Patients in Scotland have not benefited from a new NHS consultants contract, according to a report by MSPs.
The contract for consultants cost an extra £235m over three years
An extra £235m has been paid out to Scotland's 3,500 NHS consultants over the past three years.
A report from the Scottish Parliament's Audit Committee said health boards and the Scottish Executive should do more to ensure it delivers what it promised.
It criticised the lack of accurate cost estimates and information on working hours and conditions in Scotland.
The new contract, introduced three years ago, fixed consultant working hours at 48 hours a week and brought salaries to more than £100,000 a year.
In return consultants were expected to work more flexibly and improve their job planning.
The Audit Committee's investigation was triggered by a report in March this year from the Auditor General for Scotland, Robert Black.
He found that the Executive had "significantly" underestimated the expense.
The contract had cost the NHS an extra £235m in the first three years, compared with a predicted £65m extra.
The Audit Committee's report said the contract had the potential to pay consultants fairly while delivering improvements in service, but it was not being used to best effect.
It said: "The anticipated wider service benefits from the considerable investment in the consultant contract are not being demonstrated.
"SEHD (the Scottish Executive's health department) and boards must take steps to ensure that the stated benefits of the contract are both achieved and demonstrated more effectively."
The report went on to call for the impact and effectiveness of the contract to be kept under review.
The committee's convener, independent MSP Brian Monteith, said: "In two successive overview reports on NHS performance, we expressed concern about inaccurate cost estimates, lack of information, lack of clarity about the benefits to patients, and the contract's failure to properly reflect Scotland's needs.
"Having now considered the auditor general's report on the implementation of the contract in Scotland, these concerns remain.
"For example, the committee is extremely critical of the decision not to collect information on consultant working patterns in Scotland."
The contract was introduced as part of UK-wide NHS pay reforms.
The Scottish Executive said the benefits would be evident in the long term.