Monday, December 01, 2008

Insane NHS bureaucracy

Paying government employees more seems to be their main aim in life. Too bad about getting anything for the increased pay

An NHS nurse has broken the 100,000 pounds sterling ($200,000) barrier for the first time as health staff cash in on generous incentive schemes. The nurse consultant in Rotherham, South Yorkshire, has doubled her basic salary of 50,000 by working overtime under an NHS initiative to bring down waiting lists. On this rate she would be hit by the tax raid launched by Alistair Darling against high earners - a startling indication of how public-sector workers have prospered under Labour.

Figures obtained by The Sunday Times under the Freedom of Information Act suggest dozens of NHS nurses now earn more than 60,000 a year. The incomes of hospital doctors have also rocketed, with many consultants' NHS earnings exceeding 200,000. One consultant at the Royal Devon and Exeter NHS Foundation Trust was paid between 225,000 and 229,000 in the last financial year. A consultant at Tameside Hospital NHS Foundation Trust in Ashton-under-Lyne, Greater Manchester, earned 228,000.

Consultants' basic salaries are being boosted by bonuses, or clinical excellence awards, and by payments to bring down waiting lists. One doctor at Gateshead Health NHS Foundation Trust was paid an extra 50,000 in the last financial year to help cut waiting times. Labour has promised to meet a waiting-times target of 18 weeks by the end of December. There are no set national overtime rates. They are negotiated between trusts and their nurses and doctors, and are not publicly available.

The generous payments are controversial at a time of economic hardship. The health department has already been accused of awarding unduly generous new contracts to NHS employees without achieving better treatment for patients. A recent report by the Commons public accounts committee found that a new contract for hospital consultants boosted their pay by 27% without any measurable improvements in productivity.

The disclosure of nurses' true incomes challenges the perception that they are all poorly paid. Last month the Royal College of Nursing, a nurses' union, claimed members were struggling to make ends meet. An appeal was launched last year to ask Premier League foot-ballers to donate a day's pay to a fund for impoverished nurses.

The nurse who earned between 100,000 and 105,000 in the last financial year is a "nurse consultant", one of the top grades of the profession, employed by the Rotherham NHS Foundation Trust. The NHS employs more than 800 nurse consultants in England. Their roles can range from running clinic sessions advising patients on how to manage conditions such as diabetes, to performing minor surgery to remove cysts and moles. They also carry out research.

A newsletter published by the Rotherham trust last year said it had four nurses on this grade. It featured one nurse consultant, Julie D'Silva, who carries out endoscopies - internal examinations often inside the stomach. In another issue D'Silva spoke about her contribution to cutting down the waiting list: "We have put in a great deal of effort to deliver the best service we can to the people of Rotherham. However, we don't want to stop there and we hope that in time we will manage to get waiting times down even more."

This weekend the trust said that for reasons of privacy neither it nor D'Silva would confirm whether she was the nurse who had earned in excess of 100,000. A spokesman defended the extra payments: "The trust is very clear that these payments represent good value for money with real and tangible benefits to patients."

A full-time nurse consultant normally works about 37.5 hours per week. Under the European working time directive, nurses should not do more than 48 hours a week. The trust declined to disclose how many extra hours the nurse was working for her additional 50,000.

The FOI returns show many nurses have annual incomes in excess of 60,000. A nurse at Buckinghamshire Hospitals NHS Trust had an income of 71,000, while a nurse at Sandwell and West Birmingham Hospitals NHS Trust earned 61,000. Official figures for September 2008 show NHS nurses had an average annual income, including overtime, of 31,600, while the average consultant salary was 119,200.

The British Medical Association, the doctors' union, advises members they can maximise extra NHS payments if there is no competition from private firms in the area. Consultants are estimated to be paid 600-900 for four-hour shifts to cut waiting lists.


Tasmanian public hospital waiting lists continue to grow

It's a problem in the public hospital systems of all Australian States -- though NSW and Queensland seem to be the worst

The waiting list for elective surgery in Tasmania increased by almost 10 per cent in the three months to the end of September, compared with the same period last year. New figures from the Health and Human Services Department show that at the end of last September, the number of patients waiting for elective surgery was 8,600. That's a jump of 9.9 per cent from the end of September 2007, when about 7,800 people were waiting.

The department's Progress Chart, which has just been released, says the waiting list will continue to grow because of Tasmania's ageing population and increasing rates of chronic disease.

Other figures show the number of women screened for breast cancer in the September quarter dropped by 9 per cent, compared to the same quarter in 2006.

The number of adults getting dental treatment increased by 15 per cent.


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