK, the British arm of the global outsourcing giant.

The DoH figures show that Capgemini UK was paid £3.2 million in 2007/8 for management consultancy to the DoH and the agency running the NHS IT programme.

Information released under the Freedom of Information Act discloses for the first time the details of 111 management consultancy contracts held by the DoH and two of its central agencies.

In total, the DoH, its IT programme Connecting for Health and the NHS Purchasing and Supplies Agency spent £470 million on management consultants in the three years from 2005/6 to 2007/8.

It came after the department had made hundreds of its own staff redundant via an “efficiency programme” intended to save money.

The spending came in addition to an estimated £350 million spent annually on consultants by 150 primary care trusts. Research has shown consultants in the NHS earning up to £2,000 a day for project work.

Matthew Sinclair, from the TaxPayers’ Alliance, said: “It is particularly alarming that many of these management consultants are political cronies or have only recently finished working for the Department of Health.”

Dr Mark Porter, deputy chairman of the BMA’s consultants committee, said: “These consultants aren’t just taking money from the front line, they are often drawing up policies which in themselves damage patient care.”

Dr Peter Carter, general secretary of the Royal College of Nursing, said: “We are unable to find any evidence about whether this represents good value.”

Andrew Lansley, the health secretary, said: “This lays bare the hypocrisy of Labour’s claims to have cut back on Government administration costs.”

PA Consulting group said Lord Warner’s advisory work for them did not relate to any contracts held with the DoH. Deloitte said the peer’s role as a strategic adviser ran from March to December last year.

Lord Warner said he only began advising PA Consulting in Autumn 2008, and was no longer advising four of the eight companies he has worked for since stepping down as a minister.

He added: “Provided people leave a decent period after they are in office before they take up such posts – which I did – provided they clear it with the Advisory Committee on Business Appointments, which I did, and provided they register the interest in a public document – which again I did, I don’t think it is right to stop people who were involved in Government forever from working elsewhere. I would defend to the death the right to have a free flow of labour.”

From: http://www.telegraph.co.uk/Millions-spent-on-NHS-management-consultants-with-Labour-links