V NHS CONSULTANTS AND PRIVATE
PRACTICE
38. As we have already noted, approximately two thirds
of NHS consultants also undertake private practice.[62]
The following table shows the average earnings of NHS consultants
in the private practice by specialty:
Estimated average net private income per NHS
consultant[63]
| Specialty
| 1993 Average
Earnings (£)
| Consultant
Numbers
| 1999 Average
Earnings (£)
| Consultant
Numbers
|
| Plastic Surgery |
55,000 |
103 | 75,413
| 169 |
| Orthopaedics | 43,000
| 733 |
58,959 |
1,067 |
| ENT | 29,000
| 379 |
39,763 |
415 |
| Urology | 27,000
| 215 |
39,231 |
358 |
| Ophthalmology | 25,000
| 426 |
36,325 |
598 |
| General Surgery |
23,000 |
911 | 33,419
| 1,197 |
| Obstetrics and gynaecology
| 21,000
| 745 |
30,083 |
1,040 |
| Anaesthetics | 19,000
| 2,072 |
27,218 |
2,955 |
| Cardio-thoracic surgery
| 18,000
| 121 |
25,786 |
166 |
| Oral/maxillo facial surgery
| 17,000
| 200 |
24,353 |
230 |
| Radiology | 15,000
| 1,120 |
21,488 |
1,481 |
| Neurosurgery | 13,000
| 89 |
19,687 |
130 |
| Psychiatry | 11,000
| 1,534 |
16,658 |
1,896 |
| General Medicine |
9,000 | 1,963
| 13,630
| 2,300 |
| Pathology | 5,000
| 179 |
7,572 |
174 |
| Total |
| 10,790
|
| 14,176
|
Notes:
(1) The 1999 figures are internal
estimates based on the growth of private sector activity since
1993.
(2) Some 7,000 consultants are excluded from this analysis
because they earn little or no private patient income.
39. A comparison of NHS and private elective treatment
and day case treatment shows that the NHS has 4,349,722 admissions
per year, compared with 739,810 in the private sector, with the
private sector therefore undertaking 14.5% of the total elective
volume.[64]
Professor John Yates also makes the point that, of the operations
in the two sectors, a much higher proportion of those in the private
sector are conducted by consultants compared to those in the NHS.
His evidence states that "In the NHS, whilst the work of
junior surgeons is directly or indirectly supervised by consultants,
the actual number of operations consultants personally perform,
or assist with, is commonly regarded as something under 50% of
the total number of procedures. Within NHS hospitals private patients
are operated on, almost without exception, by consultants".[65]
40. Estimates of the time spent by consultants in
private practice are difficult to make because of the absence
of objective data. As Professor Yates's evidence stated, "information
on the division of time between the two sectors [NHS and private]
is restricted to self-reported surveys and investigative studies
of private sector activity".[66]
As well as the Monopolies and Mergers
Commission's survey (which we note at paragraph 32
above), which showed that in a 62 hour working week, consultants
spent an average of 11 hours in the private sector, Professor
Yates quoted a Norwich Union study of operating in private hospitals,
which showed that 72% of operating took place in normal working
hours.[67]
41. The Consumers' Association told us that in 1998,
Health Which? undertook an investigation into the hours
that consultants from three specialties set aside to work in private
practice. Although they concluded that "it is near impossible
to establish how much time NHS consultants spend in private practice",
they attempted to do so by using a researcher, posing as a relative
of a patient wanting to be seen privately, to contact the secretaries
of 60 consultants and ask when the consultants were available
for private consultations and which days had been set aside for
private surgery. Their key findings were that:
- on average, the consultants set aside over two
half days per week for private consultations and operations;
- almost half set aside two or more half days per
week for private consultations alone;
- one consultant was available to see private patients
on four half days per week and set aside a further half day for
private operations.[68]
62 Appendix 1, para. 24. Back
63
Ev., p. 33. Back
64
Ev., p. 10, para. 19. Back
65
Ev., p. 10, paras. 20-21. Back
66
Ev., p. 11, para. 27. Back
67
Ev., p. 11, para. 28. Back
68
Ev., p. 4. Back
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