NHS consultants: are they really “stuffed with gold”?

Last week, after reading the Independent article by Oliver Wright on the subject of NHS consultants’ salaries, I was left mildly bemused.

Wright’s article reports figures from the National Audit Office that claim that the average NHS consultant earns in the region of £120,000, constituting a substantial 68% rise over the past 9 years, an indication of the extent to which doctors mouths have had to be “stuffed with gold”, originally quoted by Aneurin Bevan. However, I deem this to be not only a grave oversimplification of the actual situation but also, rather misleading.

Firstly, the starting salary of a new NHS consultant, as of the year 2010/11 is £74,504 (figures from BMJ Careers) – far removed from the much larger figure quoted. Basic salaries rise incrementally over the following years with attainment of greater experience and can rise up to £100,446 (NHS careers). Indeed, this amount, especially in the current financial climate, is no meagre amount; however, it is also by no means a  grotesque amount.

This is especially true when one takes into account a number of crucial factors that seem to have been overlooked, namely that of- delayed remuneration. The five to six years during medical school of an absent income, in addition to the accumulated student debt, which is not unheard of to reach £30,000; then once qualified a starting salary of around £22,000 which rises over the best part of a decade, the minimum amount of time it takes to train to become a consultant.

It is worth reiterating that doctors in hospitals grossly exceed the average 40 hour week, and when considering the number of hours worked and relate this to the wage per hour, I’m sure it certainly pales in comparison to other occupations. Even with the introduction of the European Working Time Directive, it is still customary for assiduous doctors to surpass this and work extra hours out of an ethos of good will.

In addition, the extra expense of post qualification exams, conferences, workshops in conjunction with the aggravating extra hours consumed with imposed and incessant bureaucracy spent at home with log books, appraisals in the name of “personal and professional development”.

Neither is there any assurance of a consultant post at the end of it, as there seems to be a bottleneck currently and a distinct paucity of positions, creating greater competitiveness and ubiquitous anxiety.  It certainly is not the gravy boat that some commentators purport it to be, especially compared to much more lucrative professions such as law or the financial sector.

It is not within my remit to quantify an appropriate financial wage attributable to being an NHS consultant. I am not a consultant; nor will I be.

I am also not an economist, but in my very humble opinion it seems that the real question ought to be how to find the right balance between rewarding NHS consultants – both in monetary terms and otherwise, commensurate to their expertise and service – whilst also taking thoughtfulness to the sensitivity of the current crisis.

It is a thorny issue, and one which if not reconciled, in a conducive and tentative manner will merely result in doctors, as they have done before, fleeing the NHS in favour of the outstretched arms of private practice or foreign shores – surely that would be a higher price to bear?

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• highlandjock

  I was an NHS consultant until my retirement fourteen years ago, at which time the maximum salary was £57,000p.a., unless one did private practice, in which case one’s salary was reduced by two elevenths (18%), whilst still being expected to do as much work for the NHS as full-time colleagues.
  Also, in 1973, I was offered a post in the USA at $850,000 p.a., but preferred to stay in my own land.
  In my last year of work, I calculated that at the private rate for the work I actually carried out I should have been paid £7,500,000!!!
  “Stuffed with gold”? I don’t think so!!

• SmileyPip

  If you read many other talboid and broadsheet newspapers then the public at large would only believe that most doctors are paid ‘fat cat wages’ and always playing golf. This could not be further from the truth! And certainly not the truth in the junior years of training. However, it is my opinion that when one considers the many many years of training, debt, anti-social hours to monopoly employee that only knows how to ‘take’, once a doctor reaches a consultant level they should be renumerated accordingly. Most of the consultants today do not earn what a banker with half the dedication and commitment would earn from one years bonus or a PL footballer would earn in a week! A sobering fact, although despite this many would question the wage of a highly trained doctor. ‘But the taxpayer pays doctors in the UK’ – often the cry of those critical of pay – well, doctors are good value in the UK. If you don’t believe me, go and pay for healthcare in the USA – your opinion would change quickly!