DOCTORS and nurses at the Count-ess of Chester Hospital will pocket bonuses worth hundreds of pounds for carrying out extra operations.

The Countess is among 32 trusts selected to pilot a fee-for-service scheme, spearheaded by health minister John Hutton.

The radical scheme could see clinical teams divide up bonuses of £250 a session for treating more than a benchmark number of patients, while nurse specialists could take home £400 a month bonuses on top of their pay for exceeding a set number of cases.

The system was signalled in the NHS improvement plan published by health secretary John Reid last month as a further extension of the payment by results financial system being introduced in the NHS, which will mean hospitals being paid per patient treated.

Officials at the Department of Health announced details of the fee-for-service system this week - the same time Chancellor Gordon Brown axed 104,000 jobs to fund front-line services such as health.

Health chiefs say the new system will slash hospital waiting lists and lead to 8,000 additional operations and 6,000 extra out-patient consultations being carried out.

But extending the scheme to individual staff is likely to spark anger among the unions which have resisted individual bonuses in the past.

The announcement also comes at a delicate time with the proposed new Agenda for Change pay system for 1.3m staff.

Unions will ballot on whether to accept Agenda for Change in October, but the feefor-service scheme could be seen as cutting across its system of salary bands and payments for out of hours work, which was designed in part to protect the NHS against equal pay employment tribunal cases.

The fee-for-service scheme at the Countess was also criticised this week by Paul Offer, prospective Tory Parliamentary candidate for Chester. He says NHS staff are already strained and financial incentives in the workplace will only add to that strain.

Mr Offer said: 'I think it's a poor way to be managing the health service.

'Doctors and nurses already work incredibly long hours. I have a friend who is a doctor. As a junior doctor he worked 20 hours a week.

'This new financial incentive is degrading to the profession. It's an old fashioned approach to managing an organisation.'

Despite the criticism, health chiefs at the Countess have welcomed being involved in the government initiative.

Professor Paul Edwards, deputy clinical director of surgical services at the Countess, said the fee-for-service scheme will operate in the hospital's general surgery speciality.

'The hospital's pilot scheme will also feature an innovative team-based incentive recognising that most operations involve not just the surgeon but also other professions and staff including specialist nurses, junior doctors, anaesthetists, theatres staff, and radiology services,' he said.

'Our aim will be to maximise the productivity of general surgical sub-specialities through the development and achievement of objectives that have the backing of the whole team and which will make the best use of the resources that are currently available.

'Increased performance will be rewarded with an incentive payment to the team, which can be used for staff education, re-search, extra equipment and in a variety of ways to improve surgical services as a whole.

'It will also empower clinicians to move their service forward and make changes that will ultimately benefit their patients.

'The pilot project will include the monitoring of clinical outcomes to ensure that not only are we treating more people but the quality of these services is also maintained and, indeed, improved.'

He added: 'Generally, we see this initiative as a positive way in which surgical services can be developed and more patients can be seen and treated here at the Countess.'