Thursday, 13 January 2011

The BBC's Nick Triggle on Consultant 'overtime'- Crap journalism at its worst

There has been a lot of chatter in the news today on how much money some consultants are earning for 'overtime' work, and it stems from the BBC's Nick Triggle's shoddy journalism:

"Some consultants are making more than £100,000 a year in overtime payments from the NHS, the BBC has learnt. The sums - paid on top of basic salaries and bonuses - have been criticised at a time when the health service is trying to save money. Consultants have been accused of playing the system, but doctors said poor planning by managers was to blame. Overtime rates vary, but are often about £600 for four hours - treble what senior medics get for contracted work. Basic pay for consultants stands at just under."

Essentially the government promised a lot and couldn't deliver it without increasing the capacity of the system. To do this surgeons, anaesthetists and all the other staff had to be paid for doing this extra work, so that all the waiting time targets could be met. It is also key that none of this work is within their contracts, it is all outside the obligation of their consultant contracts, it is work in their 'free time', that is a more honest term for Triggle's 'overtime'.

It is certainly not 'overtime' as most people would understand it, but this is the story that the BBC's Nick Triggle's tries to spin to the reader. This is work which the NHS needed to get done and in order to get it done it had to pay the market rate.

Surgeons and Anaesthetists aren't going to work outside their contracted hours for much less, it may surprise Nick Triggle to know that in the private sector the very same consultants would probably be earning a hell of a lot more per hour than they are for this NHS 'overtime' work:

"Managers at Mid Staffordshire NHS Trust tried to reduce the rate for overtime for orthopaedic surgeons from £1,000 to £500 for a four-hour session. But minutes from official meetings showed consultants would be "downing tools" if they did so. In the end, managers had to compromise on a fee of £750."

This is down to simple market forces. If managers started offering way under what consultants can earn privately for extra work in their free time then they simply wouldn't do it, they are under no obligation to. It may surprise the dishonest or stupid Nick Triggle that Consultants can earn many hundreds of thousands of pounds for their private work, it can also be argued that they are underpaid in the NHS for the work they do.

The lame duck Alan Maynard is even brought in at the end of the article for a rent-a-quote to have a dig at doctors, maybe this bitter failed academic is just jealous of people who have a job they enjoy, I don't know. It remains clear that Maynard should be able to understand how the market forces he loves to go on about are at play with the pay for this extra consultant work, either he is stupid or dishonest like Nick Triggle.

It remains clear that this so called 'news' piece is just a rather lame misrepresentation of the reality of a situation in which a group of professionals are being paid a reasonable market rate for doing some extra work to clear the decks. Triggle and Maynard may like to think how much it costs to call in the plumber or the electrician at the weekend, they may also like to think how keen they would be to work extra weekends for their normal rate of pay? Mind you, I can't think of any reason for anyone needing Alan Maynard at a weekend, maybe that's why he's such a bitter individual? Either way, shoddy journalism all round I say.


Jobbing Doctor said...

I was really angry at this.

Really angry.

Poor biased shoddy rubbish. I wondered who planted this story and why.

I think my consultant colleagues should be really pissed off with this.

Garth Marenghi said...


there are obvious parallels with the GP bashing that has gone on

basically the monkeys in the media like Triggle are too dumb to work out how much crap they are fed from government sources

they can't even analyse the most basic of blatant propaganda in a vaguely objective manner, so they end up reproducing the government's stories as their own

it's funny that all the nurses, ODPs, HCAs etc who have been paid good overtime rates are not mentioned in all this

a surgeon cannot operate on his own!

Anonymous said...

Dear Ferret Fancier,

To be fair the nurses, ODP's, HCA's etc usually only get the regular Saturday rate, rather than waiting list initiative rates.

Its all about supply and demand, and market forces. First greatly reduce the numbers of trainees and restrict their hours; secondly ratchet down waiting time creating pressure on managers to prevent breaches; thirdly, fail to expand Consultant appointments as Trusts are unable to ensure that they will still have work for them next year.

Restricted supply and increased demand? result payments go up! don't these people read economics textbooks? they need to decide whether they want market forces or not, these forces work both ways...

ptl said...

"this bitter failed academic"

I was, to coin a phrase, really angry at this. "Failed academic" my arse. And the man has been working away supporting the NHS, antagonising governments by doing so, for decades. Yes he was perhaps never all that left wing, yes he has of late proposed stuff like GP budget-holding (guess he has too much faith in doctors...), so perhaps we should set his support for the NHS aside. We're left with "failed academic". See here:


"it's funny that all the nurses, ODPs, HCAs etc who have been paid good overtime rates are not mentioned in all this"

funny you should mention lower-paid workers (of course, you left most of them out), you could have been reading Alan Maynard

ptl said...

"they need to decide whether they want market forces or not"

so do doctors.

Anonymous said...

Dear ptl,

I am pretty comfortable with market forces, as you may have gathered. I think that it is clear that demand exceeds supply, therefore my charges can go up.

