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Locum fees cut due to superannuation changes, says BMA

The changes to locum superannuation payments implemented this month are risking a ‘distortion’ in the workforce, with locums being forced to cut their fees and practices being placed in a ‘very difficult situation’, says the BMA.

In a letter to the health secretary, BMA chair Dr Mark Porter called for a Government U-turn on the decision to make practices in England and Wales responsible for paying locum superannuation, before sessional GPs are forced to quit saving for their pensions.

Dr Porter said the BMA has already seen evidence that their fears are being confirmed by ‘dozens of cases’, despite only weeks passing since the changes came into effect.

Before the changes, which formed part of the GP contract imposition, English PCTs and Welsh health boards were responsible for paying locum pension contributions, but since 1 April this responsibility now lies with practices themselves.

As a result of the overhaul, the Government distributed an equivalent sum of money to that paid in locum superannuations by PCTs last year evenly across practices in their global sum equivalent. But the BMA said that the payment, which for an average GMS practice with around 7,000 patients translates to an extra £1,000 a year, would last only between one and three weeks.

Dr Porter’s letter makes the example of one part-time locum GP who has seen her fee cut by the single-handed GMS practice she works for to take account of the 14% employer pension contributions, as well as a GP who told the BMA he will only be able to employ GPs who are no longer making pension contributions.

Dr Porter wrote: ‘Because locum fees vary around the country, this would last between one and three weeks, putting a small practices or a single-handed GP relying on locum cover for sickness and holidays, or short term maternity leave, in a very difficult situation.

‘Although it is only a few weeks since the change, we have been made aware of dozens of cases where locum GPs are having their fees cut because practice funding is insufficient to cover the cost of the employer pension contributions.

‘We have made it clear that we would expect practices to cover this cost, without seeking to recoup payment through reducing locum fees, while we seek to resolve this problem. The cases we have been made aware of have confirmed the fear I expressed in my last letter, that the impact of the change is having unintended consequences which could lead to a distortion of the GP locum workforce.

‘The only fair and equitable way to deal with locum employer pension contributions is for this to be dealt with centrally. I would again urge you to resolve the issue swiftly by mak[ing] this the responsibility of area teams in England, to deal with in the same way as PCTs, and it remaining the responsibility of health boards in Wales.’

Click here to read the full letter

Dr Vicky Weeks, chair of the GPC sessional doctors committee, said: ‘We’re getting increasing reports to the office and to me personally about the concerns of our members. ‘For younger GPs, they are being placed into a position where they are being asked by practices either to cut their fees or to take the hit of the 14% [contributions] themselves.’

GPC deputy chair Dr Richard Vautrey added: ‘The key thing about this is that it was completely unnecessary. We warned the Government that this was a big mistake. At best, we said delay it yet. They still haven’t sorted out the PMS funding issue so I think there is a complete mess that is of the Government’s making.’

Readers' comments (8)

  • The unstated goal of the government is to reduce its state pension liability.The fact that many GP locums will now stop paying into the NHS pension pot just goes to show that this policy is working.

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  • We pay 82.00 per hour for a three hour session. When you calculate it over a year, it works out to be the average income of a GP. Expecting us to pay another 14% is unsustainable.

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  • Nhs pension pots may turn out to the next victim to any government seeking to shore up its finances..anf for most young gp-s with 20 y to go before possible retirement they may be the proverbial pot of gold(honey for winnie the pooh)at the end of a rainbow...i have felt that nhs pension like any othr civil service pension scheme is a ponzi scheme and all that is needed fr it to be exposed is for enough recent entrants to refuse paying into it...

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  • @Anonymous | 20 April 2013 7:30am

    State pension is indeed a Ponzi scheme.Most people are under the misapprehension (fed by the politicians of course) that their national insurance contributions help to build their own pension pot.The truth is that they go into a common tax pool part of which is then used to paying the state pension of current retirees.A meagre 1.3% uplift is totally insufficent to pay for the extra 14% employer's superannuation contribution.The end result is that either:
    1.GP locums stop paying into NHS pension
    2.Take a significant fees cut
    3. long term locum positions disappear completely

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  • £1000/yr to contribute to the superannuation of locums is paltry. But look at the maths: For arguments sake, a locum session is £250/session (over the odds for my area). 14% superannuation of this is £31.50, which would fund 32 sessions/year. Factor in 6 weeks holiday (equating to 6 sessions), a few sessions of annual leave and you are up to 40 sessions. With 52 working weeks a year, if a practice is having to employ that much locum time, maybe they should be thinking about an extra regular session - salaried or partnered.

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  • Problem with the last arguement is the unstable climate we live in. Many of the CCG board GPs are using locums to cover their position when they attend board meeting, management training, conferences etc. It is difficult to predict how long their position is tenable and therefore may not wish to employ a permanent replacement. As the practice income id dwindling and costs rising, many of us are cutting back - again easier to cut locum then to make redundancies.

    We have stopped employing locums in the last 12 months. Now the partners simply give up their holidays and admin sessions to cover the gap. It's not unusual for me to be working on weekends to catch up on admin work.

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  • Anon 12:38

    If thats what the partners want to do so it maximises thier income and profits thats upto them. But they are well rewarded for their time doing CCG work so its not as if the money isnt there.

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  • As a locum, I had to face a decision to work sessions as a locum and take the pay "cut" or not work as there was no other options/negotiation. Unfortunately I have to work and cannot be fussy in this particular employment climate hence the pay cut. I am not happy about it and there seems to be little unity or support. The governments games of divide and conquer are working well.

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