The NHS is paying out almost £40 million a year in bonus payments to leading medics at a time of intense pressure on services.
Consultants are taking home lucrative payments of up to £75,000 a year through the system of “distinction awards” and “discretionary points”, on top of annual salaries of up to £102,000.
The payouts went up by almost £700,000 in total across Scotland last year, figures obtained under Freedom of Information laws have shown.
The biggest payouts were in Greater Glasgow and Clyde where £12.2 million was paid out in 2013/14, up by £500,000 on the previous year, while £6.6 million was paid out in Lothian.
The increase follows another stretched winter period for Scotland’s NHS which saw many patients left waiting for hours in overrun A&E departments, while waiting times targets were regularly missed. Consultants can expect to earn a basic salary of £76,000 to £102,000, depending on their level of seniority, and many already supplement this by doing operations in the private sector which the NHS does not have time to carry out.
When she was health minister in 2010, First Minister Nicola Sturgeon pledged to bring bonuses for top medics under control and is now facing calls to explain the rise.
Although “distinction awards” have come down, in line with Ms Sturgeon’s pledge, other “discretionary” payments by health boards have soared by more than £3.5 million.
Liberal Democrat health spokesman Jim Hume said: “It is right that we reward exceptional performance, and that is what we get from doctors in our NHS on a daily basis. But as with any other area of public spending, SNP ministers need to be transparent about pay awards.”
A spokeswoman for the British Medical Association (BMA) said the payments were needed to attract the “brightest and best”.
“Distinction awards and discretionary points are an important part of the NHS remuneration package.”
Pressure on the NHS has intensified as budgets are squeezed amid soaring demand, with NHS Lothian among other boards in failing to regularly hit waiting time targets of seeing 95 per cent of all patients within four hours in accident and emergency departments.
Jim Crombie, chief officer for NHS Lothian Acute Services, said: “Doctors’ terms and conditions are set nationally. This includes the discretionary points system which recognises the contribution made by senior doctors to improving services for patients.
“We award the minimum number of discretionary points each year, as required in the national guidance issued by the Scottish Government.”