GPs paid just £68 an hour for commissioning work

Too much if you ask me. It's not like they are seeing patients.
Max should be 15 pounds per hour. And that's generous. All commissioners will be doing is follwoing national guidelines. anon

No wonder the practices try it on and offer £30/hr locum rates locum

Pay peanuts - get monkeys... if the Government wants the brains of the medical profession to lead commissioning and the practices want good locums to provide backfill then these rates can only be regarded as insulting. How much were all the management consultants and others involved in the PBC fiasco being paid - a lot more than £67.50/hr I suspect. I was costed out at £600/day by my former practice to cover my absence on a PCT project and I still went back to do my own admin after a full day's work at the PCT. locumdoc

Tell it like it is please. £67.50 per hour means £540 for an 8 hour day. The working year (excluding weekends, bank holidays and annual leave is 220 days, so this equates to an annual salary of £118,800). Hardly puts you on the breadline, does it? And "reading time" of £25 per hour? Who else in the real world gets paid for that?! Exasperated

Can anyone advise what the £68 covers ? I know that some part time lecturing rates seem high but they include prep and travelling. PCT Manager

Dear Exasperated, try getting a locum for less than £75 per hour to cover the lost GP time. Once again we will be self funding the loss. And why you are at it try finding a solicitor, accountant etc etc who works for £67.50 an hour. BurntOut GP

Doesn't seem unreasonable to me. Other businesses and professions do not get paid that much. In response to the comment above re accountants and solicitors, these professions only get paid for time working on clients affairs. They get nothing for the time spent administrating and running their business, lecturing, presenting and networking and participating in local chamber groups etc, all seen as ancilliary activities essential to bring in work. Doctors are just being asked to take responsibility for administering their own businesses and consortia rather than have everything handed to them on a plate. They have had it too good for too long and should be grateful they are being paid at all. Anon

It seems rather obvious, but if you need to pay someone to do something when they have a full time job doing something else and you then have to pay for a locum as well, that is a crazy waste of money Andrea Franks

I appreciate it sounds frustratingly high but actually the money doesn't go directly to the GP, it (mainly) goes to make sure that the patients who the GP isn't seeing is still cared for. So the GP isn't getting any extra; the issue is that GPs here are being expected to do this work not just for free but at a cost. local GP

Dear Anon from London:
<p>
£15/hr is enough for commissioning work. But who will see the patients waiting in your surgery during that time? Do you think any locum doctor will see patients for that rate?!?! Thenramizh Aendhal Irumporrai

Dear Burntout GP, you are not working as a solicitor nor an accountant so why expect to be paid similarly? You are indeed a GP but are workinig as a commissioner, I am a commissioner my hourly rate for the hours I work equates to £22.70/hr.
<p>
I would suggest that I have greater experience, am better trained more competent and skilled at commissioning than you. My question would be why would you expect to be paid nearly 3 times as much. Where is the VFM?
<p>
Ps I would stick to being a GP it's much better rewarded. PCT Manager #2

Dear Sir / Madam,
<p>
What a dilemma! Mr Lansley wants to reduce costs and bring decision making closer to the patient, this example clearly demonstrates how ridiculous his plans are. For example; for the plans to work GPs could not possibly be paid the current locum rate, it would be hugely more expensive than the current situation, but why should GPs get paid less than the cost of the locum and have to shoulder the difference? Locumdoc, I agree that too many useless, overpaid consultants are used, but the NHS managers you refer to are typically paid significantly less than £68 per hour. Bearing in mind that some PCTs currently get about £36 per head of population to run themselves and GP consortia will have circa £9; this situation will only work if consortia are at least as big as the PCT they replace. This is because each one will need all the supporting fuctions (HR etc) and other roles, which will end up being duplicated. Mr Lansley, have you ever heard of the basic principle of 'Economies of Scale'? Most schoolchildren have! Additionally, based on the figures in the above article, GPs will have to have a minimal role, giving direction and then letting (less expensive) managers get on with the day to day nitty gritty and implemenation. One final point on the 'decisions closer to the patient' issue; Many influential GPs in consortia are also on the board of/co-own provider organisations, will this lead to patient-focused decisions, or profit-focused decisions? Well done Mr Lansley, a fundamentally flawed plan that will lead to more inefficiency, a questionable conflict of interests and a breakdown in the patient/GP relationship! Anon NHS Manager

Local GP - It doesn't just "sound frustratingly high" it is actually a colossal amount of money by the standards of 99% of the population. It is also two or three times higher than the current going rate for the job as performed by non-medics. I am the first to say that we need doctors involved in commissioing work, but not at any cost. Exasperated

Interesting that £67.50 is peanuts for a GP, but paying a highly qualified nurse practitioner less than £20 to organise clinics and diagnose and treat patients is deemed as generous! ANON

This is like reading the Daily Mail..... I don't want any additional pay I just want my locum costs reimbursed so I am not commissioning at a practice/personal finacial loss. BurntOut

Dear pct manager #2... I am afraid we can all see where your commissioning skills have got us. Most of your colleagues, and undoubtedly you will be an exception to the rule, can barely see beyond the end of their desks, let alone provide real vision and innovation... anon gp

If I took a day off work each week to do another job then I would not expect to continue to be paid for that day off by my original employer.
<p>
As practice income will not fall the money GPs are not now being paid for their 'day off' doing another job will be available to the practice for a locum.
<p>
Hence only area for rational debate relates to any differential between locum daily rates and their daily rates.
<p>
Or were GPs perhaps expecting to be paid twice by the taxpayer for the same period of time? anon

Anon, GPs aren't employed by the practice, they ae self employed. So if they take time off, they themselves have to pay someone else to take their place.
<p>
That point aside, in this part of the country I would see £69 as being quite reasonable as it's about the going rate for locums (though there'd still be the paperwork to do when u got back). Hazel Drury

This forum has been an eye opener as to how thick some NHS managers must be. BurntOut GP

Dear anon GP, in defence of pct manager#2; most commissioners (PCTs) are rendered next to useless by their senior managers who are busy protecting their counterparts at the local acute trust and far too timid to back up any imaginative idea from their managers. This situation has developed because each PCT typically has one acute trust in its area and a very unhealthy relationship develops. The PCT has very little power on this basis. PCTs needed to have 3 or 4 acute trusts in their area to prevent this and initiate some healthy competition. Unfortunately Mr Lansley is going the other way where a large number of consortia will have almost no power and Acute Trusts will use the opportunity to ride roughshod over them. PS: National rules on commissioning do not help either and these are not changing in any significant way. Anon NHS Manager