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Battles brewing over local NHS pay schemes

Performance-related pay PRP) is set to become a major political battleground between health professionals and the government, as the NHS Executive’s push to decentralise pay bargaining gathers momentum.

The drive to introduce local pay schemes and PRP is likely to meet the stiffest opposition from the medical profession, though other staff groups are also gearing up to meet the challenge.

The British Medical Association is vigorously resisting government proposals that from April 1995 some part of doctors’ pay would be locally determined according to ‘productivity’, with basic salaries being set at a lower level than would otherwise be the case.

The BMA argues that PRP schemes do not work. ‘They have a demotivating effect, can be discriminatory and are being abandoned in the commercial sector,’ it says.

It has already written to doctors asking them to lobby their MPs and the media on the issue.

Meanwhile, staff and management sides of the General Whitley Council, which sets pay levels for staff not covered by review bodies, has agreed that local pay schemes in the NHS should be subject to the criteria that they improve patient care, and are agreed with trade unions. Health service unions believe this represents a significant victory.

‘If employers try to bring in PRP we will try to make them stick to these guidelines,’ said Roger Kline, head of labour relations at the Health Visitors Association. ‘The likelihood is that the government will link PRP to next year’s pay rise.’

Supporters of PRP claim that it increases staff motivation, rewards employees who work hard, and allows employers to gain greater control over salary costs. But evidence from published studies of PRP indicates the opposite. For example, a 1993 study of 1,000 employees by the Institute of Manpower Studies concluded that there is ‘a risk that PRP may contribute to a downward spiral of demotivation for the bulk of employees’. Other evidence shows that women and ethnic minority staff suffer discrimination in such schemes.