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Not a pay cap – just an incentive to invest

Ministers believe GPs should be 'incentivised' to invest a larger share of their income in their practices, rather than face pay caps, Pulse has learned.

Sources close to ministers say Health Secretary Patricia Hewitt's comments to the BBC, where she was reported to have called for a GP pay cap, were misrepresented.

They told Pulse ministers were considering proposing an 'incentivised mechanism' to bring practice investment back to pre-contract levels.

But the Department of Health is understood to recognise that any such move would have to be negotiated.

In January Health Secretary Patricia Hewitt was reported by the BBC as saying the Government should have capped the money GPs can make out of the GMS contract as media reports put average GP pay at above £100,000.

She said: 'I think if we

anticipated this business of GPs taking a higher share of income in profits we would have wanted to do something to try to

ensure the ratio of profits to the total income stayed the same and therefore more money was invested in even better services for patients.'

NHS figures show the proportion of gross earnings GPs took in profits rose from 40 per cent in 2003/4 to 45 per cent in 2004/5.

But Dr Peter Fellows, a GP in Lydney, Gloucestershire, thought GPs were already investing enough in their practices. 'I would far rather the Government picked up the tab for all expenses and paid me a decent salary as a consultant,' he said.

'There's no way the Government is going to force any more investment. We invest what's

required in practices and we

invest far more than the health service is investing in other branches.'

Dr Peter Holden, GPC negotiator, said ministers had to

realise that GPs would want longer periods of stability between GMS contract renegotiations before they would want to risk investing more in their practices. He said: 'Why should I pour money into it when I don't know if I will have a contract in four years' time?

'If you chop me off after three years I'm going to be left holding depreciated assets that haven't got a market. What the Government has done is produce an ice age where nothing's going to happen.'

Dr Holden said GPs would be more open to investing if they had guaranteed contractual

stability and that this could bring about other savings for the NHS.

He added that the Government needed to appreciate that GPs were in a different position from larger firms where insolvency did not have such direct personal consequences: 'If I get it wrong, they have my house – they have the shirt off my back.'

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'If you will guarantee me a contract subject to meeting proper quality standards to deliver service X over 10 years, it's going to be a cheaper contract per patient treated than one for three years,' he said.

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