The Scottish Executive could garner savings of over £1 billion a year by pulling up its socks with regard to waste and reform across the public sector, an independent report has found.

The report, by Bill Howat, former chief executive of Western Isles Council, claims that as much as £818 million could by siphoned off by diverting money away from programmes performing under-par.

For the health service, it says as much as £50 million could be saved on drugs, by improving pharmacy contracts, drug prescribing and monitoring, and reducing drug wastage. In addition, it suggests freezing GPs’ pay through 2008 to save £28 million, as well as cancelling the £20 million worth of bonuses consultants take home through the Distinction Awards and Discretionary Points system for consultant bonuses.

The report argues that, while the DADP scheme “is important as an incentive to retain consultants with an international reputation,” it “cannot understand why the scheme was not negotiated out, given the very substantial pay increases flowing from the consultants' contract.”

'Close down' DADP

"The difficulty in disbanding the scheme is that it applies in other parts of the UK, and there appears to be a general reluctance to antagonise the British Medical Association,” it claims, and adds that it would be easier to dump the system if all four countries acted together. “We do not accept that the scheme is giving best value and, notwithstanding the views of those who support it, we feel that it should be closed down," it concludes.

However, a spokewoman for the BMA told PharmaTimes UK News that the BMA would “resist such proposals very strongly, as they would ultimately damage patient services and effectively be a reprisal against the hard work and commitment of both consultants and GPs.”