Last financial year (2009/2010) according to their annual report the Care Quality Commission paid £2,399,000 in fees and expenses to SOADs (Second Opinion Appointed Doctors), the psychiatrists who authorize treatment (ECT at any time during detention, drug treatment after 3 months detention) on non-consenting detained patients or patients subject to community treatment orders. There were 110 psychiatrists on the panel in 2009/10, so if the work had been evenly distributed they would have earnt on average about £22,000. But the work wasn’t evenly distributed. Eighty-seven members of the panel earnt less than £30,000 in fees and expenses; 3 members earnt more than £100,000. The highest earning SOAD earnt £188,291 in 2009/10.
With fees set at £180 for an individual visit and £540 for a whole day, it is hard to see just how they managed to fit in enough visits to earn this amount, even with expenses. Presumably this was a retired (or unemployed) psychiatrist.
Writing 15 years ago in his book Treatment without consent, lawyer Phil Fennell pointed out that the 25 retired doctors on the MHAC (Mental Health Act Commission – the predecessor of the Care Quality Commission) panel were responsible for a disproportionate amount of the opinions. In those days (his survey was conducted in 1991/92) there were a total of 154 doctors on the panel. The fifth MHAC biennial report (1991/93) mentioned attempts to distribute the work more evenly. These attempts have evidently not been successful. In addition, although the number of people being treated without their consent has increased*, the number of doctors on the panel has decreased, leaving an opportunity for those who are prepared to turn it into the equivalent of a full-time job, or more, to earn enormous sums of money.
*This increase is accounted for by people being treated with drugs without their consent; the numbers of people being given ECT without their consent remained much the same until 2008/09 when they decreased owing to a change in the law