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BMA criticises decision to cut GP trainee pay

The BMA has said that Government plans to cut the pay of GP trainees by 31% threatens to worsen the current recruitment crisis.

In its submission to the Review Body on Doctors’ and Dentists’ Remuneration, published on Friday, the BMA said that the plans to reduce GP trainees’ pay to match those of hospital specialty trainees amounts to ‘a considerable reduction in salary’ for GP trainees.

The submission said that the move could exacerbate recruitment problems for GP trainees, adding that the Government’s target for 50% of medical students to choose general practice is already ‘ambitious in the current climate’.

The DDRB is reviewing proposals for a new consultant and doctors in training contract, which would create a single contract for all trainee doctors, after negotiations between the BMA and the Government broke down in October. It is expected to report its conclusions to the Government in the summer.

The news comes as the latest warning over GP training numbers was issued before Christmas, when figures obtained by the GPC indicated there was only ‘one applicant for every four’ training places in the northeast of England for the August 2015 intake.

Issuing its warning over the training supplement, the BMA said: ‘This is likely to result in medical graduates continuing to predominantly opt for hospital specialty training posts, leaving general practice with the substantial recruitment and retention problems it is currently facing. About 400 GP training posts were unfilled this year.

‘For many trainees who are seriously considering general practice, this kind of relative pay cut could prove to be a huge disincentive. Those with fixed family or financial commitments could find themselves unable to pursue careers in general practice due to the financial burden of a substantially reduced salary.’

It added that ‘anything that negatively impacts on medical graduates choosing GP training could exacerbate existing workforce shortage’.

In the submission the BMA also warned against rolling out seven-day working across the NHS - a key sticking point in negotiations - for political rather than clinical reasons, and without a credible plan for how a seven-day service could be safely staffed without patient service cutbacks.

BMA chair Dr Mark Porter said: ‘The BMA has been clear in its support for better seven-day services, but the Government needs to be clear about what an expansion of services will look like and, crucially, how it can be safely staffed and resourced, without existing services being scaled back… We hope that, in its submission, the Government has provided the detail, evidence and modelling on the changes it wants to introduce, which it failed to produce throughout negotiations.

‘This includes detail on what additional services it wants to make available, how much they will cost to deliver and guarantees on what support services need to be in place to provide them safely. Without this detail, we are being asked to sign up in the dark to changes without knowing how patient care and doctors’ working lives will be affected - something the BMA cannot do.’

Readers' comments (54)

  • Took Early Retirement

    How funny! A critical shortage of GPs and someone is actually thinking of reducing their pay!
    Funny old world, innit?

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  • Hidden agenda behind all of this mess?! Surely not!............

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  • WTF... I'm a GP trainee with a family and mortgage. If this happens I'll resign on the spot and go back to an easier and more well paid job in hospital where I don't have boundless responsibility. I simply can't afford the hit, especially when my OH is a GP already so is having pay shafted as well. Insanity.

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  • "happy new year" Tory style. Cretins.

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  • Vinci Ho

    You see , Harvey Dent said whatever he said about 5 years forward plan but then you have this crap in reality . Two-faced really .......

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  • Bane: It doesn’t matter who we are, what matters is our plan.

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  • Una Coales. Retired NHS GP.

    The BMA issues a warning to government. Is that all?

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  • Recently a very senior GP Partner was overheard saying
    "if Department of Health imposes a contractual requirement for all GPs to dance naked for one hour in front of their surgeries ,the only plea that BMA GPC will take would be that they should be allowed to cover their genitals with leaves as it may offend some patients."

    I remarked they would surely go on strike ......?

    "No chance my friend" he turned towards me and with a sparkle in his eye whispered "even if they strike the turn out will be only 21 percent as most of GPs would argue that they cant strike as patient services would suffer and Daily Mail would be really upset and one hour of dancing is good for health any way and may be a new QOF for this will bring much needed extra funding for patient care "

    sorry if any one finds it offensive please report to 111 who would send an emergency ambulance ,after all they get paid more dealing with per patient than you moron GPs.

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  • My god they hate GPs

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  • I think this is a step towards a total take-over of general practice by hospital trusts. There will be training schemes run by the hospital across both general practice and hospital jobs such as AE. This will continue into general practice or " community services" run as part of the outreach hospital.
    The aim is to have the doctors interchangeable and make some become hospital based gPs.

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  • I want to get back in to hospital medicine, but as they are trying to eliminate progression pay I stand I lose literally tens of thousands over the course of the 5 or 6 years r would take me to train if I do this. I now feel trapped :( I feel as if I'm living in a nightmare. Oh I am - Cameron's Britain 2015. #cameronmustgo

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  • Secure environments GP

    The BMA needs to do more than politely asking the band on The Titanic to put down violins. Would they mind awfully re-arranging and tying down the deck chairs instead? This will make Captain Hunt very happy. He has issued a "stern warning" stating that a rapid unplanned "movement" will be unpopular with the wealthy and those of social prestige.

