Talking Point: Should GPs work harder for their money?

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As controversy continues to circle proposed NHS reforms, we ask if the Government should do more to ensure we get full value for money from our family doctors, who on average earn £106,000 a year and receive annual pensions of £46,600. Interviews by Neil Hudson and Grant Woodward

Dr Ron Singer chairs the doctors’ section of the union Unite, which represents more than 100,000 health workers, “GPs’ practices are small businesses, contracted with the NHS to provide services, how they do that is up to them, within certain guidelines.

“The average length of day for a typical GP is between nine and 12 hours, this has increased significantly over the last five years.

“GPs pay a very high price in personal terms for their increased pension and income. As a group, doctors have the third highest suicide rate in the country. It’s not a job most doctors take lightly, most are conscientious and care about the decisions they make because they know they impact on people’s lives and have consequences for their families.

“They expect to see a large number of people in a relatively short time and to have to decide, in that 10 minutes, whether they have a serious illness or can be treated in a routine way. It is a huge responsibility.

“The BMA is considering industrial action short of a strike over proposed changes to the pension scheme, which four years ago was self funding – the Government wants GPs to pay more and get less.”

Katherine Murphy is chief executive of the Patients Association.

“The issue with GP pay is not about whether they deserve it, it is a question of variation. There are many committed and deeply concerned GPs who genuinely care for their patients.

“However, at the other end of the spectrum we hear from patients that there are a few GPs whose attitude towards patients is unacceptable.

“Patients deserve to be treated with respect and involved in all decisions about their care, yet some patients have told us they feel they are being treated as a nuisance.

“GPs who involve their patients in decisions about their care, go out of their way to ensure patients understand what is happening and receive the best care possible certainly deserve to be rewarded for their efforts.

“But still we see some GPs earning huge amounts of money while patient care suffers. Certainly high GP pay is a bitter pill to swallow for the patients who tell us that healthcare services have got worse in recent years.”

George Mudie, Labour MP for East Leeds said: “The old fashioned idea that we treasured of local doctors being very close to their patients and being able to be seen by patients at the drop of a hat, is sadly no more. We miss that.

“Under the last government, doctors’ salaries shot up but there was no real pay-off for the general public, which I think was a huge missed opportunity. While their wages went up, we didn’t really get anything in return.

“Doctors have very good salaries and very good working conditions, so we ought to have got a bit back for our money.

“The Government wants to turn GPs into business managers and there is a danger that the treatment of patients might be viewed on cost grounds as opposed to need.

“In terms of their pensions, I think there is a general principal worth upholding, which is that pensions are precious and people work hard for them and to have the Government come along at the last moment and say we are reforming them is unfair, it undermines people.”

Leeds GP Richard Vautrey is deputy chairman of the British Medical Association’s GP committee.

“People will always be able to see a doctor when they need urgent care and surgeries are increasingly open on an evening, but the bottom line is whether there are enough resources within the NHS to do everything that everybody would like to do.

“The health service is not like a supermarket, where the more people who walk through the door the greater the profit.

“The more people who are seen, whether it be by GPs or in hospitals, the more costly the service is to run.

“As taxpayers we all want to ensure the health service is as efficient as possible and delivers the highest care possible, but few of us want to pay larger amounts to expand the service.

“GPs’ pay is falling and has been since 2006. Over the last three or four years there has been a 10 per cent drop in GP income. There is no sign on the horizon that is going to change.

“The brightest and best in schools and universities are looking at alternative careers to medicine. We need to ensure medicine continues to attract the best people to be doctors in the future.”

Professor Ian Kirkpatrick is director of Leeds Social Science Institute, part of the University of Leeds.

“People have a right to demand better service from the NHS but whether that means calling on GPs to work longer hours, I don’t know.

“GP contracts were renegotiated fairly recently rather favourably – the BMA is the only organisation to have gone to the Government and come away with more than it asked for.

“Part of the proposed reforms would see GPs taking on the role of commissioning services, which is fine but the speed at which the Government wants this to happen is perhaps too quick. They are talking about handing 80 per cent of the NHS budget over to GPs within 12 months.

“Ministers argue this will bring cost savings and better service. This is not proven, If anything, judging by oversees models, it could increase administration costs – in the US, administration and contract costs are significantly higher than in the NHS.

“In terms of overheads, the NHS is among the cheapest in the world and people are generally satisfied with it. The claim that the reforms will increase choice is open to question and so too is the idea that having more choice means better services.”

FACTFILE

The average pay of GPs now stands at just under £106,000, but figures vary due to the fact that some work as salaried GPs while others operate as partners within a practice.

Their pensions are based on their average earnings throughout their careers – not their final salaries, as with most other NHS workers including consultants.

The average male family doctor retiring at 60 receives an annual pension of £46,600 – compared with a public sector average of £7,541.

Reforms to the NHS under Tony Blair introduced new GPs’ contracts that meant they were no longer required to work unsociable hours, such as at weekends.

The Government has now said it wants to change the pension schemes of all doctors so that they contribute more from their salaries into the pots and retire later.

In January the British Medical Association officially rejected these plans and threatened to take industrial action.

According to the BMA’s latest available figures, a typical GP partner running a practice on a national contract earned £95,900 in 2008-9.

The average pay for a salaried GP stood at £57,300 – and the organisation says those figures have dropped in recent years.

Stewart Jefferson.

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