The £142,000-a-year NHS director of public health says society would benefit if the medical profession -- which enjoyed substantial pay increases when new working conditions were introduced five years ago -- was paid less.

Dr Linda de Caestecker, a director for Greater Glasgow and Clyde told The Herald that doctors, including herself, should consider a reduction in salary and stop demanding significant pay increases every year.

The move comes as Finance Secretary John Swinney considers calls for a 5% across-the-board pay cut for senior public-sector staff to address the squeeze on Government finances.

Dr de Caestecker bases her argument on the belief that pay inequality needs to change to address some of Scotland’s entrenched health problems.

Asked if she would be willing to sacrifice some of her own income, Dr de Caestecker said: “I suppose the simple answer is yes, if it was done in a fair and transparent way and was about redistributing income across the pay scales between the well-off and less-well-off.”

The public health director, who publishes her annual report today, questioned what would be achieved by her taking a solitary stand, saying: “I think it would be much better if it was done in a way that, as a profession, we were saying we understand health inequalities are to do with inequalities in income as well as opportunity, aspiration and environment, and we will lead the way on that.

“I think we should as a profession say we want a more equal society, therefore we will not be fighting for large pay increases, particularly at a time like this, when the public sector will be facing financial challenges.”

The earning power of doctors became particularly controversial after new contracts boosted salaries while cutting working hours in 2004.

Hospital consultants are said to have enjoyed a 25% pay rise, while a recent survey by the magazine Scottish Review showed 13 senior NHS staff were paid more than the First Minister. The average pre-tax salary of a Scottish contractor GP is nearly £90,000.

Dr de Caestecker’s annual report, described as her manifesto for health improvement over the next two years, notes that a 15-year-old boy in a deprived area of Glasgow has only a 50% chance of reaching his 60th birthday, while for his counterpart in a more affluent area the chance is 90%.

She later quotes other commentators on the need for the wealthy to change as well as the poor in order to redress the balance, and says of the medical profession: “I wonder how many of us would be willing to campaign for salary reductions for the overall benefit of society, yet we might actually be better off if this happened.”

Professor Phil Hanlon, a public health expert at Glasgow University and a trained doctor, said there was evidence that in more equal societies everyone fared better, and that doctors should take some leadership on this issue.

He added: “The embarrassing thing is that doctors have done well in the last 10 years or so. That puts us at least with the possibility that people will say it is a bit rich coming from us, this kind of message.”

The British Medical Association Scotland, which negotiates pay deals on behalf of doctors, did not want to comment.