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It’s time to discuss how much we earn

Dr Shaba Nabi

Despite having been born and raised in Essex, I have a somewhat bird’s eye view of Western culture as I am the child of an immigrant. This gives me the ability to muse over certain idiosyncrasies of the British – a peculiar one being a reluctance to discuss our earnings. I suggest any of you who are squeamish about this should now swap your copy of Pulse for Fifty Shades of Grey, and continue living happily in fantasy land.

So why am I discussing money so openly? Am I empowered by the BBC publishing the pay of its top earners, thereby exposing the gender pay gap? Surely I should be grateful for belonging to the top-earning quintile in the country? The answer is depressingly simple – a permanent GP practice role no longer pays.

Endless work has to be shoehorned into our days, which is not matched by the pitiful rises in funding per head we have been offered in recent years. This has a direct impact on salaried GP pay, because partners simply can’t afford to pay them more than they pay themselves. As the days get longer, we all take a pay cut by stealth, because it is far too vulgar to be paid by activity as opposed to a block contract.

Amid the spiralling workload and austerity, there is nothing like an indemnity crisis to focus the mind on what we are actually earning. In July I experienced a 40% hike in indemnity fees, leaving me with an hourly rate of just £25.50 before tax. I can assure you it wasn’t much more than this as a partner because of the endless management hours. This is significantly less than half the hourly rate for any other GP career choice: locum work, out of hours, education, commissioning, appraisal and medical politics. In fact, some of my non-clinical roles offer me more than three times this hourly rate.

So is it any wonder GPs are now choosing to RELP – retire, emigrate, locum or portfolio? Clearly, I have opted for the latter because the portfolio aspect not only nourishes me, but also offers me a fatter pay cheque. I do not wish to stop my salaried role as I value the continuity and training aspects, but I keep it to a minimum so that the majority of my income comes from other sources.

How did we end up in this dire situation where coalface general practice – easily the most demanding and emotionally draining of the roles – pays so little in comparison to all others? This insulting hourly rate (can’t wait for a Daily Mail reporter to get hold of that line!) speaks volumes about our self-worth and the price we put on the most challenging aspect of our role – seeing patients.

So let’s stop trying to be martyrs and running away from openly discussing our pay for fear of giving a bad impression to the public and suffering reprisals. Talking money appears to be synonymous with blasphemy in the upper echelons of the GPC and RCGP – and this surely has to change.

I’d much prefer my patients to have a GP they envy rather than no GP at all but if the clinical exodus continues there will be none of us left to see.

Dr Shaba Nabi is a GP trainer in Bristol

 

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Readers' comments (27)

  • Thats yours after after deductions, but before tax, you can comfortably see 4-5 per hour......1% indemnity..... so I wonder how many GPs NHSE will persuade to come back.... my prediction.... only if the GP already needs to come back for family reasons.... there won't be anyone going back because of their campaign...

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  • Vinci Ho

    Think about our wonderful health secretary, folks:
    How much did he earn last year as total income and how much was his SOS salary constituting as a percentage of this total? Where would your main interest and attention lie if you were him?
    Sign of the times as I always said.

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  • David Banner

    One of the big deterrents in discussing income is the vast difference between partners in different surgeries. A well run, fully staffed, dispensing practice in a leafy suburb will see partners far better off then the poor souls trapped in a failing practice in an inner city slum, bereft of partners and relying on expensive locum/salaried GPs (if available) just to survive on a pittance (or face bankruptcy shelling out on redundancies and lease payments). For polar opposite reasons they would both want to keep schtum.

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  • Macdonalds medicine - where do you work in Australia? (I'm in the process of looking into options).

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  • I am not sure all GPs would agree.I know of atleast 3 GPs locally who only do 1 session a week but because they have fingers in many "extracurricular" pies are earning in excess of £200,000/yr.Those are the ones that torpedo the public relations exercise for the rest of us.

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  • 'Genuine thought' Im in Tasmania.....not too hot.... four seasons, good vineyards, its a med climate, you do get frosts in the winter but usually blue skies most days..... they can't build proper houses when it comes to insulation, and they've no idea about double glazing but I'll be building my own in time..... some of the clinics are old and need revamping, but you are you're own boss. I earned £5.5k GBP before tax last week, on exceptional weeks over £6k (08:30-6:00pm ish). If you like to work harder than average and do the odd evening or weekend on a regular basis on top of 10 sessions a week you can take your salary to around £300k on current exchange rates. A lot of doctors aim for about £180k and the easier life 4 day lifestyle. Taxes work out higher, but indemnity is cheaper, petrol is cheaper, cost of living a bit more expensive than UK but more than offset by higher income. We're looking at demographic data to see if we can get a few more DWS passed as quite a few GPs retiring around here next 1-3 yrs. Canada is also very much worth looking at - cars are a lot cheaper there .... here they are a little bit more expensive than UK, but some Japanese / korean brands can work out cheaper. Australia will be closing the doors soon. New Zealand is a great family friendly option. Tasmania is the 'new zealand' but of Australia that everyone overlooks. Just 3 species of snake here...one antivenom..... simples! Last deadly bite was in the 60s or 70s- no-one can quite remember

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  • No Nonsense.... what are the extracurricular pies that are so lucrative in the UK? Botox?Medicals? not many public funded posts that pay so well.

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  • I think one problem is that many people work hard or feel they work hard for a lot less money than GPs so public sympathy is thin. When the system collapses then some sympathy may surface.
    It is difficult to demonstrate to the public how hard and stressful GP work is.
    Following a whistle blowing exercise and NHSE/ CCG investigation lasting 6 months it is clear we are at risk from complaints, legal claims, GMC, PAG, CCG, NHSE, the media and our own personal stresses from working in an unsustainable work situation.
    No other profession has so many lines of oversight
    We must take action and control our work which is impossible under the current contract

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  • No nonsense
    re "I know of at least 3 GPs locally who only do 1 session a week but because they have fingers in many "extra-curricular" pies are earning in excess of £200,000/yr".

    Good for them. If that's what they have to do to get a proper rate for the highest qualified,most in-demand and most risky role in the UK rather than £6 per consult then so be it.

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  • "I know of at least 3 GPs locally who only do 1 session a week but because they have fingers in many "extra-curricular" pies are earning in excess of £200,000/yr"

    Did you actually read this article?? If they are earning more than you for what you perceive to be work you could do easily, why the hell are you moaning about it here? More Fool you?

    Everyone has a choice. If you dont feel you earn what you deserve, no one is chaining you to your role.

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