A bonus scheme for top doctors which costs Scotland tens of millions of pounds each year should be scrapped, according the Health Secretary.
Nicola Sturgeon has written to Prime Minister Gordon Brown and Health Ministers in England, Wales and Northern Ireland, urging them to replace distinction awards for consultants with a scheme which recognises the achievements of all NHS staff.
The current system costs Scotland £28 million each year but the Scottish Government wants to freeze the bonus budget this year.
The scheme has been in place since the creation of the NHS 60 years ago, but Ms Sturgeon insisted it was no longer effective.
She said: "The NHS now works in very different ways, with a completely different skill mix from that of the past.
"It is important that we recognise and reward the high level of talent that we have in the workforce but that we do so in a fair and cost-effective way.
"The existing schemes are outdated and do little to create a drive for excellence throughout the clinical teams we have now and which we would wish to encourage further. They are, therefore, in need of change."
The awards costs taxpayers more than £350 million across the Scotland, England and Wales every year.
Ms Sturgeon said Scotland wanted to freeze it's bonus budget, but that the move would need to be undertaken by all four UK countries to avoid one gaining a recruitment advantage over any other.
She added: "We are in a difficult financial climate at present and the pay of already highly paid NHS staff should not be increased."
Under the current system, consultants can receive bonuses of up to £75,000. Figures show around half of Scotland's consultants retire when they get the awards.
Ms Sturgeon has also written to the chair of the Doctors' And Dentists' Review Body, Ron Amy, saying there should be no increase in the bonuses in Scotland in the coming year.
She told him a freeze was necessary to reflect the "difficult financial situation for public finances in general".
