Consultants are part of a team of medical and non-medical professionals that contribute towards the production and delivery of health care services in hospitals in the UK National Health Service. With increasing demand for medical care and the rising cost of care, it becomes more important to employ (human) resources more efficiently to improve productivity. To do this, it also becomes important to understand the factors that drive doctors' behaviour and which can be used as policy instruments to motivate them to work better. Consultants' job satisfaction is central to these factors and is defined as an index of the individual's evaluation of the experienced job against outside opportunities, contingent on information available at a specific point in time. It is correlated with labour market factors such as participation, morale, performance, intentions to quit and mobility, and can therefore be related to some underlying measure of utility from both pecuniary and nonpecuniary rewards from labour. Against the background of specific institutional arrangements such as central wage setting and policy changes such as a new contract and European Working Time Directive (EWTD) which limits consultants' hours of work, this thesis uses survey data on consultants in NHS Scotland to analyse their job satisfaction and labour supply in order to understand the relative pecuniary and non-pecuniary factors that motivate them. The thesis is written around three empirical chapters, with each chapter devoted to a specific labour market problem. The first empirical chapter analyses the labour supply of consultants using cross section data while the second models the determinants of job satisfaction (overall and for different job aspects) before and after the new consultant contract. The third empirical chapter analyses the determinants of two components of supply; clinical hours and extra hours, following the new consultant contract. Results show that consultants' labour supply is inelastic to changes in NHS pay and to overall job satisfaction. It also shows that the new consultant contract led to an increase in job satisfaction (overall and for all job aspects analyses), and to a reallocation of hours in favour of clinical hours. There was also a reduction in total and extra weekly hours of work largely due to the new contract defining doctors' commitments more clearly and the implications of the European Working Time Directive. The results have implications for the way in which consultants' labour markets are analyses and provide empirical evidence about the effects of pecuniary and non-pecuniary factors on consultants' job satisfaction and labour supply. For policy, the results of this thesis highlight the early effects of the new contract which are related to an increase in job satisfaction as well as a reallocation of hours among consultants in NHS Scotland.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:589483 |
| Date | January 2010 |
| Creators | Ikenwilo, Divine Chinedu |
| Publisher | University of Aberdeen |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=203456 |
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