Row over NHS consultants' overtime
Poor planning has been blamed after figures suggested that some consultants are making more than £100,000 a year in overtime from the NHS.
Consultants warned that the situation is likely to get worse under Government plans to commercialise the healthcare system.
Documents seen by the BBC reveal that senior doctors frequently earn about £600 for four extra hours of work, on top of their salary and bonuses.
Basic pay for consultants in England stands at almost £90,000 a year on average, paying for 10 four-hour blocks (full-time) a week.
Those consultants who do private work are also obliged to do an extra four-hour session paid at their basic rate if their NHS trust needs them. Any extra work beyond that attracts a higher rate, with many trusts paying between £500 and £700 for four-hour sessions, the documents show.
The rates are set by individual health trusts so there is no national picture of how much overtime is costing.
Dr Ian Wilson, deputy chairman of the BMA's Consultants Committee, said: "These kinds of numbers sound alarming but are acknowledged to be acceptable and will only be after consultants have done a considerable amount of work above their contracts and for free. It's usually hard-pressed specialists being asked who are already overstretched, and the vast majority of consultants never ever do a Waiting List Initiative.
"The fact is that this happens because trusts can't plan for the future - a situation which will get much worse as the Government's NHS White Paper seeks to marketise healthcare even more - and so have to bring in extra help as a quick fix when things get desperate.
"We hear of many cases where consultants are pressurised to do this extra work much against their will and in spite of the figures being bandied about. We'd much rather a healthcare system which is transparent, open and fairly regulated, without the pressures of commercial models which make this kind of thing inevitable."
A spokeswoman for the Department of Health said: "We expect the NHS to increase productivity and improve health outcomes - this includes making effective use of consultants' time. Consultants and managers should work together to ensure that clinicians' time is planned cost-effectively whilst delivering high-quality patient care."