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GP trainees 'could face a one-third pay cut'

GP trainees could face huge pay cuts as a result of the Government’s imposition of a contract on junior doctors, a GP lobbying group has claimed - although the health secretary has said there is ‘no question’ incentives to join general practice will be removed

NHS Employers this week confirmed they would ‘press ahead’ with reforms of the contract in England, which will see a supplement given to GP trainees removed.

The GP Survival group said the decision to remove this GP Registrar (GPR) supplement - which increases GP trainee pay in line with junior hospital doctors - would equate to a 31% pay cut for GP trainees.

However, in a blog to RCGP members, chair Dr Maureen Baker said that the college had been given assurances from the health secretary that other incentives to join general practice will be brought in to replace this supplement. She added that still ‘ambiguity’ remains.

The BMA has said it is trying to clarify the situation, and that the Government has suggested that it will bring in ‘flexible pay premiums’, which will be used to increase the pay of GP trainees.

However, NHS Employers says calculations being made are based on example figures and that the final basic rates of pay have not yet been agreed.

Dr Zoe Norris, a founder of the GP Survival group, told Pulse: ‘The issues are a pay cut of up to a third, and getting rid of pay progression for GP trainees.’

She told Pulse: ‘For GP registrars, if the banding goes – which is their basic pay + 45% - that means they’re effectively on a 31% pay cut. So we’re saying a third when we’re talking about it.’

She added: ‘It’s unfair, and more to the point, how on earth are we going to persuade anyone to be a GP?’

However, a BMA spokesperson told Pulse that it is still trying to determine how much GP registrars will be paid.

They said: ‘We are seeking to clarify the position with the Government,’ adding that the BMA’s position was set out in a statement on its website.

The statement said that the Government’s proposals could potentially mean ‘less pay for GPs’. It said: ‘The Government continues to state that it is going to introduce thousands of GPs to fill the shortfall, but how can that be achieved if GP trainees are paid much less, on average, than hospital trainees? This would be the effect of removing the GP supplement.’

NHS Employers and the Doctors and Dentists Remuneration Board (DDRB) have said that the supplement could be replaced with a ‘flexible pay premium’, which could ‘incentivise hard-to-fill specialties’.

However, the BMA warned that, under the proposals, this would reduce if more trainees were enticed into general practice, which is the aim of the Government.

It said: ‘What happens if we do get more GPs? The premium would stop and GPs’ pay would again reduce to much less, on average, than their hospital colleagues. We don’t think introducing a system that varies depending on the popularity of the specialty is appropriate – there must be a better way.

GP trainees in Scotland or Wales will not lose out, as the devolved administrations have agreed not to impose a new junior doctors’ contract.

Under the imposed contract in England, NHS Employers has also redefined ‘unsociable hours’, so that 7am to 10pm from Monday to Saturday is now considered ‘sociable’ hours.

The contract - based on the DDRB recommendations - states: ‘Under our proposal, nights would attract a 50% supplement and Sunday days a 33%supplement. We want to reward those who work during the most unsocial times. Basic pay would also rise significantly under this proposal.’

Dr Norris says: ‘GP registrars don’t do out of hours – apart from the compulsory out of hours they do for their training. Most of their core hours aren’t counted as additional so they won’t be getting higher pay for that.’

She added that doctors are currently calculating how the changes would affect their current salary.

However, in correspondence sent to the RCGP, health secretary Jeremy Hunt says there is ‘no question… of removing incentives to enter general practice training’.

He added: ‘The process for determining the application and level of the premium would be very much the same as the current process for determining the application and level of the GP trainee supplement.’

Dr Baker said: ‘While there is arguably still some ambiguity associated with these statements, they represent significant progress.’

NHS Employers has said that it has not determined basic salary yet, so any calculations would be misleading.

A statement said: We are aware of a number of pay calculators (including the BMA’s “ready reckoner”) that junior doctors are using to calculate what their pay would be under the new proposals. These are based on a serious misunderstanding – the pay elements in the proposals are illustrative, and do not represent a definite position on how pay would be distributed.

‘However, even measured against the illustration, most calculators that we have seen are underestimating what junior doctor earnings would be, either through errors, or because they are not including all aspects of pay.’

This was updated at 10:00am on 21 September to include the blog from Dr Maureen Baker

Readers' comments (51)

  • Well, that's us truly stuffed then. Idiots.

