NHS managers were ‘left in the dark’ over what the government wanted from the consultants’ contract, a damning report has found.

The Commons public accounts committee report says consultants are working fewer hours than they did under the old contract even though their pay has gone up by 27 per cent since 2003.

Despite the massive pay hike, trusts have not used the contract to extend patient services such as weekend outpatient clinics. Few are measuring consultants’ productivity.

Many managers have been paying consultants to work more hours than their trusts can afford after agreeing hours based on historical patterns.

The report recommends that managers are given clear boundaries in which to negotiate individual contracts based on a clear understanding of what trusts need and can afford.

It also reveals that the Department of Health underestimated the contract by at least£150million.

Edward Leigh MP, PAC chairman, said: ‘In the event, the introduction of the deal was rushed, with NHS managers left in the dark by the Department of Health over what it wanted from the contract.

‘The point was lost that the deal was to deliver improved and new services for patients and not entrench existing ways of working.’

The Conservatives and Liberal Democrats both criticised the government’s ‘incompetence’.

King’s Fund chief executive Niall Dickson said the report ‘calls into question the rationale behind the combined pay rises which should have delivered measurably better care and services to patients’.

But Jonathan Fielden, chairman of the British Medical Association’s consultants committee disagreed with the findings. He said: ‘The chairman of the PAC shows a complete lack of understanding about how consultants work.

‘He ignores the vast efforts that consultants have made to reduce waiting times and improve patient care and fails to appreciate the enormous pressure that hospital trusts have been under to meet government targets.’

Consultants were ‘worth every penny,’ he said.

Alistair Henderson, deputy director of NHS Employers, said the committee had underestimated the time required to deliver the full benefits of the contract.