Hospital Consultants Pay Structure

– in the Scottish Parliament at on 17 March 2011.

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Photo of Ian McKee Ian McKee Scottish National Party

5. To ask the Scottish Government what progress is being made in reforming the pay structure of national health service hospital consultants. (S3O-13319)

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

The new consultant contract was introduced in 2004. The pay structure contained within the contract has not been significantly reformed since that time. The Doctors and Dentists Review Body makes annual recommendations on the pay uplift for consultants. This year, 2010-2011, the DDRB accepted that it was difficult to justify pay increases for highly paid individuals in the current economic circumstances and recommended that there be no increase to the national salary scales. Next year, as with all public sector workers earning above £21,000 a year, there will be no uplift in their salary. Ian McKee will also be aware of my proposal to freeze the value of distinction awards and discretionary points in 2011-12, on which I shall make a final decision shortly.

Photo of Ian McKee Ian McKee Scottish National Party

I know that the cabinet secretary is aware of the general public disquiet at the principle and scale of distinction awards for NHS hospital consultants. Is she prepared to comment on the fact that, over the past five years, a retiring Lothians, Grampian or Glasgow consultant was up to five times more likely than a colleague retiring in Lanarkshire and seven times more likely than one from NHS Forth Valley to be in receipt of such an award? Does she agree that although, doubtless, some of that difference can be accounted for by the presence or absence of a teaching hospital in the health board area, the overall disparity is a potential cause of resentment and needs to be addressed urgently, whatever the results of the DDRB inquiry?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

Given that this will be the last health question time to which Ian McKee contributes, I thank him for his interest and the significant contribution that he has made to furthering health policy in this Parliament. [Applause.]

I want first to put on record the high value and appreciation that I have for the work of all consultants in Scotland, but it is a matter of public record that I believe that the time has come to review the system of distinction awards. There are many reasons for that—Ian McKee has cited some today.

I gave evidence to the DDRB earlier this week as part of its review, and I look forward to receiving its recommendations later this year. It is not fair to pre-empt those recommendations, but I look forward to our having in place a fair system that recognises that many different groups of staff in the health service do excellent work.

Photo of Murdo Fraser Murdo Fraser Conservative

I echo the cabinet secretary’s remarks about Dr Ian McKee, as he approaches retirement.

The cabinet secretary will know that distinction awards for consultants contribute not just to their salaries but to the pensions that they draw, which are paid on a final salary basis. Following publication of the Hutton review, does the cabinet secretary have a view on how pensions for top earners in the public sector, such as consultants, might be reformed?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

First, I hear the views of members across the chamber about distinction awards and I point out for the record that I am, I think, the first health secretary to say publicly that it is time to reform distinction awards. We have taken action already in this financial year to freeze the budget and, as I said, proposals are currently being consulted on for the next financial year.

On pensions for consultants and the relationship between pensions and distinction awards, one of the expressed elements of our submission to the DDRB has been on the fact that distinction awards are consolidated and pensionable. That is one of the most difficult to justify elements of the current scheme. Again, I will wait to see what the DDRB has to say on that. I look forward to hearing its views in due course.

Photo of Jackie Baillie Jackie Baillie Labour

It is not often that I agree with the cabinet secretary, but let me do so in relation to her comments on Dr Ian McKee, who has made a considerable contribution to the Parliament. We will miss him.

The cabinet secretary is right to point out that final salary pensions including distinction awards are inappropriate in the current financial climate. However, the previous Administration initiated a review that she signed off a couple of years ago, and we now have another review. What does she intend to do to take the issue forward beyond asking the UK coalition Government, which is busy dismantling the national health service as we know it, to do so?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

Not for the first time, Jackie Baillie takes people’s breath away in expecting them to forget history. Apart from initiate a review in 2006 that tinkered at the edges and did not question the fundamental underlying basis of distinction awards, the previous Labour Administrations here did nothing to reform distinction awards; in fact, the budget increased by just under 50 per cent, even when we factor in inflation.

We have taken action to freeze the budget, and we are proposing further action. I certainly look forward to hearing the views of the DDRB and continuing in the position of the past couple of years in which the SNP Government is at the forefront of pressing for change to the system.