Receiving private and NHS care at the same time. This is clearly a conflict of interest and totally unethical”, said Deborah Douglas, one of Paterson’s victims. The average percentage of private patient income for all FTs was 2% in 2011/12. The statistics show just five out of the 100 top-earning NHS consultants in England are female, despite women making up a third of the total workforce. David Rowland, the thinktank’s director and author of the report, said the existence of such financial relationships – most of which are hidden from public view – give the doctors concerned a direct financial incentive to refer patients to a private hospital for treatment they do not need. “Because of the systems we have in place [consultants] cannot influence where patients go to have treatment and they do not have any involvement in the decision-making or management of the contracts. So, a consultant earns £117,700 pa in the NHS. The data reveals that average total salaries in the UK consulting industry range from roughly £44,000 for junior consultant to just under £170,000 for partners. The Christie declined to respond to the CHPI’s findings. Applying this ratio to mean NHS earnings for April-June 2010 implies consultants earn on average £54,000 per year through private practice and a total of £174,000 per year. NHS trusts are sending growing numbers of their own patients to be treated in private hospitals because their own services are so busy that they cannot treat them themselves. The care is usually provided by NHS doctors doing private work in their own time. But they said it was clear some of the gap was unfair with the system of bonuses and awards weighted in favour of men. In the NHS, basic pay for consultants is topped up by a system of merit awards, which can be worth almost at least as much. His victims described him as a “monster”. Trusts spent £1.1bn in 2017-18 paying for NHS patients to be treated by private firms, the department of health and social care’s last annual report showed. Ensuring equality in pay progression systems. Overall 548 senior NHS doctors own shares or equipment or both. A report says 371 consultants own shares in private healthcare, exposing a potential conflict of interest, Sun 30 Jun 2019 13.13 EDT Traineeship was a major drawback with migration, and retraining domestically is an option that few consultants are willing to entertain. The single unit for awards granted between 1 April 2018 and 31 March 2021 is now valued at £3,092. Last week Simon Stevens, chief executive of the NHS, expressed concern that female doctors were far less likely than male doctors to receive clinical excellence awards. • Private and NHS care should be kept as clearly separate as possible. In addition, consultants can earn several times their salaries in private practice. That sum has increased in recent years as the number of patients waiting for planned care at at NHS hospitals has risen, now standing at a record 4.4 million people. Junior doctors in the NHS will now be able to undertake their training in private and independent hospitals thanks to a new agreement reached between the sector and the health service. UK private hospitals have 8,482 beds, according to LaingBuisson, which supplies healthcare data to the government. But the Christie defended its ties with HCA Healthcare to Rowland. For example, the Christie hospital in Manchester, one of the NHS’s specialist cancer hospitals, co-owns the private patient unit it created in partnership with the US-owned private operator HCA Healthcare, called LOC@The Christie LLP. However, in order to ensure that there is no risk of the NHS subsidising private care: • It should always be clear whether an individual procedure or treatment is privately funded or NHS funded. Interestingly, if you add the full‐time NHS salary of a consultant on their sixth seniority increment to the mean annual private practice earnings in the UK quoted by Stubbs et al. The average full-time income of UK doctors who responded to the survey was £114,600, with a median value of £95,000. Private health firms have also spent at least £1.5m on treating NHS consultants to trips to Wimbledon, cricket matches and golf tournaments, Rowland also discovered. Records show that the trust paid Claremont £16.3m between 2015/16 and 2017/18 and its referrals accounted for 30% of the private hospital’s overall income, Rowland said. NHS trusts have paid at least £40m to 11 private hospitals in which some of their own consultants own shares, according to CHPI’s findings. The hours worked also fell, from 51.6 per week to 50.2. In my experience men are better at pushing for more money, putting the case for awards and they get them.". UK Nurses can work in the NHS or the private sector and pay can vary greatly between the sectors. We are legally obliged to offer patients a choice of where they want to be treated and we have six hospital choices, only one of which is Claremont hospital and the work is less than 0.5% of our total activity,” said Priestly. In the most notorious case of that scenario, disgraced breast surgeon Ian Paterson referred 750 patients from Solihull hospital, part of what was the Heart of England NHS trust, where he worked on to private hospitals at which he performed operations. 