Is the NHS pay scheme racist?

The awards aim to recognise excellence

By Ray Dunne BBC News Online health staff

Dr Rafeek Gardee has worked in the NHS for 25 years. A public health consultant in Glasgow, he has never received a distinction award.

Dr Gardee is not alone. Just one in three consultants is given the coveted awards each year.

They are much sought after not least because they can boost an individual consultant's annual pay by between £2,500 and £65,000.

The awards are in recognition of exemplary performance within the NHS, such as innovation or outstanding clinical and managerial skills.

The figures

Non-white doctors make up 15% of the NHS workforce

In 2001, non-white doctors accounted for less than 7% of those with awards

In 1998, non-white doctors accounted for just 5% of those with awards

But Dr Gardee, who now advises the Scottish Executive on race equality and is a director of the Public Health Institute of Scotland, believes he may have been passed over for an award because of the colour of his skin.

"It is not unusual for whites to get these," he told one newspaper recently.

That view has been backed up by researchers at the University of Manchester.

Racism claims

Dr Aneez Esmail, a senior lecturer there and president of the Medical Practitioners' Union, has carried out research into NHS distinction awards.

He found that white consultants are three times more likely to receive an award compared to doctors from ethnic minorities.

In some specialities, white doctors are 30 times more likely to be given the pay bonus.

Mr Milburn does not believe the awards are racist

Four years ago, Health Secretary Alan Milburn announced plans to overhaul the awards to ensure they were distributed fairly.

In a statement to journalists, Mr Milburn said: "We have changed the doctors' distinction awards system to help eradicate racial bias and ensure that awards are genuinely made on ground of merit and merit alone."

The Department of Health insists the current system is free from racism.

Officials say the awards are handed out on merit alone and are not influenced by skin colour or ethnic origins.

"Racism is not tolerated within the NHS. Distinction awards are given to consultants based on fair consideration of the merits of each candidate," a spokeswoman said.

Nominations

Under the current system, regional committees, comprising hospital managers and doctors, recommend consultants for distinction awards.

The medical and surgical royal colleges can also nominate individuals.

Their recommendations are considered by the Department of Health's Advisory Committee on Distinction Awards.

The scheme should be scrapped and replaced with something that is much fairer

Dr Aneez Esmail, MPU

The committee's own figures show that a small proportion of the awards go to non-white consultants each year.

In 1998, non-white doctors accounted for just 5% of those who received the pay bonuses.

Non-white consultants make up 15% of those working in the NHS.

By last year, that situation had improved only marginally with non-white doctors accounting for less than 7% of those with awards.

Dr Esmail says the government has failed to keep its promise to reform the process.

"We were told that changes would be made but really nothing has changed."

But he adds: "I don't blame the government. This is essentially a scheme for doctors, run by doctors. They have found to be coming up short."

The government is committed to replacing the current distinction awards with new clinical excellence awards by 2004.

Officials say that system will also be based on merit and that there will no room for racial discrimination.

"It will continue to be a clear duty on those granting the new clinical excellence awards, which will replace distinction awards, to ensure that individual decisions made on these awards are based on individual merit against clearly set criteria," says a spokeswoman.

But Dr Esmail believes the entire system needs radical overhaul.

"The whole thing should be wrapped up and the scheme should be scrapped and replaced with something that is much fairer."