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  • I struggle to understand what this government is up to. It is well established that countries with strong primary care systems provide better care for less money and when patients go direct to specialists it costs more and more harm is done.

    If this story is true, then I ask why are the Tories trying to destroy general practice? Either there is a hidden agenda - increase the UK net spend on health and privatise = massive profits for some at the expense of all - or it looks like gross miss-judgement.... any ideas?

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  • Easy, the pot of money is going to remain the same, it's not going to increase, therefore to increase the number of trainees the pay has to reduce. Well done rcgp , good successful campaign for more trainees

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  • 31% pay cut. Sounds familiar to partnerships ? All incremental steps towards a lower paid Salaried Service. Master plan is on course whilst the RCGP and BMA say "it's jolly awful".

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  • even if this is the most awful sounding news, it must be a part of a bigger plan, we still havent arrived at the A-HA moment, If anything the BAPIO challenge has achieved, it is awareness that for Overseas trained doctors GP training is not the best option, hence the difficulties in recruitment. Local Graduates too are shying away from the GP training due to changes post GP training. The Ploy currently is Confuse the masses and please the classes.

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  • If the CSA could be sorted out so that it would be constitutional other democratic countries (recordings & two examiners - currently not permitted) this would be a start.

    If the eportfolio was sorted out too that would be help.

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  • Took Early Retirement

    Agree- e-portfolio is a nightmare and the main thing that stopped wife and I being trainers

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  • The UK has £trillions of debt

    The NHS does not make any money. In fact it costs the Government huge sums. When Doctors are successful people live longer, post retirement, to develop yet more problems that need to be treated and higher social care and state pension (even higher than the NHS) costs. So, as far as Her Majesty's Government is concerned, Doctors are a huge problem, but of course they can never say this. From a purely economic point of view the Government would prefer everyone to die the moment they stop earning GDP!! In fact the only health care that makes sense from an economic point of view is to keep people well enough to keep earning GDP.

    Given the above, the present action by our Government makes perfect sense.

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  • Dr Richard Smith, past editor of the BMJ, seems to be making a start on the cull, to reduce HMG 's pension and NHS costs..

    http://www.dailymail.co.uk/news/article-2893367/Cancer-best-way-die-allows-people-time-say-goodbye-loved-ones-says-leading-doctor.html

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  • sorry but BMA part of problem rather than constant warnings - why not some credible plans?

    how long do we have to wait before we can start looking at alternative models?

    the RCGP have already suggested one model i.e. total salaried service - fair play that they have suggested it.

    but why do we only have a choice of the current contract vs total salaried model? why can't we debate anything else?

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  • BMA warning the government,,,,ooo how frightening, I can see those claws out and teeth bared and gnashing..... the governement is still laughing. So is BMA a joke?

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  • its clear what the govt want - to prepare future registrars for salaried job on 50k.

    The heroic BMa of course are going to stop that with a stern "warning"....

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  • So who is prepared to strike?

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  • Excellent way to let undecided doctors know how well -paid GPSTRs are. Genious ,mmmmmmmuuuuuuaaaahhhh

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  • yes interchangable doctors would be my master plan. pay the btards 40k a year and work them to the bone.
    who is going to stop me? Clarkson?

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  • Why do people keep talking about striking. Boycott the out-of-area sheme, F&FT, CQC inspections and any other hairbrained scheme that Jeremy thinks up. OK it may cost a bit of money but with a General Election coming up Jeremy is going to look even more stupid than he is and the patients will immediately get an improved service.

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  • good god. madness frankly. If i was cynical i think i might suggest that it was all a scheme to end general practice. And really, a "warning" from the BMA. That has to be about as scary as a not scary thing with a degree in how not to be scary from fright university (to misquote blackadder). We are all doomed to either work for tesco. But obviously i am not cynical...........

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  • Can anyone tell me why GP trainees should be paid 31% more than their hospital equivalents ..?

    The recruitment crisis is just as deep, if not even worse, in specialty medicine, so that's not a reason.

