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Don't fall into the trap of confusing GPs' income with profit

I was disappointed to read one of the headlines in Dr Sam Everington's recent guest editor issue of Pulse 'GPs divided on reinvesting profits' ( news). The article itself was more accurate, but was clearly talking about the balance of GP take-home pay and practice expenses, rather than reinvestment.

This is about how one divides the gross NHS income, not the profit. It has been a dirty example of Government spin to deliberately confuse profit (gross income minus expenses, but before tax) with gross NHS income, as if all the income we receive is profit unless we altruistically decide to reinvest it. I have even seen examples of gross income being called profit to illustrate how GPs have become 'fat cats'.

I was disappointed to see Pulse collude with this deliberate mistake.

If expenses are truly an investment (and some are) then the investment will pay off and profitability will actually rise in the long run. However, most expenses are necessarily incurred. There are hundreds of factors that affect expenses and by no means are they all linked with quality of patient care. Low expenses are not necessarily a marker for poor quality but rather a genuine marker for good business acumen. The same GPs that can organise money well will probably deliver quality care with the same skill. We need research to find out for sure.

So, should GPs publish their accounts, as Dr Michael Dixon asks in the same issue (

Yes - if you are going to use the data to research into any link between profit and quality.

The result might be in either direction, but I expect you would not find a statistically significant link. But we should not publish our accounts if the rabble are just going to use the figures to raise their eyebrows.

From Dr Jeffrey Cotterill, Rugby, Warwickshire

I think Dr Dixon has been sucked into the maelstrom of GP misrepresentation. He is not to be blamed as the media are experts at manipulation.

GPs are independent contractors. Once the monies have left the primary care organisation, the NHS has no further accountability for the finance. GPs are accountable for the service they provide within the GMS/PMS contract, not how much it costs them individually.

From Dr Rob Colebrook, Acharacle, Argyll

Don't fall into trap of confusing GPs' income with profit

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