Met pays doctors £200k for examining prisoners

The doctors were able to reach the astonishing sums because they were paid for each patient they saw. If they visited one station but saw three people, they were paid three times.

A report to the Metropolitan Police Authority says the "fee-per-case" system attracts "significant fees during a relatively short attendance in the custody suite".

Figures obtained by the Standard under Freedom of Information rules show that in 2007/08 the Met spent more than £13.4 million on payments to 153 doctors.

It means each was paid an average £87,890. Fifty-three were paid more than £100,000 in a year, and seven got more than £200,000.

The huge cost emerged amid a growing row over medical cover for prisoners. The Met plans to recruit 200 nurses to provide 24-hour cover at custody centres, partly in a bid to control costs.

Under the new scheme, the specialist doctors — called forensic medical examiners — will no longer be able to claim on a "fees-per-case" basis. In future they will have to claim for sessions they work rather than for individual visits. But the doctors — who examine prisoners to determine if they are fit to be detained or interviewed — accuse the Met of recruiting agency doctors to replace them who have minimal or no experience in custody healthcare. They also question whether nurses will have the experience to examine prisoners.

Superintendent David Imroth, head of the Met's Custody Directorate, said the forensic nurses would get five weeks training and would work alongside the doctors. Nurses will provide instant care for minor cuts and ailments, which will reduce the need to call in a forensic medical examiner.

They will also help custody sergeants decide if a prisoner needs a doctor. The first team has been introduced at Charing Cross police station. Mr Imroth said: "We are building a professional team who will be able to look after not only the detention rights of prisoners but also the healthcare of individuals."

Dr Michael Wilks, of the Society of Forensic Physicians, said that under the new system the Met would be using 40 to 50 locum doctors who were not necessarily trained in forensic medicine. "The Met used to have a very secure system which ensured forensic medical examiners had the right level of expertise," he said.

"Now because the system has been taken apart it is not possible to know whether the doctors they are using are competent." He admitted he was surprised by the number of doctors earning more than £200,000 — saying this showed they were working "dangerously long hours".

The total cost of payments had been expected to rise to more than £15 million next year — but under the new system the budget will be kept to £13.5 million. Many of the police doctors also work as GPs and their specialist forensic work topped up their NHS income. Others rely solely on their income working for the police. Police said they did not have any control over the costs of the system which they said was open to abuse.