HPV vaccine a step nearer
Larger gifts to GPs can be a problem in a way that small ones never are.
Dr Jim Sherifi recommends that all practices should have a policy on gifts
The presence of plastic conifers, illuminated Santas and sparkling baubles in the shops highlights the fact that Christmas is but two months away, leaving doctors with little time to plan how they are going to manage the annual input of liquid largesse from grateful patients.
Traditionally Christmas has indeed been the time of year when doctors and practice staff receive presents from a small but loyal fraction of their patient population.
Such gifts are usually of small value but welcome nevertheless for the thought that goes into them. Some, indeed, may be from professional colleagues such as opticians, chemists or funeral directors, in which case they are likely to be declared as a tax-deductible expense in your tax returns.
In principle, the taxman expects gifts, however small, to be declared in the individual doctor's tax return as a gift in kind and thus liable to taxation.
In practice the taxman recognises that the proportion of such gifts to the overall income of a GP principal is small, difficult to verify (how much is a bottle of wine?) and will thus not question their absence in the tax returns.
Apart from being a non-scientific poll of a doctor's popularity (or longevity), small gifts create little friction within a partnership. But what of much larger, more expensive gifts?
Being left a large sum of money, a car or even a house in a grateful patient's will is rare but can be a potentially life-changing event. It is the stuff of family doctor dreams. However, such gifts, if not handled carefully, can also raise issues on a number of levels that can turn the dream into a nightmare.
Problems may arise from the following quarters.
A general practice surgery is a hotbed of gossip. Staff have varying opinions on the doctors with whom they work. The recipient of a large gift may or may not be highly thought of. If the latter is the case, then
gossip is likely to be spiteful and tinged with envy. The atmosphere may become tainted.
Partnerships of doctors are essentially a business-based modus operandi for delivering primary care. While most, with luck,
operate on a social as well as a professional level, it would be naive to claim that there are never strains within that relationship. A large bequest to one doctor will inevitably create tensions by raising questions such as:
•Why did Dr A receive the bequest when Drs B C and D had also helped Mrs Z in the past? Should not the practice as a whole benefit from Mrs Z's generosity?
•If the partnership divides all the income and profits between all the partners, then should the same not happen with other forms of income such as large gifts?
The donor's family
Unfortunately, thanks to the lurid tales published almost weekly in the tabloids, doctors are no longer held in quite the unquestioning esteem that they were years ago. The public has always been suspicious of pecuniary involvement in medicine.
Mrs Z's family will be suspicious of why Dr A, rather than they, benefited from Mrs Z's estate. Legal challenges, lengthy, vexatious and costly, will be mounted. The case will undoubtedly be covered in the local and even national newspapers, creating intolerable pressures for Dr A.
HM Revenue and Customs
The taxman will most certainly be interested in large gifts, which will have to be declared and inevitably taxed at 40 per cent of their value. Likewise the disposal of assets such as property or shares that have gained value in excess of £8,500 (in 2005/6) in one year will be liable to capital gains tax, again at 40 per cent.
From the above, it can be seen a gift can turn into a poisoned chalice. Rather than deal with such situations reactively, it is advisable to have a practice policy. This should be as a clause within the practice agreement or a salaried doctor's contract which deals with gifts above a certain value.
Policy on gifts
In our own practice we have decided upon the following policy. Other than gifts of a personal nature whose value is less than £100, which may be kept by the intended recipient, all gifts – whether from patients, their relatives or representatives, or from any other source – must be made over to the practice.
Any gifts kept by individuals must be declared on the recipient's tax return.
Recipients of three or more gifts from a single source within 12 months must inform the practice manager.
Donors of gifts made over to the practice will be asked how they wish the practice to use their gift – for instance on a particular clinical service, staff training, improving or providing facilities for patients. If no preference is stated, the practice will make disbursements against equipment, training and so on, as it deems necessary.
High-value gifts or bequests are like winning the lottery. Ultimately the money is more likely to bring happiness when shared!Jim Sherifi is a GP in Sudbury, Suffolk