Posted by: Editor's Blog21 November 2012
As astonishing claims about general practice go, it's right up there with David Cameron’s talk of dinner party cliques and NHS Commissioning Board chair Professor Malcolm Grant’s infamous golf-playing jibe.
Can the Department of Health really believe - as it argued in its evidence to the doctors’ pay review body yesterday - that GPs are happier than ever and maintaining their net income?
The immediate response from furious GPs - many of whom logged on to the PulseToday website late yesterday evening to read all about how happy they are after an exhausting 11- or 12-hour day - was to demand the evidence for such a claim. But this was the DH's evidence, and it presented some numbers to back up its claim.
Happiness was based on the National Primary Care Research and Development Centre’s Sixth National Work Life Survey, published in June 2011 and looking at an increase in job satisfaction from 2008 to 2010. The DH acknowledged that these figures are somewhat dated, and has commissioned Manchester University to undertake a ‘GP National Work Life Survey’. But results for that will not be available before next summer, and in the meantime the DH insisted that the 2011 study ‘remains the most up to date comparable evidence in measuring GP satisfaction’.
As far as a steady income? Well, the DH revealed ‘current departmental estimates’ show that since the last official figures from the NHS Information Centre - which showed that GP net income had fallen for five consecutive years - the trend has somehow been arrested. It projected that average GP partner net earnings, which were £107,700 in 2010/11, remained at exactly that in both 2011/12 and 2012/13.
Quite what the basis for these estimates is isn’t clear, but certainly such findings don't tally with what medical accountants have reported.
Statistics, of course, can prove whatever you want them too - but whatever outrage GPs may feel at the DH’s outlandish claims should be tempered by an understanding of the wider political context. The key point about the DH recommendations to the DDRB yesterday is that they didn't actually make any recommendation on uplift, instead warning they would do so only after further negotiations with the BMA on the far-reaching proposed changes to the GP contract.
The DH reiterated its threat that the 1.5% uplift attached to those proposed changes currently on the table may be removed if the GPC doesn't sign up to the changes in the interim – and it has already said it won’t. Yesterday's determinedly upbeat assessment of GP pay and morale perfectly paves the way for the DH to tell the DDRB in February that no uplift at all is required, should it be so minded.
Viewed in this light then, the DH’s portrayal of a happy, well-remuneated profession skipping their way through a 41-hour working week is pure politics, and very effective politics at that.
There was frustration too from readers last night at the GPC, with the widespread perception so far that in this contract dispute it is the DH who has made all the running. Shortly the DH will publish its Statement of Financial Entitlements, paving the way for an imposed deal - and then, we are told, the GPC will respond.
Steve Nowottny is the editor of Pulse. You can follow him on Twitter at @stevenowottny.