The way GP expenses are calculated should be radically overhauled as practice pay is failing to keep pace with rising costs, says the BMA.
In its official submission to the Doctors and Dentists Review Board for this year, the BMA argues that new expenses around CQC registration, revalidation and an increase in staff pay mean that the pay review body should reform the current ‘uplift formula’ used for calculating the rise in funding they recommend for practices.
The Government has asked the DDRB to exclude GPs from its recommendations on doctors’ pay this year, but any change in the formula could affect negotiations in future years.
In August, former health secretary Andrew Lansley wrote to the pay body to say that any decisions on pay would be taken in negotiations with the GPC. The BMA has asked for GPs to be restored to the DDRB process as it was unfair they were treated differently from their colleagues.
The DDRB can choose to include GPs in its recommendations for any potential pay increase. However, the Department of Health can choose to ignore recommendations if it so wishes.
The BMA’s submission says: ‘We believe that GPs should expect to be treated fairly and in line with other doctors in the NHS, so that in this instance they receive the same increase as the rest of the profession in their take home net pay.’
To do this, the funding formula must be revised, it adds.
‘The formula used by the DDRB for calculating GP pay uplifts needs revising in light of evidence that gross and net GP earnings have failed to keep pace with inflation and rising staff costs.’
The BMA claims that the ratio of expenses to take-home pay has increased significantly in recent years.
‘On the subject of the review body’s uplift formula, while we believe this was an acceptable method of generating a gross earnings increase when the review body was able to make its own recommendations, we now believe the formula may need revision with the Government’s imposition of a pay freeze and now a 1% cap, as well as new expenses around revalidation and CQC registration,’ it adds.
It also drew the review body’s attention to premises, which is to be a ‘major issue’ in coming years, it says.
‘The share of premises in total expenses has continued to rise faster than general inflation. While much of these are directly reimbursed… we have a very real concern that GPs will be unable to invest adequately in premises to be able to deliver additional work, for instance that previously provided in an acute hospital setting,’ the BMA’s submission adds.
Dr Mark Porter, BMA chair, said: ‘There is a growing fear that medical students and doctors are being deterred from seeking a career in academic medicine because of the continuing pay gap with NHS work.
‘The BMA’s evidence to the DDRB outlines a number of ways these problems can be addressed, from a revision of the formula used to agree GP pay uplifts to specific allowances for junior doctors.
‘It is vital that the DDRB recognises that we need a fair approach to pay in the years ahead that recognises the enormous pressure that doctors are operating under.’
