While Northern Ireland’s beleaguered health service is being placed under further pressure as it tries to cope with tough financial constraints and impending budget cuts, the Belfast Telegraph can reveal today that the top medics in the NHS — consultants — have pocketed more than £57m in bonuses over the past five years.
These financial rewards, known as Clinical Excellence Awards, are given to doctors and dentists on top of salaries and pay rises and, in some cases, are the equivalent of THREE nurses’ annual pay.
More alarming, the money handed out over the last five years — £57.5m — would be around the same amount needed to build a new hospital in Omagh.
Unions have reacted with fury saying it was “unacceptable” that an elite group of medical professionals were able to receive the massive payments when a pay freeze has been imposed on ordinary health workers, and emergency departments are being closed in a bid to make more than £100m in “efficiency savings”.
The revelations come just weeks after the loss of A&E services at Whiteabbey in Co Antrim and the Mid-Ulster hospital.
Figures obtained by this newspaper following a Freedom of Information request reveal the Department of Health spends £11.5m annually on these payments, which are awarded in recognition of “exceptional contributions to Health and Social Care which are over and above the standard normally expected”.
Currently, the basic salary range for a consultant is between £74,504 to £100,646.
According to the figures released to this newspaper, in the last financial year 657 consultants — almost half the 1,380 working in Northern Ireland — were in receipt of one of these financial rewards which are given on top of salaries and are also pensionable.
On average, this bonus equates to £17,503 per consultant.
However, the awards are broken down into 12 lower and higher awards and therefore carry different monetary values.
The lowest, Step 1, has a value of £2,957. The highest, Step 12, is a hefty £75,796.
In the last financial year 109 consultants were in receipt of higher awards (Step 9-12) with a monetary value between £35,484 and £75,796.
Of those, five are in receipt of a Step 12 award which carries the £75,796 financial bonus, one is in receipt of a Step 11 (£58,305) and 41 are in receipt of a Step 10 award which is worth £46,644.
There are also 52 consultants in Northern Ireland still in receipt of Distinction Awards — the previous award system with a similar financial reward scale — which have been continuously paid as far back as 1995. The system was set up in 1948 to advise the Government on the remuneration of consultants and specialists in the NHS and was renamed in 2005.
In order for a doctor or dentist to receive an award, they must have at least three years experience at consultant level.
Self-nomination is the only method of application within the scheme and those applying for higher awards — the ones with the biggest monetary value — must have achieved a minimum of four local awards to become eligible.
Recipients are chosen by the non-departmental Northern Ireland Clinical Excellence Awards Committee (NICEAC) which is made up by a combination of peers and lay people.
The process takes about a year but once candidates have been selected, the list is signed off by the department and Health Minister.
The financial payment is then added to a consultant’s salary and is subject to review every five years. In order to keep the bonus, medics must be able to justify receiving it.
A spokeswoman from the Department of Health defended the awards scheme saying the money spent each year in Northern Ireland was “proportionately” less than in other regions of the UK.
She also said clinical awards were important in “ensuring expertise is kept within the Northern Ireland Health Service”.
“Stopping these awards in NI, while it continues in the rest of the UK, will only make it more attractive for our doctors to go to other areas of the UK — a detriment to our health service already facing recruitment problems in specialist areas,” she added.
Rewards highlight inherently unfair system, say unions
By Emily Moulton
Health service unions have reacted with fury after it emerged millions of pounds have been shelled out on bonuses for Northern Ireland’s top doctors.
The Royal College of Midwives, public sector union Unison and the Royal College of Nursing have questioned whether the system which allowed more than £57m to be given as rewards to consultants over the past five years was justified or fair.
Unison regional secretary Patricia McKeown said it was unacceptable that an elite group of medical professionals were able to receive the payments when ordinary health workers gave up bonuses to introduce a fairer pay system.
She said the unions had no problem with consultants receiving pay rises in general but objected to payments as high as £75,000 — an amount that would pay for around three health workers.
“One of the things we worked on for many, many years was a fairer pay system for health workers called ‘Agenda for Change’. The aim of that system was to tackle the problem of equal pay in the service and to reward a range of health service jobs because their value has not been recognised over the decades,” she said.
“If the doctors, the consultants, the most senior people are all outside that system getting greater levels of pay rises, it underscores an inherently unfair system.”
Breedagh Hughes from the Royal College of Midwives said she was shocked by the figures and questioned whether the money spent on the rewards was justified in the economic climate.
“This is something our Assembly needs to take notice of and I would question whether this is money well spent at a time of such severe economic stringency in the health service,” she said.
“Everybody is having to make sacrifices in the health service at this time and I hope that this is something the Assembly will investigate and make sure only those who are truly worthy of these massive payouts get them.”
Janice Smith from the Royal College of Nursing said the organisation was not opposed to a scheme which rewards clinical excellence, but she said that it should be applied across the board.
“The RCN is aware of the scheme. It is expensive and does need to be looked at, and if there needs to be any such scheme then it has to be for all,” she said.