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If you're receiving private and NHS care for the same condition, your NHS and private treatment can be supervised by 1 healthcare team. From Analysis of Consultants’ NHS and Private Incomes by Morris et al. Under the deal, agreed in 2003, consultant salaries have risen by 27% - from average pay of £87,000 for their NHS work. The figure is two and a half times the earnings of the highest paid woman. Dr Jacky Davis, a radiologist and former chairman of the NHS Consultants Association, said she was "surprised and disappointed" by the figures. NHS trusts can be different: The last thing to consider before we look at the pay scales, is that some NHS Trusts can interpret the pay scales and a doctor’s experience in different ways. Some doctors said some of the earnings differences could also stem from the fact men were more likely to do overtime. A few trusts had very large incomes, as shown in the following table. Once a bonus is given, it is normally handed out for life, and is pensionable. One in five of the trust’s oncologists own shares in that unit, and – with the Christie and HCA Healthcare – share in the profits it makes, Rowland found. Like all averages, this figure hides the wide range of income. www.england.nhs.uk NHS England Mandate • Published each year by the DH “To make sure the taxpayer has a say in how this money is spent, the Government provides direction and ambitions for the NHS through a document called ‘the Mandate’.” • Accompanied by Financial Directions • Financial directions set out Revenue resource limits, Much of that involves surgery for hernia repairs, hip and knee replacements or eye conditions. And within the NHS, pay alters according to experience and professional development. Sir, The recommendation by Sir Malcolm Grant, the chairman of NHS England, that NHS consultants should declare their private practice income may seem straightforward (report, Sep 20). It said only that the true proportion of its oncologists who own shares in its joint venture with HCA was more likely to be under 10%, rather than the 20% which Rowland stated. Britain’s major health bodies have backed the initiative, announced by the Independent Healthcare Providers Network (IHPN) this week. In a similar arrangement, Sheffield Teaching Hospitals NHS trust pays for patients with musculoskeletal conditions to be treated at the Claremont Private Hospital, in which Sheffield Orthopaedics Ltd – in which many of its own consultants own shares – has a 10% stake. Follow The Telegraph Facebook icon Best paid of all was a male doctor who earned almost £740,000 in 2016/2017, according to the figures obtained by the BBC. The 2012 NHS reforms in England allowed trusts to generate more income from private practice in the expectation that this would support improved NHS care, but, as Sarah Walpole and colleagues show, existing governance arrangements provide no assurance that such benefits are being realised The 2012 Health and Social Care Act was the largest ever reorganisation of the English NHS… The private income quoted is less than 0.5% of the NHS budget for 2013/14. NHS private patient income predicted to grow every year to 2020 By Ben Clover 2017-10-17T09:55:00 Income from private patient work carried out by NHS run units will grow by more than 5 per cent in each of the next three calendar years, researchers have predicted. T he highest paid doctor in NHS is earing £740,000 a year, according to new figures showing a £14,000 pay gap between male and female consultants.. In light of the size of these pay differences, should senior doctors consider retraining in a new specialty? “Private practice is extremely appealing when you consider that the NHS is getting worse in terms of doctors’ working conditions,” said Cosmo Hallstrom, a consultant psychiatrist based in London who went into private practice 15 years ago. Consultants say NHS England move to reveal additional income from private practice is an attempt to misrepresent them The HCSA said most senior doctors did no private … "With women making up the majority of medical graduates in recent years, it's vitally important that we address the root causes of the gender pay gap, and develop a wider programme of work to eliminate it across the medical workforce," she added. Contributed by: Diversity and inclusion Alice Sorby and Yemisi Osibote who are staff-side and management side co-chairs of the Equality, Diversity and Inclusion Group (part of the NHS Staff Council), share insights on the importance of partnership working to ensure pay progression equality. Just 16 women received this award. How do NHS consultant earnings compare with private consultant earnings? Such gifts included a hospitality package to an England-West Indies cricket match that cost £1,068. Of those receiving awards for the first time in 2015, just 65 new awards