Consultants (Distinction Awards) (Hansard, 12 May 1967)

§ The Prime Minister

Yes. In accordance with normal practice the Review Body have considered the number of awards available by reference to the number of consultants eligible to receive them and have concluded that an increase in the number of awards is justifiable in view of the rise in the total number of consultants, the increase in the standard of skill among consultants generally, and the attraction of more men of high ability to those specialities in which important developments have taken place in recent years.

The Government are indebted to the Review Body for their Report and have accepted the advice tendered.

The following is the text of the Report:

REVIEW BODY ON DOCTORS' AND DENTISTS' REMUNERATION

EIGHTH REPORT

Consultants in the National Health Service: Distinction Awards

In the Seventh Report of the Review Body on Doctors' and Dentists' Remuneration (Cmnd. 2992) we recommended (paragraph 116) that the numbers and values of distinction awards for consultants in the National Health Service should be increased from 1st April, 1966 to the following—

100 A Plus awards of £4,885;
315 A awards of £3,700;
950 B awards of £2,175;
1,900 C awards of £925.

At the same time we indicated (paragraph 117) our intention during the autumn of each year to consider whether any change in the number of awards to be made available at the next allocation was called for and to make recommendations in time for them to he taken into account (if accepted) in the ensuing review by the Advisory Committee on Distinction Awards.

2. We have accordingly received memoranda of evidence from the Joint Consultants Committee and from the Health Departments. We have also heard oral evidence from Lord Platt and Sir John Macpherson, the Chairman and Vice-Chairman of the Advisory Committee.

3. In their memorandum of evidence to us the profession repeated their previous proposal that the number of distinction awards should be related once more by fixed percentages to the total number of consultants in the National Health Service. They recognised, however, that such a system might not commend itself to the Review Body and they accordingly proposed that the number of distinction awards should be increased to produce the following totals: 485 A Plus and A awards; 975 B awards; and 1,950 C awards. The profession's proposal involved a relatively large increase in the number of A Plus and A awards which they regarded as essential in order to improve incentives in hospital medicine and go some way towards redressing the differential distribution, between general practice and hospital practice 301W under the National Health Service, of the additional expenditure recommended in our Seventh Report.

4. The Health Departments' memorandum of evidence endorsed our conclusion in paragraph 114 of our Seventh Report that the considerations which led the Royal Commission on Doctors' and Dentists' Remuneration to prefer a system of fixing numbers of awards rather than percentages were still valid. They drew attention to the relatively large increase in the number of awards in 1966, which seemed likely to have remedied the situation in which no awards had been available for many consultants who had deserved them. The resultant situation in 1966, had, they thought, been broadly satisfactory. Although the Health Departments had no direct evidence on the question whether the current number of awards was likely to correspond with the number of consultants who ought to receive an award in 1967, they gave it as their opinion that the normal rate of increase in the number of consultants would appear to justify a small increase in the number of awards in 1967.

5. In oral evidence Lord Platt and Sir John Macpherson gave us information regarding the effect of the substantial increase in the number of awards (particularly B and C awards) which the Review Body had recommended last year. They also let us have the benefit of their views on the present situation. We were particularly grateful to Lord Platt for his evidence having regard to the shortness of time since he assumed the chairmanship of the Advisory Committee.

6. After considering the evidence before us we remain convinced that, for the reasons we gave in our Seventh Report, the allocation of awards should continue to be based on prescribed numbers of awards, reviewed annually. We also consider that the numbers we recommended for the year following 1st April, 1966, enabled the proportion of consultants holding awards to be brought to an appropriate level for that year. We appreciate, however, that the total number of consultants has continued to rise, that the standard of skills amongst consultants generally is increasing, and that in recent years the important developments which have occurred in several of the newer specialities have attracted more men of high ability to these subjects. In our view these considerations warrant an increase with effect from 1st April, 1967 in the number of C awards and by implication in the A and B awards as well. We consider therefore that for the year commencing 1st April, 1967 the number of C awards should be increased by 60 and that there should be increases of 15 and 30 respectively in the number of A and B awards. As a consultant who receives a B award usually holds a C award already, these increases will make it possible to allot about 100 C awards to consultants who hold no award at present, in addition to any awards which become available through death or retirement. The A Plus award is by its very nature appropriate only to men of the very highest distinction; we see no present need for an increase in the number of these awards.

302W

Recommendation

7. We recommend that the numbers of the distinction awards for consultants in the National Health Service should be increased from 1st April, 1967 to the following—

100 A Plus awards,
330 A awards,
980 B awards,
1,960 C awards.

(Sgd.) KINDERSLEY.

28th February, 1967.