Consultants paid £1800 by NHS Lothian to sleep through night shift

The huge payments are being given to paediatricians and neonatologists by NHS Lothian to cover night shifts at St John’s Hospital in Livingston.

It takes a nurse on basic NHS pay of £21,000 - which is also the average wage for a Scottish worker - a month to earn what the senior doctors collect for a 12.5 hour shift.

The triple pay shift payments come on top of average consultant earnings of £90,000 a year plus bonuses. They have been approved in order to plug gaps in the rota at the under-threat children’s ward at St John’s.

The consultants spend the night in the hospital as an on-call medic – a job for which they are overqualified as it can be carried out by a mid-grade doctor – to meet safety requirements.

The payments can be revealed by the Evening News as nurses jobs are being cut by NHS Lothian and other health boards in order to cope with budget pressures.

There are 2000 fewer nurses working in the NHS across Scotland now than when the SNP came to power in 2007, according to official figures released today.

The payments were described as “inordinately excessive” by Gordon Beurskens, below, of the Action to Save St John’s Hospital group.

He said: “These are admittedly highly-skilled personnel, but they are on call and are not guaranteed to be working.

“The whole thing is really distasteful. Is this the tail wagging the dog?”

The triple-time payment is made under the conditions of consultants contracts, which are agreed nationally.

Between April and July, when trainees were withdrawn from the paediatric service at St John’s Hospital, hospital bosses were paying an extra £65,000 a month to provide additional staffing including making the extra payments to consultants for overnight stays.

The high cost of staffing the paediatric service in the absence of trainees is one of the key reasons the ward once again finds itself under threat.

Although five new consultants were hired in the summer, and work an overnight shift one night in every nine, it is anticipated that there will still be gaps in the rota from February.

Health bosses are likely to prioritise paediatric and neonatal care units at the Royal Infirmary and Sick Kids hospitals in the Capital, the Victoria Hospital in Fife and Borders General Hospital above St John’s Hospital, which looks set to miss out on trainees.

Dr Jean Turner, a former MSP and director of the Scotland Patients Association, said: “You can’t change contracts, but we need to find out why we can’t recruit more doctors who want to do paediatrics. It’s a jolly good job and children are great patients.”

The future of the children’s ward at St John’s Hospital is to be discussed today at a meeting of the NHS Lothian board.

Neil Findlay, Labour MSP for the Lothians, said the campaign to save the facility “started today”. He added: “The SNP Health Secretary, Alex Neil, has to step in and get a grip of this situation very, very quickly indeed.”

Dr David Farquharson, the health board’s medical director, said: “For four years, we have been working to recruit more staff but, in the meantime, the burden of ‘shoring up’ the middle-grade trainee rota has fallen on the existing  consultant paediatricians at St John’s. We require one consultant to be on call through the night and one to ‘work down’ and act as a middle-grade doctor by spending the night in the hospital to meet essential safety requirements.”

‘MORE TRANSPARENCY ON PAY IS NEEDED’

ONCE basic salary, bonus payments and overtime are totted up, consultants can earn well in excess of £200,000 a year.

Basic pay for consultants stands at just under £90,000 a year on average. For full-time consultants, this pays for ten separate four-hour blocks a week. Their pay tends to go up when hospitals experience recruitment problems or attempt to clear waiting list backlogs for the obvious reason that they are needed to work longer hours.

Some health boards have tried to tackle the high pay culture, but it can be extremely difficult.

Managers at Mid Staffordshire NHS Trust tried to cut the overtime rate for orthopaedic surgeons from £1000 to £500 for a four-hour session. But faced with the threat of consultants “downing tools”, they compromised on a fee of £750.

Professor Alan Maynard, of York University, who is a former hospital chairman, said managing consultants can often be a “challenge”. “They don’t always keep to their job plans and then get to do the overtime. I think there needs to be much more transparency about consultants’ pay. The public are just not aware of the sums they can earn.”