HEALTH Secretary Shona Robison said she was “determined to tackle” the rising overtime costs for consultants in hospitals across Scotland after it was revealed that they had been paid £20 million in the past year for extra hours.

Spending on high-cost overtime has shot up by more than a third in the past two years with one doctor making an extra £375,000 last year on top of their salary. The British Medical Association blamed a consultants shortage amid rising demand.

Robison said there were a “number of reasons” for the increase in overtime costs and that it was a “small fraction” compared to the overall costs.

She added: “Clearly we have some gaps in certain specialities which are hard to fill. Sometimes there are vacancies which take a while to fill and there are sickness and maternity issues to cover, so boards sometimes do have to use people on a short-term basis. I also think its important to put that in a bit of perspective in that the figure spent on consultant overtime payments does represent a small fraction of the overall cost of consultant staff, less than three per cent of the £720m a year that we spend on consultant medical staff.

“So this represents a small amount, but clearly something we need to tackle and something we are determined to tackle.”

Medical leaders insisted consultants’ overtime payments were “not at all extortionate” despite figures showing an increase of almost 50 per cent in just two years.

NHS boards paid out £20.92m in overtime and additional pay to some doctors in 2015-16 compared to £14.27m in 2013-14, according to data revealed under Freedom of Information.

Two of Scotland’s 14 regional health boards did not respond, meaning the overall total could be higher, as it was reported consultants could be paid £600 in overtime for four hours of work.

Dr Peter Bennie, chair of the BMA in Scotland, said the increase in overtime was due to a lack of staff.

He added: “The overall picture here is the straightforward issue of there simply not being enough consultants on the ground to do the jobs.”

He added that 162 consultancy posts had been empty for six months of more – saying this alone represented approximately £15m not currently being paid by health boards.

“That balances out quite a bit of this,” Bennie said. “The issue for us is – and has been for some time – that there are not enough consultants to do the job, and that actually applies across all branches of medicine: there is a similar problem with general practice.

“The main figure that is being quoted is £600 for four hours work. That’s four hours of work, almost always at weekends or late into the night. That’s working out to about £85 an hour after tax and it seems to be that that is not at all extortionate for a group of the most highly-trained and most expert people we have in the country in the health service.”

Dr Nikki Thompson, chair of the BMA’s Scottish Consultant Committee, said the level of vacancies was “not sustainable”.

He added: “High vacancy levels increase pressure on services and colleagues are having to work harder and longer to try to fill the gaps, making it even more challenging to attract staff to commit to working here.

“It is simply not sustainable.

We need proper workforce planning and adequate numbers of consultants, so that services can be properly planned and provided, without relying on what staff we do have working longer and longer hours.”