Thought you may find this of interest...

GPs surgeries are privately run business which contract themselves to the NHS. This model has been in place from the inception of the NHS as it was unfeasible to buy out every GP surgery in the country and nationalise them. Each surgery gets paid a per capita rate for each patient on their list, for providing certain services (immunisations , smears etc) and , since the introduction of the new contract in 2004, a proportion of income is related to achieving certain targets regarding patient care (eg achieving blood pressure control in patients with high blood pressure). After practice outgoings such as staff pay , equipment , building expenses etc have been taken off the remaining 'profits' are distributed between the GP partners who own the business.

So a few points :

In the past most GPs were partners who owned a stake in the practice but increasingly many GPs are employed directly by the practice on a fixed salary. Whilst GP Partners saw an initial rise in their income in the early 2000's as a result of the new contract the majority of salaried GPs earn a wage which is comparable with the lower rate of senior hospital doctor pay.Talk of GP earnings mostly focuses on the income or Partners who only account for about half of GPs.

The initial increases in pay as a result of the 2004 contract have largely been whittled away over the past 7 years through changes to the contract, freezing of pay and rising practice expenses. Most GP surgeries have seen substantial falls in their income over the past few years whilst facing a large increase in workload.

The changes in the GP contract in 2004 was meant to reflect the shift of work from secondary care (hospitals and consultants) to primary care(GP surgeries) and the change from treating acute conditions to managing chronic conditions within an aging population. It was felt that GPs were well placed to provide this care as effectively, more cheaply for the NHS and more conveniently for patients compared to the secondary care model. I believe that British GPs are the only doctors in the world paid partly on the basis of results in the improvement of care.

GPs provide non-emergency care. GPs used to be given just over 6000 pounds per year per GP for organising cover for out of hours emergency care. In 2004 the government felt that large private providers would be able to provide this service more effectively and cheaply (hah!).This money was taken away from GPs and given to the Private providers who soon found out that GPs had been subsidising the service for years out of their own pockets and they quickly demanded more money. Somehow this was seen as the fault of GPs.

It is difficult to compare the incomes of GPs in France and the UK as they operate under different systems and provide very different services. As far as I'm aware most French GPs operate in single-handed or small practices with a very small practice team and a list size of less than half that of a UK GP. They are also not responsible for the management of as many chronic conditions as in the UK .

GP partners income has also been inflated by a neat accountancy trick played at the time of the new contract. GPs , although technically not directly employed by the NHS , have been entitled to join the NHS pension scheme. In the past the employers contribution to this scheme was paid directly by the NHS as for other NHS employees. After the new contract this money was paid directly to practices where it appears as profits so inflating the apparent income of GPs. GP partners pay 22% of their income into their pensions.If you are in a pension scheme at work imagine being told by your boss that your pay had increased by 10% only to find they were just recalculating your salary to include their contribution to your pension. Now imagine they told you that, as your salary had just increased by 10% you weren't going to get a pay rise for the next 7 years.

Despite media suggestions to the contrary GPs today see more patients and spend longer with each patient than they ever have done in the past. Most GPs do not earn anything like the figures quoted in the newspapers and the very very few that do earn very large salaries are entrepeneurial businessmen who oversee the running of multiple practices staffed by nurses and salaried doctors.

It is quite apparent that there was a media campaign , run from the Department of Health since 2005 to discredit GPs and turn the public against us in a bid to have leverage in negotiating future contracts and to allow large private providers into the NHS. Unfortunately this has been largely successfull.

Posted By: Vivid Data Shark on June 20th 2012 at 23:36:01

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