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Monday, 17 January, 2000, 18:02 GMT
Hospital doctors: how they are paid

Hospital doctors Hospital doctors will get a 3.3% pay rise


The latest pay deal boosts the pay of hospital doctors above the rate of inflation. BBC News Online looks at what this will mean for them.

Hospital doctors are, unlike GPs, salaried NHS employees.

There are different grades of hospital doctor depending on how much training they have received.

The term "junior doctor" refers to those who are still in training, and encompasses the house officer, senior house officer and specialist registrar grades.

The amount paid for each post depends on how busy the job is, and how advanced in training the junior doctor is.

House officers - those in the first year of hospital work - now earn a minimum of £24,165, and a maximum of £27,270.

This figure, however, assumes that the doctor concerned will be carrying out an extra 32 additional duty hours (ADHs), or overtime above a 40-hour week.

In reality, although some juniors still work these long hours, the government and doctors' leaders are aiming to bring everyone down to the so-called "New Deal" hour limit of 56 hours a week.

The government has invested an extra £5m to enforce this limit more rigorously.

After the first year, the doctor reaches senior house officer (SHO) grade, and, including the same number of ADHs, can now earn between £30,150 and £40,265, depending on the number of years they have been an SHO and the toughness of their job.

At specialist registrar - the highest junior grade - a doctor can expect to make (including 32 ADHs), between £33,700 and £49,110.

A specialist registrar is far less likely than a houseman to work 32 ADH weeks.

Junior doctors' leaders are currently negotiating with the Department of Health to try to improve the rate paid for ADHs - currently only half their usual hourly rate.

The chairman of the BMA's Junior Doctors' Committee said: "It is insulting that junior doctors will receive just a few extra pence for working under extreme pressure out-of-hours."

Training over

Hospital doctor pay (1999-2000 in brackets)
House Officer £17,260(£16,710)
Senior House Officer £21,535-£24,425(£20,845-£23,645)
Specialist registrar £24,070-£35,080(£23,300-£33,965)
Consultant £48,905-£63,640(£47,345-£61,605)
Consultant with discretionary points £66,190-£84,005(£64,065-£73,925)


Once the lengthy training has been completed, doctors take up "senior" jobs, either as consultants, paid up to £63,640, or as associate specialists or staff grades, who are paid much less.

However, hospital trusts can reward individual consultants by awarding them discretionary points, which could in theory increase a salary up to more than £84,000.

However, those considered the best consultants can double their salaries if they are given distinction, or merit, awards. Merit awards are given for "outstanding contribution" to NHS services. They are awarded by a body of doctors called the Advisory Committee on Distinction Awards.

Although the system is currently under review with a view to including lay people in the selection process, a consultant already earning £66,190 could be given an A+ merit award which boosts the salary to £124,100.

There are only a few consultants nationally with A+ awards - but even the lesser A and B awards are extremely lucrative.

On top of this, consultants may be able to boost their earnings with private work, with excellent opportunities for earning in certain specialties.

However, senior doctors' leaders claim that equivalent professionals in law and commerce can earn far more than even the most amply rewarded hospital consultants, and they call fo
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See also:
17 Jan 00 |  Health
Nurses welcome pay boost
17 Jan 00 |  Health
NHS pay: The reaction
17 Jan 00 |  Health
The GP pay system

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