Dr Phil

Garth Marenghi said...


these idiots can't have it both ways, that's the point

Maynard is a sad individual and his comments betray this

Anonymous said...

I nearly wet myself at the BBC 'coverage' of this.

Their 'Health Correspondent' in an operating theatre, wearing scrubs and holding a retractor.

When she said that Consultants might "down tools" were rates lowered, she illustrated this complex issue... by putting the retractor down in the instrument tray.

[The pathetic nature of this piece to camera also neglects the cost that must have been incurred dressing her up in blues and emptying a Theatre for her to stand in. Not to mention having to sterilise her and the camera crew.]

While this crap passes for journalism, I despair of having a rational discussion of the issues.

Dr No said...

Maynard has spent most of his life bashing focktors (sic), so nothing new under the sun there.

Garth - of course I agree with the general point, but I do think you weaken your case by special pleading that somehow the rest of society do overtime, while noble doctors generously work in their 'free time':

It is also key that none of this work is within their contracts, it is all outside the obligation of their consultant contracts, it is work in their 'free time', that is a more honest term for Triggle's 'overtime'.

Given contracted hours, any work done over and above those hours is overtime done in what would otherwise be free time. All, not just doctors, give up free time to do overtime.

ptl said...

these idiots can't have it both ways, that's the point

I accept that -- as a theoretical point! In practice, I think 1. most of us do operate with a mix of market/nonmarket assumptions, it's impossible not to, 2., many doctors seem, anyway, to want to have it both ways i.e. don't want to compete for jobs, do want to compare their salaries with those for very competitive jobs.

And doctor supply/demand is something the BMA once influenced (by regulating supply; that may have changed) and now uses blatantly, if only as a talking point, to further doctors' interests. Doctors (corporately) want more doctors unless and until a greater supply of doctors threatens medical salaries and introduces, yes, competition (e.g.).

drphilyerboots I have read your blog! :)

Dr Aust said...

I heard an interesting story a month or two back from one of my medical friends, a consultant in a scarcity (of consultants) specialty, but not one with a waiting list in the normal sense.

He told me he and his two consultant colleagues had been screaming at their Trust for years to increase consultant numbers to cover the expanding service commitments, which had them all doing lots of on-call cover and extra activities. The service, they said, needed expanding, which meant extra consultants.

He tells me his Trust have now increased the no of consultants, but have drastically reduced each of their working so that the total number of consultant "activities " is exactly the same as before.

He and his original colleagues are spitting tacks because the managers are telling them "you should be pleased, you've got just what you asked for", while their service has not actually expanded its total activity. I wonder, though, whether his employer might be saving money overall if they had previously been paying "overtime supplements" analogous to the Waiting List Initiative payments?

Alef said...

to be honest, 10 years ago GPs earned an everage of 59k and now its over 100k, and GPs worked on average 38 hours a week in 2000 compared with 39 hours in 2010. 1 hour a week more for over 40k!!
when the Blair administration increased the NHS funding most of it was eaten up by GPs wages. GPs are overpaid, they wont even take a blood-pressure unless they get paid for it. They have no sense of altruism, only an eye for money, fair play if they earnt a pittance but they don't, they earn a tonne! And with 1 in 4 haviong shares in their local private clinics they're only going to increase their incomes further when they're given the fundholding.
Money grapping swines, the lot of them!

Mexico hospitals said...

I didn't know GPs make over 100k, and 1 hour a week plus they got over 40,000 GBP ?! It's more than overpayment and not fair. How is the administration plan to save on health care by the way ?

Mexico medical tourism

Anonymous said...

Same with today's story on a RCN survey on patients on trolleys in A&E. Based on a shock horror survey by RCN - they got 1200 replies which means that less than 3% of their membership bothered to reply. Hardly a deep upspring of concern - except the BBC majored on it big time with no apparent editorial control

It appears that the BBC just now recycle press releases without much of a thought process inbetween

Anonymous said...

I was distressed to read of the sad episode of a little boy with a cerebral tumour whose parents removed him in order to seek a recognized form of treatment pelsewhere. Nick Triggle is wrong to say that there is no right to a second opinion. Any patient (or his parent) may seek an opinion from any doctor anywhere and there is nothing to prevent him from doing so. It is not the prerogative of the hospital to 'grant' a second opinion. The inappropriate use of an arrest warrant originally introduced with the object of combatting terrorism was lamentable.The prognosis for the unfortunate boy is bleak whoever treats him. To have used this kind of heavy handed approach to deny his parents the comfort of having explored all the avenues, and to have denied them access to their child in Spain is simply cruel.
Loud warning bells should be ringing in Westminster when MPs are asked to vote on taking away more of our civil liberties. Perhaps that they should insist that the powers be restricted to terrorist offences would be appropriate and defeat the objectives of those in the police and security services who are always trying to persuade governments to give them more unbridled power.