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Independents' Day

GP registrars' pay cut explained

Morale has been hit by the recent registrar pay cut and rising training costs, as Dr Andrew Perry explains

Morale has been hit by the recent registrar pay cut and rising training costs, as Dr Andrew Perry explains

While the pay freeze for qualified GPs attracted extensive press coverage, the registrar pay cut slipped through relatively unnoticed.

The Doctors and Dentists Review Body (DDRB) decided that from April 2007, those taking up GP registrar posts would receive a 55% banding allowance, instead of 65%.

For me, heading towards a final GP placement in December as a third-year senior house officer, this equates to an annual drop from about £48,430 to £45,496 – a whopping £244 less a month.

And this cut comes at a time, when registrars are facing other financial hurdles, including:

  • the recent car allowance loss of about £350 a month
  • ambiguity over how much the nMRCGP will cost
  • the £750 payable to the good old folk at PMETB (consider that even if it takes eight hours to assimilate our RITA/VTR sheets, this equates to the PMETB charging more than £90 per hour).

The price of training is rising more than ever before and registrars feel stuck in quicksand against this tide of increases.

A considerable sore point in this fiasco has been the lack of pay protection for doctors already on a vocational training scheme (VTS), but who have yet to sign a contract with a training practice for the GP registrar component of their training.

Unlike a rotational hospital post, the contracts on VTSs do not provide a fair system of pay protection. The DDRB is counting these doctors as 'new registrars' even though they are already on a three-year scheme.

The 65% banding was introduced as a recruitment incentive when the Department of Health was looking at GP shortages. But now that applicants far outnumber places, people who had already entered a VTS on an understanding of their levels of pay are discovering the cash isn't there.

Also unpopular with the registrars at present is the COGPED and how it has handled matters. As the announcement was made, advice was being issued that contracts already signed would be honoured at the 65% banding level. Deaneries were quick to act on this and rapidly contacted practices instructing them not to sign any contracts until after 1 April, with an alleged threat of refusing to pay any excess.

The deaneries have shown no interest in promoting or protecting the interests of its trainees – they seem merely interested in protecting their own financial situation.

Our hospital colleagues may scoff at our level of pay and point to the fact we GP registrars do fewer night shifts or weekends. But you would be hard pushed to find a registrar working less than 48 hours a week.

Many starting a registrar post will say they are more tired and exhausted moving from hospital to general practice; it's not the cushy life our secondary care colleagues may envisage. And hospital doctors should be on their guard – if the DDRB can squeeze through a banding pay cut for GP registrars, they could be next.

So what can we do? The ambivalent attitude displayed towards our profession would lead one to suspect that we will effect little change by complaining. Indeed, the efforts by the BMA to secure pay protection for doctors already on a VTS have been rejected.

Direct action, although appearing to some to be an option, is unlikely to serve our profession well. All this being said, to protect our futures and those of the registrars following us, we must do all that we can to highlight the issue. As individuals we should rally our MPs, deaneries and the BMA to address this unfair decision. Apathy is one sure way to let things like this happen again.

Dr Andrew Perry is a GP registrar in Sheffield


'We should rally MPs, deaneries and the BMA to address this unfair decision'

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