went to women. All rights reserved. Analysis of consultants' NHS and private incomes in England in 2003/4 Private earnings vary significantly by specialty; plastic surgeons on average earn an additional 190% on top of their NHS income through private practice, whilst paediatricians We rely on advertising to help fund our award-winning journalism. The unit value of these awards has been uplifted by 2.5% from 1 April 2019. It means a consultant earning the maximum £103,000 NHS salary could be paid up to £77,000 more in annual bonuses, plus any income from private work. The Department for Work and Pensions (DWP) also produces an analysis of the UK income distribution in its annual Households below average income (HBAI) publication, using data from its Family Resources Survey (FRS). By highlighting NHS consultants' private income, health bosses seem to be spoiling for a fight. Based on a relatively small sample of 670 respondents to a survey of 3,000 NHS consultants, the BMA estimates that 53 per cent of consultants undertake some private practice, a You need to be a subscriber to join the conversation. And six times as many men as women were paid the highest bonuses, worth more than £77,000 each. the NHS. The development is important for the Christie as [the profit from] it makes a significant contribution towards our NHS services.”, Available for everyone, funded by readers. Sir Jim Mackey, the trust’s chief executive, told the Health Service Journal: “No one wants to wait for treatment, especially when they have been diagnosed with cancer. These doctors are referring growing numbers of patients because understaffing and the soaring demand for care means the NHS is struggling to treat people quickly enough. “The prevalence of financial incentives in the English healthcare system is first and foremost a patient safety risk,” said Rowland. Medical Directors, NHS England Regional Directors, NHS England Directors of Commissioning Operations, NHS Trust CEs Communications Leads N/A N/A N/A Consultant to Consultant Referrals Good Practice Guide Superseded Docs (if applicable) Contact Details for further information Document Status 0 This is a controlled document. Another 177 medical consultants own equipment in private hospitals such as CT scanners and lasers, 67 of whom earn a fee each time it is used, according to a study of links between NHS doctors in England and the private sector by the Centre for Health and the Public Interest (CHPI). Figures obtained by the BBC last year showed the highest paid doctor in the NHS … Overall - 22,874 of 43,856 consultants in England - more than half - received some kind of bonus, of between £17,000 and £77,000 a report to ministers shows. In all, 371 senior doctors have a stake in some of the private hospitals that are earning more than £1bn a year from NHS trusts. In total, 103 men got the highest bonus worth £77,000 a year. He earned fees for performing unnecessary surgical procedures on patients, including mastectomies, after exaggerating or inventing symptoms to persuade the women that they had breast cancer. If women applied for them they were just as likely to receive them, with both genders having success rates of 26 per cent. But his notion Earlier this year, the National Audit Office (NAO) said the new consultant contract had not improved patient care. Male consultants working full-time earned an average of £127,683, including bonuses - 12 per cent more than female consultants, who received an average of £113,874. NHS income by an additional 45% through private practice. It explained that it “entered into the joint venture arrangements as we saw that there was a big market potential to develop private patient services. Peter Walsh, chief executive of the patient safety charity Action against Medical Accidents, said the CHPI’s findings showed that better regulation of private healthcare was needed. 2.13 Where a patient wishes to change from private to NHS status, consultants should help ensure that the following principles apply: • a patient cannot be both a private and a NHS patient for the treatment of one condition during a single visit to a NHS organisation; • any patient seen privately is entitled to subsequently change his Some NHS trusts have entered into a joint venture with a private company to set up a profit-making private facility to which they refer patients and at which some of their leading doctors also work, the CHPI report discloses. According to the NHS Information Centre, NHS Staff Earnings report (January - March 2011), the average NHS consultant salary (under the new NHS contract) is £117,700 pa. (There are around 35,000 consultants working in the NHS.) The pay gap shrank to £1,500 when overtime and bonuses were stripped out. “It encourages consultants to look at patients as cash machines and not people”. She called for more leadership training and mentoring of women working in medicine. Share-owning Christie consultants were entitled to £2.35m in dividends of the overall £22.6m in dividends generated in 2013-17, on top of their NHS and private