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  • The BMA news review had a winning entry by Dr Sassa.
    She worked 4 days and nights with 4 hours sleep and started a meltdown which was stopped by a cup of tea.
    If this happened in a 3rd world country, there would be a hue and cry.
    The EWTD put a stop to that,but if it was left to the BMA the juniors would still be doing it because they DO NOT care about their workforce.
    I have done 800 such weeekends.
    Do you know any one any where that does 4 days and nights without sleep ? Only members of the BMA.
    That is the measure of our Union.
    Judges still pay 3% in pension, ours has gone up to 14% and 28% for GPs.
    A solicitor firm made almost 3 million last year from legal aid and many barristers made 1 million plus.
    Perhaps we should all join the Lawyer's Union. The BMA will never DO anything, only point out to us lackeys how bad everything is. As if we did not know already.
    Hopefully, the whole of GP land will collapse and we may have to negotiate.
    I think we forget they need us more than we need them.
    We need to resign en masse from the NHS.
    Well, GPC/ BMA ?

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  • A Barrister I spoke to earned £1.3million last year, mostly through legal mediation not too contentious work.

    He basically called us doctors "mugs" for putting up with this as skilled professionals "saving lives". I told him how much I earned after tax and that a work 12 hour days etc. He said he spent that much on holidays in the last 18 months....

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  • Una Coales. Retired NHS GP.

    http://bma.org.uk/membership/bma-subscriptions

    If your trade union is not performing, then why pay them £443 of your hard-earned wages? Just saying.

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  • Anonymous | Work for health provider | 05 January 2015 4:44pm

    The 45% banding was originally a nationally agreed number to try and encourage doctors to enter GP training.

    the GP recrutiment crisis is worse, and more damaging to the NHS than hospital ones.

    From my personal opinion the GP registrar job has more responsiblilty involved than a hospital reg.

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  • @ Una Coales Sessional/Locum GP | 05 January 2015 6:18pm

    Dear Una
    I have cancelled my BMA membership with no regrets whatsoever. If many more did the same it might take notice of our anger.

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  • So how much longer ARE you going to put on with this crap?!?...

    (Spot on, Hasan!)

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  • I was thinking of applying to GP...but now not sure

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  • There are too many armchair Generals and resigners in this profession. If you want some action to be taken against the government then start by walking out of CCGs. You don't need the BMA to do this for you.

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  • Re Dr Browning comment 10.17 pm, brilliant, where would the government be without the GPs in CCGs?
    Of course, it would have been much better for us all to have refused to implement the changes to the nhs in the first place. I didn't want to say 'I told you so' but oh dear, I seem to have said it. And yes, the only people who get anywhere are the legal profession.

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  • 05 January 2015 9:57pm

    you should consider it -

    things to look forward to

    1) end of independent practice in less than 10 years - announced by our own leaders and actively pursued by RCGP
    2) 24 / 7 day working on a rota without no OOH increment
    3) end of EWTD so you can do 80 hr / week
    4) full responsibility for your patients even if you are not involved in their care eg if they have seen PAs
    5) guilty until proven innocent (and you will have to prove yourself innocent) on any issue - including if you don't look right or malicious accusations
    6) pay at 54 k a year
    7) increased pension contribution to 25%
    8) retirement at 70 years of age
    9) increased MDU, GMC, RCGP, BMA fees
    10) internal cover to reduce locum costs at no compensation to yourself

    there are loads of other benefits too!

    sign up now.

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  • without cutting Gp Trainees pay to put them off;NHS policies of imposing non cost effective and harmful to patients(from widespread Expert Opinion),GP and Medicine is ot the profession to take nowadays.You could be called to GMC for sulphonamide induced hypos through arresting Traffic officers ,who have glucose testing strips but GPs are not allowed to precribe of Oral Antidiabetic medication having patients.It is nit worth being a GP in todays world in the UK

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  • Anonymous | Salaried GP | 06 January 2015 7:24pm

    That was some list..I've signed up to Pulse to consider GP. Maybe I'll do histopath or something, 9 months to see a positive change

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  • 06 January 2015 7:24pm

    there is a global shortage of doctors

    look at usmle for US, australia, new zealand, canada, singapore, and the middle east .

    do a google search for jobs for doctors abroad - there are loads.

    also check out the bmj careers fair in october.

    there are also resources on the net on career planning eg www.medicalcareers.nhs.uk/

    i think we will get clarity in may 2015 on what the likely future is ...

    good luck :)

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  • Junior doctor | 06 January 2015 9:54pm

    there is a global shortage of doctors

    look at usmle for US, australia, new zealand, canada, singapore, and the middle east .

    do a google search for jobs for doctors abroad - there are loads.

    also check out the bmj careers fair in october.

    there are also resources on the net on career planning eg www.medicalcareers.nhs.uk/

    i think we will get clarity in may 2015 on what the likely future is ...

    good luck :)

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  • second year mature medical student here..they keep saying to us 50% of us will be GPs... if this pay cut comes in by the time I have to decide on speciality then I dont think ill choose GP. I shall probably choose psychiatry or something else instead.

