 Consultants' workloads may have been underestimated |
A pay agreement for consultants which cost the NHS almost four times as much as expected has failed to produce any clear benefits, a watchdog has said. Audit Scotland said the new employment contract awarded two years ago had not been exploited to improve patient care.
It also criticised the Scottish Executive for underestimating the cost of consultants' deal that rose from �65m to �235m over three years.
But the health minister insisted patients would see long-term benefits.
The contract was introduced for Scotland's 3,513 consultants in April 2004 as part of UK-wide NHS pay reforms.
It offered a considerable pay rise in return for a greater commitment to NHS work rather than private practice
Consultants' workloads
Auditor General Robert Black said: "The contract is an opportunity to improve patient care by better planning the work of consultants.
"There is not yet clear evidence to show this has happened, despite the additional money that has been spent on the new contract over the past three years."
The Scottish National Party said the report disclosed "a complete failure of governance" by successive health ministers.
SNP health spokeswoman Shona Robison said: "They have failed to set clear targets for health boards on how the contracts will improve patient care and they have demonstrated extreme financial ignorance and incompetence."
Conservative health spokeswoman Nanette Milne described the situation as a "scandal."
She added: "This executive measures its success by how much it spends, instead of by how well our public services are performing.
"Prior to the contract, the annual bill for consultants was �257m. This has risen to �335m by 2004-05 and projected to rise to �354m in 2005-06.
"To invest so much of taxpayers' money without being able to show better outcomes for patients is a scandal."
Defending the costs Health Minister Andy Kerr said: "The new consultant's contract is a once-in-a-generation fundamental shift in the way that the work of the consultant is governed.
Service concerns
"This is a significant cultural shift and the work involved in achieving this transformation should not be underestimated."
The British Medical Association said it was too early to be able to measure the benefits the contract would bring, but called it "an essential tool" in NHS modernisation.
Dr Peter Bennie, chairman of the BMA's Scottish consultants negotiating sub-committee, said the executive and NHS employers had failed to acknowledge the true extent of consultants' workloads throughout the implementation process.
He said it was a fair deal for consultants and taxpayers, and added that the vast majority of the extra money was to pay for the unpaid overtime worked over a number years.
"The executive promised us considerably more consultants, an increase of 600 consultants from 2002-06. We're less than half way to that target and we're not going to achieve that target," Mr Bennie said.
"There hasn't been sufficient attention paid to the number of consultants required to provide a good service to Scottish patients."
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The work involved in achieving this transformation should not be underestimated
