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At the heart of general practice since 1960

Are locums paid too much? No

Locums seem to make lots of money for little work, write Dr Weeks, but the tough aspects of a ‘freelance’ career have this year been made even less palatable by the impact of new costs

Locums are one of the most underrated parts of the GP workforce, a flexible and adaptable cohort that plugs the gaps in rotas at short notice and works in areas that struggle to attract GPs. They are trained to be resourceful and adept at managing risk.

To say they are overpaid fails to recognise the service they provide and, more importantly, ignores a succession of blows landed on them in the past year.

The first was the decision that, from last April, local health bodies would no longer fund locum pension contributions for those working at GMS practices, leaving practices to consume the cost. The BMA believes that practices should pay but, as Pulse reported, some locums have cut their fees (by as much as 8% to 11%) to cope.

The second blow arrived through the withdrawal of funding for locums’ appraisals (around £300 a year, again previously paid for by the local health body). It appeared that it was being quietly dropped across many areas of the country; NHS England took ‘til May to confirm this payment would be stopped nationwide. The DH seems to have ignored both the financial strain practices are under, and the possibility locums might cut their income to pay their fees themselves.

These changes have left locums possibly the biggest losers in general practice, in financial terms. Don’t be fooled into thinking that the odd advert offering an apparently high salary is the norm for locums – these are rare, often for jobs in challenging areas or unsociable shifts that most locums couldn’t do even if they wanted to.

Dr Mark Porter, Dr Laurence Buckman and myself have raised these with ministers. But the profession must confront the fallacy that locums are paid enough to absorb these costs, which does not hold up under even the lightest of scrutiny.

Dr Vicky Weeks is chair of the GPC’s sessional GP subcommittee and a salaried GP in Southall, west London

The other side of the debate: Read why Dr Dean Eggitt thinks that locums are paid too much

Readers' comments (6)

  • While the BMA attempt to negotiate on behalf of locums to ensure practices pay locum superannuation, may I suggest that locums try to reduce their outgoing expenses by switching to cheaper MDDUS and cutting out the middle man, ie locum agencies, by booking work directly with your favourite local surgeries. Locum agencies may add £15 to £55/h to practice bills and pay you £75/h.

    DOI: London Locum BMA GPC Sessional Subcommittee Rep

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  • I think Locums have been paid over the top for many years despite GPs pay has seen no increase year on year for the past 4 years. PMS practices have been denied yearly increase & not considered for Locum superannuation to a tune of £1500 per year.
    Locums need to consider the above & austerity measures demand decrease in Locum fees.
    Locums like GPs can set their appraisals expenses of £300 against their income and claim 40% back.
    We are all in together .

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  • I was a locum for some time and the wages are rubbish. What initially looks good on paper soon gets paired down once you take into account paying your indemnity, petrol and tax (and previously pension). In addition you do loads of back room work taking bookings and managing invoices. Often you end up with unfilled sessions for which you paid insurance and sometimes practices don't pay you or pay less than what was agreed, oh and did I mention lack of job security and lack of CPD support? I've got a real job now which is a million times better but I always stick up for the locums.

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  • Perhaps it is GP partners that are underpaid in comparison to locums.

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  • I must have been living somewhere else, looking at some of the comments which say locums are paid too much. I get paid 65 pounds an hour, which is the normal rate in West Midlands for locum work. Insurance is high for locums and they also have to pay out of their own pockets for CPD etc.

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  • I think we are talking about the wrong type of GP -it is salaried doctors who are paid too much -regular income often with incentives for extended hours work, average of 7 weeks paid holidays and training , sick pay and often other financial benefits , all without any real responsibility for practice management. Locums by comparison get a very raw deal but are sometimes the backbone of unpopular practices that fail to attract partners.

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