Bonus Culture


The Herald newspaper ran a good article the other day on Scotland's bonus culture - only this time in the NHS.

The article was written by Paul Hutcheon and suggested that the Scottish Government's health secretary - Nicola Sturgeon - has backed down over a threat to bring such bonus payments to an end.

The lucrative scheme resulted in more than 800 hospital consultants either receiving a bonus payment for the first time last year - or being awarded a higher bonus than they had been paid in the previous year.

At a time when the pay of other NHS staff has been frozen of course.

According to The Herald, hospital doctors can apply for two types of bonus payments - on top of their already six-figure salaries.

Distinction awards which can land a consultant an annual pensionable bonus of between £31,959 and £75,889 - and which cost the taxpayer around £26m a year.

A separate discretionary points scheme also operates - The Herald tells us - and this works on an eight-point sliding scale.

A doctor who has one point gets a yearly top-up of around £3204 - while a consultant with eight points walks away with more than £25,632 on top of their salary.

Apparently points are awarded if doctors show an "above average" contribution to their work - the cost to the public purse was around £19 million in 2009-10 - a figure which rose to more than £22 million in 2010-11.

The doctors' trade union - the British Medical Association (BMA) - is claiming victory in its battle to retain this bonus culture in the NHS - despite such schemes coming under attack elsewhere, notably in the banking sector.

The BMA claims that these bonuses form part of a doctor's terms and conditions - and that blocking new points would be a breach of contract.

But exactly the same was true of the Royal Bank of Scotland (RBS) chief - Stephen Hester - who gave up a £963,000 bonus earlier this year - a payment he was clearly entitled to under the terms of his contract.

Yet the RBS boss declined to take what he was due - after a public outcry.

So why does this bonus culture continue in the NHS?

More to the point who decides how much people receive - and why?

I'm not sure how these things are decided nowadays - though in the past it was just a committee of senior doctors who got together - and doled out the money.

But if people's payments never fluctuate and always stay the same - or even keep increasing - then it's very difficult to see how a such a scheme can objectively be based on performance. 

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