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  • this is unlikely to happen ..yet.

    whatever the formula is ..it will allow for real pay decreases but it won't be done in an open obvious way.

    This is a classical, scary worst case scenario and then everyone is happy when rough parity to the current situation is 'negotiated'.

    Doctors need to start being less reasonable when judging their worth.

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  • Gotta fund the MPs 10% raise somehow, with the impending politician shortage and all that.

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  • 18 September 2015 7:13pm

    100 % agree.

    1. chances getting into med school low.
    2. chances of surviving medical training 80-90%
    3. chances of getting into chosen specialty ?50%
    4. debt 100-200 k
    5. high chance of being struck off, referred to GMC, litigated against
    6. pay cut of up to 1/3 on the way.
    7. retirement age increased to 70
    8. likely 7 day 12hr working
    9. 24 hr 7 day working in pipeline
    10. no independent practice to look forward too
    11. ostracized if you are ill or thinking of having a family or are female or the wrong color
    12. average salaried pay 54 k at moment but expected to fall.

    yup being a doctor not worth much at all.

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  • This will happen sadly- this country wants something for nothing

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  • If Juniors as a whole don't strike over this then God help us

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  • This is back to the 1990s i'm afraid;

    I feel for the junior doctors of tomorrow; The younger generations seem to suffer and have things imposed on them through no fault of their own; I say this as a relatively young GP myself in my mid thirties who, by the luck of the year of my birth managed to avoid this nonsense....

    back in 2004 I had a PRHO post that paid a basic salary of around 18k but had rotations in the year that were classed as band 3 and pushed the component to 100 % of basic salary. We also had the privilege of free accommodation on site and i believe that with these "perks" my wage probably equated to almost 35-40 grand per year (factoring in not having to pay rent and council tax and need transport etc).

    also during my VTS training we had a generous monthly petrol supplement of around 300-400 quid per month (which actually just covered my costs as i travelled 60miles per day during my GP reg year) before the government decided to remove this and replace it with a per mile claim with a maximum daily claimable amount.

    Its a disgrace that junior doctors may possibly receive half the amount that i made 11 years ago, and i bet the trusts will still use phoney figures to avoid having to band jobs ( eg. ignore the actual hours worked on audit forms etc).

    If i was a junior doctor today i wouldnt hesitate to move abroad and try my luck at training in a foreign country. A few of my colleagues moved to the states after sitting USMLEs and made consultant within 6 -7 years of graduating, whilst some of my other less fortunate chummies are still lingering as fellows or trying to do pointless research 11 years after graduating to help boost their CVs.

    Look at the way the UK and its socialist system values some of its best and brightest...........so glad i managed to avoid all this and get out relatively early when i emigrated as a young GP;

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  • This is ridiculous.what the hell is this?

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  • http://www.independent.co.uk/voices/comment/junior-doctors-are-being-treated-so-badly-that-we-may-be-forced-to-strike-10507763.html

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  • Were I still in the communist, neostalinist gulag formerly known as great Britian I would support my junior colleagues and strike with them!!

    I was a new GP partner a few years back when I had to convince my senior GP partners to strike with me over pension reforms, which they eventually agreed to after I pointed out that half of the doctors in our practice were "juniors" ( we had 3 ST trainees, 3 salaried and myself a a 31 year old GP partner). Initially of course they didn't see that and were protected ( some may say bought off!) by not being affected by the changes to pensions!

    All the perks I had as a trainee such as free digs in hospital, decent study budget ( one I was actually free to spend rather than being stolen or misappropriated by the hospital trusts), proper petrol supplement, on call rooms, a decently funded doctors mess, proper funding for away days on VTS teaching, have all disappeared. I understand that at teaching sessions now they serve up filth that they class as food also to save even more costs.

    For the first 4 months of my registrar year back in 2006 I was on 3k a month net ( a gross Salary of nearly 50k ) Which included banding for GP training a generous petrol supplement. I was able to buy my own house by the time I was a GP registrar. I shudder to think what the next generation of doctors will be making. Obviously this will be extremely detrimental to the governments plans to recruit or magically create an extra 5000 GPs by 2020.

    We have a situation where the government has directly challenged all doctors from consultants, GPs and now junior doctors and threatened to impose on them contracts which are not only unfair but insulting.

    It is clear they cannot be trusted and doctors of all levels and grades ought to stand together and show solidarity because enough is enough.

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