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At the heart of general practice since 1960

Profit squeeze leaves me with the BMA blues

The Department of Health's submission to the pay review body sounds fair enough in headline form.

So our Government will give GPs extra salary for additional work, but won't pay them more year on year for doing less - who can argue with that?

But our workload has gone up and up. We have had successive below-inflation rises in income and been squeezed on areas such as category M prescribing and dispensing allowances.

Despite the agreement we had in the new contract that new work would come with new resources, the QOF point allocation has been changed almost every year, so that the same money pays for additional work. And I estimate that I spend six hours each year checking the codes used by the QOF payment software, because the DH changes a few every year to try to reduce the amount of work it detects.

Are we getting the message across that GP practice income pays for utilities expenses (increasing rapidly), drug costs (increasing rapidly) and staff salaries, as well as GP take-home pay?

For the past couple of years, net profit has been squeezed harder and harder. Practices have made all the efficiency savings we can - they cannot be repeated. We have seen GP salaries start to decrease so that staff can have cost-of-living rises.

This cannot be sustained.

Who is going to explain to staff that profits are falling and that they will therefore have to share in the salary cuts? It will not be popular.

If the Government insists we cut our staff salaries, I think we should make it clear that we are being forced to do it, and the DH should take the flak.

I don't see top managers at the DH taking pay cuts. Is there no union for GPs willing to fight against this untrustworthy and malignant employer?

Dr David Church, Machynlleth, Powys

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