Wednesday, 12 January 2011

CEAs

The Academy of Medical Royal Colleges (AMRC) have produced a report insisting that Clinical Excellence Awards (CEAs) are essential to prevent consultants leaving the country, and to incentivise them to do all that stuff that gets them the award.

These two points are, I think, particularly weak, and easy to refute. They are contrived to cover blatant self interest.

Firstly they assert that consultants will leave the country in droves if CEAs are abolished. Does anyone seriously believe that? Consultants stay or go for all sorts of reasons. By the time most of us attain consultant status we have domestic and family commitments that would make emigration a major disruption. Most of us stay here because it is home.

They assert that pay can be better overseas but in fact NHS consultant pay is one of the highest in the world. We are the best paid consultants in Europe. They cite the USA and Australia as offering higher pay. The US of course can be lucrative but it is not easy getting work in the States, and the high salary is eaten away by massive malpractice insurance premiums. Their example of Australia is just plain wrong. Anyone who has looked into going there will confirm that, usually, the rate of pay is lower  there than here.

So what of incentivisation. If you read the report what they are saying is that no-one would do the other (not extra) work if it were not for the money. This is an assertion that consultants are all totally mercenary, and that all current award holders have only done what has earned them their award for financial gain. In fact I would to a certain extent agree with this, but I am astonished that they have admitted it. Bearing in mind that the individuals involved in this report almost certainly to a man get a high end award, they are essentially admitting that they are all in in for the money alone. And they expect the rest of us to sympathise with, and support them.

I have no doubt that if CEAs were abolished all the extra work would still be done, by different people, with different motivations. People motivated by a desire to make a contribution to research and development rather than self confessed money grabbing greedy bastards. To paraphrase J F Kennedy “ask not what the NHS can do for you, ask what you can do for the NHS.”

So if the AMRC is right, and all the research and development within the NHS is subsequently done, not by the mercenary, but by the dedicated, then that is another excellent reason to get rid of CEAs. And perhaps the money saved could be used to unfreeze pay and increments for all of us.

7 comments:

  1. "ask not what the NHS can do for you, ask what you can do for the NHS.”

    I believe a lot of us already abide by this adaption of Kennedy's epithet (look at all the unpaid hours we work) - the cost of losing this ethos, and it is being weakened, will be felt by the poor old patient rather than meddlers like Lansley & Co?

    By the way, has Lansley had a chance to sort out a place on the board of a company that will profit from the marketisation of UK health?

    the a&e charge nurse

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  2. I'm struck by how some of this echoes what we are told about bankers, those most vital and admirable of Britain's workers, who will all bugger off to Zurich, Frankfurt and Hong Kong if they are not allowed to trouser billions in bonuses every year.

    Of course, since these most admirable banking folk are seen to be nobly motivated to do their best by ££££ (and by nothing else), it is no surprise if this is increasingly seen to be a quality we should prize, and expect to reward, in other occupations too.

    Pass the sick bag, Alice.

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  3. PS just read you comment on the original Hospital Dr article, Dr Z.

    Perhaps their headline might read instead:

    "CEAs essential to incentivising NHS consultants, say NHS consultants who get CEAs"

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  4. "CEAs essential to incentivising NHS consultants, say NHS consultants who get CEAs"

    Bugger, I wish I had thought of that!

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  5. CEAs encourage you to concentrate on everything but your patients (outcome figures, evidence of research and teaching etc). Providing great care in the frontline for your patients does not get you any CEA points

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  6. [bankers, those most vital and admirable of Britain's workers, who will all bugger off to Zurich, Frankfurt and Hong Kong if they are not allowed to trouser billions in bonuses every year]

    Promise not to believe all you read about bankers and I will promise not to believe all I read about GPs being on 350K a year and as for those consultants...Wow, I should have made more effort at skule.

    I know who sunk the banking system, I have the names but not the funds to fight a lawsuit.

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