Declaring Income Levels – Our Quick Opinion

So, doctors are going to be asked to declare their income from private practice as part of an apparent tightening up of conflict of interest rules. We think the reason is different and more career-impactful.

Having open declarations of conflict of interest is an essential thing. But is income-level a conflict of interest? The rationale is that it helps a Trust ascertain that you are offering your services to them first and you aren’t operating privately on their time. However, you already declare income, annually, to HMRC. And it’s private… Your employer gets to see some of this in your tax code but let’s face it, anyone with even vague seniority has no tax code left!

Our view is that this is the opening salvo in addressing the new consultant contract. It’s a dirty trick to turn the public support for doctors against them, along the lines of “look at their lovely high earnings and yet they are greedily negotiating for more pay”, or perhaps “paid for by you, working for themselves…” I am sure you get the impression.

Our problem with this (dirty) tactic, is that there is an expectation that doctors will not strike. However, that expectation is underpinned by trust on both sides that each side will be reasonable and professional in discussions and negotiations. If doctors give up the right to the same industrial action protections then the solid reason why that’s OK has to be collaborative, shared end goal negotiations. It’s disingenuous to expect one side to play by some very ethical rules whilst the other wisely manipulates public opinion towards their end goal. It will turn out badly.

Aside from the above, earnings are a deeply personal thing and it is very difficult for an ‘average’ person to understand them. A single complex surgery case conducted privately, by someone with a world-renowned reputation, can produce a third of the NHS annual salary for a senior consultant. But somebody else doing minor procedures could be encroaching on NHS time weekly and yet not earning as much. The point is, that declaring the data is meaningless, unless understanding conflicts and checking up is not really the goal. What I would be concerned about is that as soon as you are identified as a high earning individual, you increase your visibility to fraudsters etc. Who will hold the liability for that?

So, those are our quick thoughts. What do you think?

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