The taxpayer funds bonuses of £76,000 a year to a privileged few. Why is a Scottish university so keen to encourage this discredited scheme?

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Kenneth Roy

We received this email a few days ago:
     ‘SR’s excellent campaign on the excesses of the medical profession – especially the merit award scheme that it tries hard to keep from public view – has its members rattled.

Kenneth Roy

We received this email a few days ago:
     ‘SR’s excellent campaign on the excesses of the medical profession – especially the merit award scheme that it tries hard to keep from public view – has its members rattled. SR will also be aware of this profession’s mafia-like practices towards non-members who threaten it, so please do not identify me beyond being a member of staff at the College of Medical, Veterinary and Life Sciences at Glasgow University.’
     Attached was a memo urging members of the undergraduate medical school to provide examples of ‘significant contributions’ to the NHS by people in ‘leadership positions’.
     ‘This is required urgently,’ the memo continues, ‘to help MSC (Medical Schools Council) prepare a response to the review of Clinical Excellence Awards/Distinction Awards that is currently being undertaken by the Review Body on Doctors’ and Dentists’ Remuneration. You may be aware that these awards are serously under threat and MSC needs to muster very persuasive arguments to try to retain the schemes’.
     Anyone willing to help is asked to contact a named senior academic.


All in all it is a hugely advantageous set-up, made all the jollier by the composition of the committee dispensing the largesse.


     Two questions need to be asked. Why – despite everything that has happened in this country in the last two years and the certainty of further horrors to come – is a discredited scheme of distinction awards in the medical profession still in existence? And why should Glasgow University be anxiously soliciting support for its continuation?
     The awards in Scotland are administered by a public body known as SACDA (Scottish Advisory Committee for Distinction Awards). They are given only to a narrow group within the profession – the consultants – in recognition of ‘exceptional personal contributions’. Repeat: no one else in the NHS is entitled to receive them.
     When we first took an interest in SACDA late last year, we noted that the value of the awards – the actual dosh – was not given on its website. After a brisk exchange of correspondence, we secured a tiny victory – the figures were added to the website.
     The highest award – graded A+ – is worth £75,889. An A award-winner receives £55,924. B people are entitled to £31,959.
     At first, we assumed in our innocence that these were one-off bonuses dished out to older consultants (the average age of recipients is 51) towards the end of their distinguished careers. Not a bit of it. If, at the age of 51, you receive a distinction award of £75,889, you get it not once but every year until you retire; and, when you retire, it counts towards your pension.
     There is then the small matter of your salary – around £100,000 a year – and nothing in the rules to stop you doing private work as well. All in all it is a hugely advantageous set-up, made all the jollier by the composition of the committee dispensing the largesse. It is dominated by NHS consultants, all of whom are beneficiaries of the scheme.
     We estimate, for example, that the recently retired medical director of SACDA himself earned almost £1 million in distinction awards.
     The initial SR revelations resulted in some press interest. One journalist who contacted us said he would be getting in touch with the Scottish government to ‘stand up’ the story. When he called back he was less enthusiastic. He said the Scottish government had assured him that the bonuses went to the consultants’ employers, the area health boards. I explained that, strictly speaking, this was true but that the employers then passed on the cash to the consultants in addition to their salary. But the official briefing had implanted a doubt; no follow-up story appeared. Perhaps
it sounded too implausible.


Do any feel a sense of shame at the widening gulf between the top earners in the NHS and the majority of workers in the public sector?


      Fifteen years ago, the British Medical Journal said: ‘No other profession would copy this system and consultants would gain respect by scrapping it – essentially self-respect.’
     But, despite the note of concern being struck by Glasgow University’s medical school, there is no sign of the system being scrapped. Scotland’s health secretary, Nicola Sturgeon, would like to see it replaced by a less expensive scheme rewarding staff across the health service. There is no sign of that happening either.
     We have been looking at the awards very quietly announced, and universally overlooked, at the end of last month. Eight new A+ consultants have been added to the roll, 16 As, 28 Bs, at an annual cost of £2.4 million. It is true that the number of award-winners is down on recent years – perhaps even SACDA is finally getting real. But there are now 630 consultants in Scotland being paid these colossal bonuses. Do any feel a sense of shame at the widening gulf between the top earners in the NHS and the majority of workers in the public sector? If they do, it seems to be a private matter between themselves and their conscience.
     Meanwhile, where exactly is the conscience of Glasgow University’s medical school?

This article was reproduced with the kind permission of Kenneth Roy.

Read kenneth Roy in the Scottish Review.