SCOTTISH Ministers are not supporting radical plans by the health service in England to compel doctors to declare their outside earnings on a register of interest.
The SNP Government has instead backed the "robust" status quo in Scotland, which requires consultants to inform their employer about the amount of time spent on private practice.
Although hospital doctors can earn well in excess of £100,000 from public work, they can also top up their income in a number of ways. Consultants work in private hospitals to clear waiting times backlogs and have financial relationships with pharmaceutical firms.
A consultation by NHS England - entitled Managing Conflicts of Interest - would bring unprecedented scrutiny of these payments.
The flagship proposal is for executive and non-executive directors, pharmacists, dentists, optometrists and medical staff like doctors to submit a register of interest.
Central to the new system would be for these groups to declare “outside employment”, including consultancy work, paid advisory positions and honorariums.
Also covered is “private practice”, which is defined as medical work undertaken by clinicians “outside of the terms and conditions of their employment with an NHS employer, and for personal gain”.
In practice, this would require hospital doctors in England to declare which private facilities they had worked in, when they carried out this additional employment, what procedures they carried out, as well as their earnings. Details of sponsorship and paid-for research would also have to be submitted as part of the new regime.
A recent consultation by the Scottish Health Council found that a majority of participants believed publication of financial payments to healthcare professionals should be mandatory.
However, despite the move towards transparency south of the border, the Scottish Government will not be following suit.
A spokesperson for the Scottish Government said: “The NHS Consultant Contract in Scotland requires consultants to declare details of any regular private practice commitments as part of the annual job planning process. This includes details on location and hours worked but not financial.
“We believe that the current consultants’ terms and conditions of service are sufficiently robust to ensure that NHS work receives priority and that effective job planning minimises the potential for conflicts of interests between different commitments.”
Dr Peter Gordon, who has campaigned for legislation requiring transparency for health service staff, said: “Given that the English health department are currently considering the development of greater transparency relating to financial interest for consultants, it would indeed be disappointing if the Scottish Government were content with the status quo.
“This is particularly the case given that a recent consultation with the Scottish public demonstrated support for the need for greater transparency.”
Scottish Conservative shadow health secretary Donald Cameron said: “If top NHS staff who are well-paid by the taxpayer are also receiving cash from private practice, that’s worth knowing about.
“We live in an age of increased transparency, and it’s important the NHS in Scotland tries to keep up with that.”
A spokesperson for BMA Scotland said: "The BMA is considering its position on these proposals in England and will respond to them in due course. It is important to remember that GMC rules already require doctors to act in a transparent manner when it comes to any potential or perceived conflict of interest.
"NHS consultants are dedicated professionals who in the vast majority of cases already work beyond their contractual hours to deliver NHS care to patients at all times, including at night and at the weekends. Under the terms of the Scottish consultant contract, if a doctor wishes to undertake private work, they have to inform their employer and to first offer extra time to the health service on top of any working hours they already perform."
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