AN expert who led a review which recommended an overhaul of the Northern Ireland health service has provoked outrage among trade unions after supporting performance-related pay for nurses and NHS workers.
Professor Rafael Bengoa, who published his ambitious report just months before the collapse of Stormont, said the cash incentive could be used to produce better outcomes for patients.
The former Basque health minister - who acted an an advisor to the Obama administration and the World Health Organisation - made his comments days after after an unprecedented nursing strike over "unsafe" staffing and pay.
He said he supported the north's healthcare workers demand for pay parity, to bring their earnings into lines with their NHS colleagues in the rest of the UK.
But speaking on the BBC's Stephen Nolan programme yesterday, Professor Bengoa said: "One needs to be thinking of a much more flexible system, this is not a privatisation, it is trying to make the public system much more flexible. We are all trying to do that with our different health services across Europe.
"The important thing is that one can identify how to measure different teams doing different work according to the results they are getting. You can measure results.
"I think the unions have to be thinking about this type of alternative and not try to standardise everyone on everything."
He used the example of nurses being financially rewarded if they reduce the number of discharged hospital patients having to be readmitted after developing complications.
"If one is to consider putting more resources into the system, one has to think about how to use those resources in a new way, not necessarily use them in the traditional way," he said.
But the trade union NIPSA , which was among those involved in strike action last week, described the remarks as "insulting".
Spokesman Patrick Mulholland said staff were already overstretched, with 3,000 nursing vacancies alone.
"Frankly in the context of where we are today with industrial action in heroic struggle with health workers trying to defend staffing levels and improve them, it is insulting that Mr Bengoa would come off with comments like that," he said.
"It is quite useful, because what it does reveal to public sector workers, the health service workers and to the trade union movement in all its glory, is the direction of travel that some people would like to take our health service - a health service which is grossly understaffed, staff not properly paid and then having to beg for pittance from their bosses - this is not an acceptable future.
"Mr Bengoa is on the wrong track and frankly Mr Bengoa does need to butt out."
