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Plans to cap earnings show an ignorance of contract mechanics, say GPs

By Helen Crump

Threats to cap GPs' earnings are 'nonsense', 'unworkable' and demonstrate an ignorance of the mechanics of the contract, GPs and medical accounts claim.

GPC negotiators said the comments by Health Secretary Patricia Hewitt last week were part of a Government campaign to soften up the public for a wider introduction of private providers.

Mrs Hewitt said in a BBC interview that the Government would have tried to stop GPs taking a larger share of practice income as profit if it had foreseen the pay rises they would earn.

She said: 'We'd have wanted to do something to ensure that the ratio to the total income stayed the same and therefore that more money was invested in better services for patients.'

Dr Barbara Hakin, lead negotiator on the GMS contract for NHS Employers, followed up by saying this was something it would look at in future negotiations. Both sides have furiously denied the move would equate to a pay 'cap'.

But GPs said that however it was dressed up, it would amount to the same thing.

Dr Stewart Drage, GPC negotiator and joint chief executive of Londonwide LMCs, said: 'They can't have it both ways. They can't say that GPs are the best example of independent and private practice in the country and then impose these sorts of restrictions.'

Dr Richard Vautrey, GPC negotiator and medical secretary of Leeds LMC, said Mrs Hewitt had showed how little she understood about GP's contracts.

Dr Vautrey said: 'There is a concerted campaign to denigrate the good image of GPs from various elements within the department. That's why there are so many stories about GPs, softening up the public so wider introduction of APMS providers is less contentious.'

Paul Kendall, senior medical partner at accountant Dodd and Co in Penrith, Cumbria, said limiting how much GPs could take as profit wouldn't work as every practice was different.

'If you're capping net income there's going to be no incentive to reduce costs and that will bring inefficiencies. '

Mr Kendall added: 'There's also a danger the Inland Revenue would look at GPs as employees and they could lose self-employed status.'

• Comment, page 84

What GPs are saying about the pay debacle

'Let's all stop QOF work, take a huge cut in income, and hand all chronic disease management back to PCTs. See how Mrs Hewitt feels then'

Dr Phil Brookes, Heaton,


'What we earn just isn't their business. Most of us do invest. There will be some who don't but there are ways of looking at that'

Dr Gary Sweeney, Clacton-on-Sea, Essex

'They put the money on the table and we're being paid because we're performing brilliantly – a cause for celebration'

Dr Mark Sanford-Wood, Barnstaple, Devon

'Our independent contractor and self employed status from the Revenue's point of view has been under threat for some time'

Dr Ian Jacobs, Reading

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