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  • 07 January 2015 10:43am

    Don't get me wrong - being a doctor is a wonderful thing and opens a lot of doors. The problem is we are not respected or treated fairly in the UK.

    do some internet research and you will find you have a lot of options but do you really want to get involved in a speciality that our leaders are trying to eliminate?

    It is really demoralising to constantly read negative articles in the press about your profession when all one tries to do is their best. Worst still is when our own leaders stick the knife into us.

    Do your research and think very carefully about career planning. The GP training scheme is good but then what? if we move as planned to a total salaried workforce pay and locum opportunities are going to be restrained - you may become trapped in a high risk low pay profession and a waste of your talent. As we become a more 'controlled' work force and lose independence our ability to innovate will go as well. As a salaried doc I have to do what I'm told - I may as well have been an accountant (with less regulation). I'm like others are looking for a way out.

    I note that 'those' who are calling for a salaried workforce are not willing to outline terms and conditions - that should be a warning to you.

    if i was in your shoes i would look at usmle and USA - pref florida or california.

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  • For being briliant at our jobs and alongside medical research and innovation, we now live longer but it costs the NHS a hell of lot to maintain this, but achieving this also it means pensioners draw their pensions for longer, and cost the state more when they all lose their memories and then go into homes!-and that's just the nhs staff! who have been pickling their brains just to cope with the emotional toll of their jobs and politically timed media crap that they have to face!

    But also. years of using the NHS as a football for political gain has finally sown the seeds of its destruction, using it as a tool to score points has driven up massive patient demand and expectation, and wasted billions on pointless management consultants, hospitals in the middle of nowhere that are now closed and white elephants like NPFIT,etc, etc.

    The country is £1Trillion+ in debt, things are NOT going to get any better, no matter what anyone says!
    Health is the 2nd biggest budget and is also the biggest employer! and what's the biggest cost in any service?

    I don't think its cynical to suggest that the destruction of primary care is deliberate! everyone knows (unless there are monstrously stupid politicians?) that 90% of patient encounters are in primary care, get that wrong, then the cost is borne elsewhere in the NHS/social system.

    So whilst the in North Eas it is likely they are going to fill ONLY15% of the GP training places available! the Govt wants to pull this trick out, this can only mean they want to deliberately ruin
    healthcare so as to reverse the nations health successes! meanwhile shafting the workforce so that we collapse before we see any of our diminishing pension!

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  • To the medical student considering psychiatry- don't bother.
    Although it was a fabulous career it is far too stressful nowadays and benefits no longer outweigh the risks.
    If a patient kills themselves the coroners court now look at whether you have breached their right to life and if you detain a patient you are breaching their right to liberty. Guilty families can now refer you to the GMC who do not understand nor care how dynamics can influence complaints.
    Add to that the generalized stigma you and your patients are under, a five year pay freeze and it becomes an unappealing long term career.

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  • Alison Glover

    for true rewarding general practice, with minor surgery, fracture management, palliative care, home visiting and a stable patient base come and work in New Zealand.. happy to help arrange short term trials if any one keen. Manchester trained 1988 and loving NZ.

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  • this is happening due to GP trainers colluding with unfair practices. They nodded and allowed the eportfolio to be used as a form of assessment. they nodded and were happy for the unfair CSA exam to continue despite having only 1 examiner, no access to your video footage and dubious feedback.These same GP trainers see a registrar as an opportunity to exploit someone for work and will b quite happy for them to do all the work, visits bloods etc and then when they fail a csa exam with actors they will happily condemn them in the educators notes eportfolio section (just to cover themselves). It is the dark reality. They also while voicing their concerns about trainees/patient safety will be quite happy to employ a nurse practitioner or a physicians assistant neither of whom have done the csa or akt. They dont have any worries about patient safety for nurse practitioners or physician assistants because they are cheaper to employ. and then moan they have a recruitment crisis.
    this problem was created by older greedy GPs. They have wrecked the future of younger GPs through their actions

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  • total unmitigated insanity.
    on top of the tsunami of unbelievable incredible stupidity from this sick failed disgusting repellent government...i would definitely support strike action...they are truly wrecking gp and nhs...time to viciously attack these utter *astards before they cause even more patient suffering by their callous incompetence...mind you i am not surprised after seeing how they treat people via their failed wasteful lickspittles like atos and nhse..caredata etc.callous inhumane and frankly evil.
    this government is hugely vulnerable on the nhs social care and esa..witness the suicides caused by the revolting atos failure..gps rcgp...if you genuinely care about patient care and gps..prove it now by a ruthless unrelenting attack and so contribute to the vital endeavour of utterly crushing this abortion of a misgovernment which in its inhumanity ,riding roughshod over democracy..2012..and frank corruption...is beneath contempt.

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