Are doctors paid too much?

If the Sunday Telegraph is to be believed this morning, the answer may be yes. Their headline blares the "fact" that consultants in A and E are being up to £3000 per shift, which, if true, is a pretty phenomenal sum for eight hours work. As a GP I was well paid for my efforts, which I always considered to be fair enough considering the pressure we work under and the responsibility we have to bear. FYI, the most I have ever been paid was £110 per hour for a six hour shift in an out-of-hours unit on Christmas day, and let me tell you I earned my money, seeing 49 patients over the whole session.

 If we take inflation into account, however, I probably got paid a lot more than that for a five day locum at Butlins in Minehead in the long lost era of 1976. I took away £1200 for my services, which consisted largely of treating the guests for diarrhoea and vomiting and the staff for a variety of venereal diseases. But this amount was nothing compared to what the practice who employed me netted. In those days you could submit a form called an "FP 81" for every patient you saw between 11 pm and 8 am, and this attracted a fee of around £80, even at that time. The senior partner explained how it worked: In the early evening, if I was asked to see a patient I was advised to stall them until after 11 pm, then see them and fill in the little goldmine called  the FP 81. If I made over £1000 in less than a week, the practice walked away with nearly five times that amount. The reason for my very attractive pay-rate, of course, was that nobody wanted to do it. Strange thing, my memories of that time are that I had a whale of a time, But that's another story...

When the NHS was rolled out in 1948 there was a problem about persuading consultants and GPs to sign up. Aneurin Bevan managed to bring them on board by first, giving GPs a self-employed status so they retained a great measure of autonomy in the way they organised their businesses, and the consultants were finally placated by the introduction of the famous and highly lucrative "merit awards", which ensured consultants could never complain about the money they made. Bevan famously said at the time: "I'll fill their mouths with gold". It worked.

Now a similar scheme seems to have been deployed, as consultant jobs in A and E aren't the most desirable or prestigious appointments- at least until now. I imagine if the claims made by the Telegraph are true (and I'm not certain they are) they are going to get a lot more popular, and soon.

One last thing. Let us put the income of doctors in context. Dentists make more money than doctors. So do lawyers. Footballers and managers make far more. Senior bankers and directors of multinationals make far more than that. And as for oil-rich sheiks and Russian oligarchs (to say nothing of the hidden trillionaires currently shielded from our view in China) well, they're in a league of their own...