"Self congratulation": This refers not only to the MCA's traditionally generous self-assessments (e.g. in annual reports), but also to the extent to which CSM members are rewarded with titles (political honours)

Most website visitors will be unfamiliar with UK practice, which may seem strange, but the nub of it is this: CSM members are remunerated at rates far below commercial norms - almost token amounts in relation to the great amount amount of work some do. Partly by way of compensation, long-term and loyal service is rewarded through the Honours System. Honours bestow some social (class) advantage and would also tend to enhance opportunities for subsequent appointments and earnings. Some people decline honours, but they are intensely attractive to many others.

Honours such as those conferred on CSM members are notionally in the gift of H.M. The Queen, but in practice routed through The Prime Minister's office. The PM's Appointments Secretary can be reached at 10 Downing Street, London SW1 and is pleased to consider recommendations.

The pecking order is complex, but the mainstream non-hereditary awards include Peerages, Knights and more and less senior ranks linked to the (former) British Empire. Peers become members of the House of Lords, one of the UK's two legislative chambers. Examples:

Lord Doe of Nine Elms   (or Baronness Doe)
Sir John Doe    (or Lady Doe)
John/Jane Doe CBE       (Commander of the British Empire)
John/Jane Doe OBE     (Order of the British Empire)
John/Jane Doe MBE   (Member of the British Empire)

Of the 30 members of the CSM (1997), four are CBEs and three have OBEs - very high numbers for a Committee of this kind. All previous Chairmen have been awarded Knighthoods - but only at the end of their term of office. Professor Rawlins retires as Chairman at the end of 1998 and will be succeeded by Professor Alasdair Breckenridge CBE.

Levels of remuneration underline how unrewarding it may seem to CSM members to undertake additional tasks (eg correspondence with Social Audit).  For each meeting they attend, CSM members are entitled to claim a preparation fee of 60 and attendance fee of 100 (Chairman's fees 75 and 125 respectively). Travel and subsistence is also payable within Department of Health guidelines. 

Point for discussion: would medicines users benefit or not, if political awards were abolished and Committee members paid at levels commensurate with the work they do?