earnings, Rowland estimates. Private patient unit income hits £360m in London By Ben Clover 2018-02-21T06:00:00 London trusts increased their income from private patient units by 8.1 per cent year on year, with earnings hitting £360m in 2016, new analysis reveals. About half of England's 46,000 NHS consultants are believed to do private work, on top of the average basic salary of £89,000 a year. There is a clear separation. "Some of it we can explain - men are more likely to do overtime for example - but that doesn't account for it all. Last year the Telegraph revealed that four times as many bonuses are being paid to male consultants, compared with those for women. Share-owning Christie consultants were entitled to £2.35m in dividends of the overall £22.6m in dividends generated in 2013-17, on top of their NHS and private earnings, Rowland estimates. Almost 400 NHS consultants own shares in private hospitals to which they refer patients, exposing them to a potential conflict between their income and patients’ best interests, new research reveals. Last modified on Sun 30 Jun 2019 15.55 EDT. Its report is based on analysis of declarations about share and equipment ownership that private health firms are legally obliged to make, accounts lodged at Companies House, NHS trusts’ financial reports and freedom of information requests. You can't choose to mix different parts of the same treatment between NHS and private care. All NHS Trusts should be following the same pay scale structures when recruiting and offering salaries to doctors, but this is not always the case! ... Average basic salary for NHS work is £89,000 in England. Patients are therefore at risk of receiving treatment which is unnecessary and harmful.”. The highest paid doctor in NHS is earing £740,000 a year, according to new figures showing a £14,000 pay gap between male and female consultants. It is believed that about half of England's 46,000 NHS consultants do private work, on top of average earnings of £112,000 a year. 27 / 9 / 2019 3.21pm. , the total comes to a remarkably similar value to this. that 28,000 consultants undertake some private practice in the United Kingdom, with the bulk of that concentrated in England (BMA personal communication, 2012). “If doctors stand to gain financially from treating patients this can influence their clinical decision-making. Morris S , Elliott B , Ma A , McConnachie A , Rice N , Skåtun D , Sutton M … The new figures obtained by the BBC from health trusts, the Government and NHS Digital showed the top-earning male consultant in England earned £739,460, compared to £281,616 for the best-paid woman. “I’m appalled that so many consultants have shares in private hospitals they work in. This figure is used to determine an NHS employer’s funding commitment for their LCEA round in a given year. Working with the Rutherford Cancer Centre will ensure our patients get timely access and state-of-the-art treatment.”. Trusts pay for privately provided care from their own budgets, though the sums private operators can charge is capped. Dr Anthea Mowat, of the British Medical Association, said despite recent progress on gender pay, the figures showed there was "clearly still a long way to go". Analysis of consultants' NHS and private incomes in England in 2003/4. Find out more, The Telegraph values your comments but kindly requests all posts are on topic, constructive and respectful. Twenty eight FTs had no private income during this period, and 89 trusts (62%) had a private patient income less than £1m. © 2020 Guardian News & Media Limited or its affiliated companies. But Neil Priestly, the Sheffield trust’s finance director, said that the Claremont is only one of six other hospitals that its patients can end up being treated at and that its consultants have no say in which one provides the care. Meanwhile 252 went to men, the report by the Advisory Committee on Clinical Excellence Awards found. The increasing outsourcing of care has prompted concern among NHS campaigners and the Labour party. Its research found that women were far less likely than men to apply for such bonuses. We urge you to turn off your ad blocker for The Telegraph website so that you can continue to access our quality content in the future. potential conflict between their income and patients’ best interests, £1.1bn in 2017-18 paying for NHS patients, https://www.therutherford.com/centres/north-east/. In a recent example of the trend, Northumbria Healthcare NHS trust signed a contract with the Rutherford Cancer Centre (https://www.therutherford.com/centres/north-east/) in Bedlington, Northumberland, for it to provide chemotherapy to between 120 and 150 people who have cancer. Telegraph Facebook icon NHS income by an additional 45 % through private.... £77,000 a year a bonus is given, it is normally handed out life! And awards weighted in favour of men this can influence their clinical decision-making of working... Christie defended its ties with HCA Healthcare to Rowland they were just as likely to do.... 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