HC Deb 10 February 1987 vol 110 cc144-5
2. Mrs. Virginia Bottomley

asked the Secretary of State for Social Services what is the annual cost of merit award payments to National Health Service consultants; and if he has any plans to review the system.

Mr. Fowler

The actual amounts paid out in distinction awards are not collected centrally since the award holder is paid pro rata to his sessional commitments to the National Health Service. The current value of awards recommended by the Doctors and Dentists Review Body for Great Britain is £56.8 million, of which it is estimated that some £47 million will be paid. We have no plans at present to review the system.

Mrs. Bottomley

Does my right hon. Friend agree that with more than 6,000 merit awards now being paid annually and with the top award being worth more than £27,000, thus virtually doubling a consultant's pay, it is in the interests of the public, the patients and the profession that more information should be readily available? It is time for people to know the by whom, the to whom, the how and the why of merit awards. That would end the secrecy and suspicion.

Mr. Fowler

I understand entirely what my hon. Friend is saying about the issue of confidentiality, which has been a long established rule, not only in the medical profession, but in the Civil Service. Consultants can inspect the record of merit awards, but I shall bear in mind what my hon. Friend has said.

Mr. Michael McNair-Wilson

Does my right hon. Friend agree that although consultants are often the leaders of medical teams, those teams depend upon the nursing arrangements for their effectiveness? As consultants are already extremely well rewarded, is it not time that merit awards were extended to senior nurses?

Mr. Fowler

I certainly agree with the first part of what my hon. Friend has said. One of the reasons why the Government have set up the independent Pay Review Body for Nurses is to allow distinctions and differentials that seek to reward the merit and long service of particular nurses. I shall bear my hon. Friends comments in mind.

Mrs. Dunwoody

Is the Secretary of State not perfectly well aware that the merit award scheme has long been total nonsense? We need to know who awards them, who sets them and, above all, why. Why does the Secretary of State not tackle what is in grave danger of becoming an abuse?

Mr. Fowler

With respect, I do not think that the scheme is in grave danger of becoming an abuse. It is a long established system, as it was under the Labour Government of which I believe the hon. Lady was a member. An incentive to maintain a high level of distinction is provided by a rising scale of awards. I cannot believe that anybody could frankly or sensibly contest that proposition.

Mr. Forth

Does my right hon. Friend agree that when consultants are overtly critical of the National Health Service, and often manipulate their patient lists to exert pressure, we are entitled to know what they are getting from the NHS at the same time as they are demanding more and more resources from the NHS?

Mr. Fowler

I hear what my hon. Friend says, and in one or two respects I have some sympathy with him, but two thirds of consultants do not receive any merit awards.

Mr. Meacher

Is the Secretary of State aware that merit awards are a secretive and elitist system which represents a serious distortion of NHS expenditure? Is he further aware that the same amount of money could be used to fund an extra 1,750 consultants to meet the consultant shortage, an extra 3,500 junior hospital doctors so that operations would no longer have to be cancelled due to the lack of doctors, or an extra 20,000 nurses so that awards would no longer have to be closed due to the lack of nurses? Why do the Government always favour tiny rich minorities at the expense of the general good?

Mr. Fowler

I knew that the hon. Gentleman would somehow work some of his well developed conspiracy theories into this. If he feels so strongly about the system, why did he do nothing about it when he was a member of the Labour Government?