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Independents' Day

BMA and NHS England at loggerheads over GP funding

The BMA has called for at least an inflationary uplift for GPs practices this year in its official evidence to the independent pay review body, while NHS England has argued that any uplift will have to be limited to ‘up to 1%’.

In evidence to the Doctors and Dentists Review Body (DDRB) published today the BMA argues that GPs have already delivered ‘substantial efficiency savings’ and have had their take-home pay cut, and calls for all doctors - including GPs - to have at least an rise in funding to match the current rate of inflation - which is 2.7% on the consumer price inflation and 3.3% on the retail price index.

But it its DDRB submission - also published today - NHS England argues that GP funding has risen more in real terms than for other doctors and that practice expenses could be further reduced by sharing back-office functions and delegating more GP work to practice staff.

NHS England said that it was too early to make a concrete recommendation for any funding uplift, but said that any increase will need to be within the pay remit set by ministers ‘of up to 1%’.

The submissions put the two bodies on a collision course for contract negotiations this year, and are the first indication that NHS England intends to take a hard line on any increases in practice funding.

In its submission, the BMA said that the 1.32% rise in practice funding last year was ‘insufficient’ to cover expenses and has called again for the formula by which the Doctors and Dentists Review Body (DDRB) calculates gross earnings to be changed.

The BMA pointed out the value of GPs’ contracts has fallen by 15% since 2007, as reported by the NHS Information Centre using the consumer price inflation measure of inflation to 2007 prices.

It also called for the DDRB to take into account the impact of the pension changes on GP expenses, as practice staff on NHS contracts - such as salaried and locum GPs - will also face the rises and seek compensatory pay increases to avoid a further cut in income.

The report said: ‘We have compared the actual outturn for the different elements against both a measure of general inflation and against the uplift (intended or imposed). This shows that gross and net earnings have failed to keep pace with general inflation (CPI), but that staff costs have typically exceeded inflation.’

But NHS England’s submission to the DDRB says that GP pay has increased by 41% over the period 2002/03 to 2011/12, and that this compares with ‘an increase of 25% for consultants and 18% for nurses over the same period’.

It says: ‘NHS England is not yet in a position to provide evidence on the level of gross uplift it deems appropriate for 2014/15. Such an increase will need to be within the pay remit set by Ministers, of up to 1%, which applies to both GMP contractors and all of the staff they employ.’

It adds that practice expenses can be reduced by ‘seeking greater efficiencies’, for example, through the introduction of federated approaches and sharing of back office functions and staff; appropriate increased delegation to other members of the practice team; and partnership working with local pharmacies.

Dr Mark Porter, BMA chair, said: ‘We recognise fully the economic constraints the NHS is working under but the continued erosion in the real value of contracts for doctors has now reached a critical point.

‘We are also concerned that despite the excellent work done by doctors under enormous pressures it is once again unlikely to be recognised as the Government has already made it quite clear what it expects the DDRB to recommend.

‘This ignores the reality. Despite claims pay is out of control, the vast majority of doctors have seen real term cuts in their income year on year.

‘Billions of the Government’s so-called NHS efficiency savings have come from the continuing erosion of staff income. It is unrealistic to think the NHS can cut its budget by almost a quarter simply by just chipping away at staff pay. Instead the Government should be working with doctors who are best placed to deliver real savings while protecting patient care.

‘When faced with an unprecedented funding squeeze, inadequate staffing levels and rising patient demand it is no surprise that morale amongst doctors is low and yet they continue to work as hard as ever on behalf of their patients. It is only fair that they do not face a further cut in pay.’

Readers' comments (11)

  • This is not going to work. Really they just need to work up a plan to leave the NHS.

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  • The chance of them agreeing = 0 %

    The chance of negative press stating greedy GPs wanting more money = 100%

    No point re-arranging deck chairs on the titanic ...

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  • Who ever has the 41% rise in my income since 2002/2003, can I have it back please because I have never seen it.

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  • Cannot believe that BMA ask for a pay rise we should change tactics and submit we want a 25% pay cut then the profession would leave the nhs in droves and at a stroke the nasty tories achieve their aims and our standard of living will soar in the private sector which every other English speaking doctor thrives around the world

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  • Time to go. .

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  • Have a look at guardian paper online at article on Steve Fields plans for GP's regulation that'll cheer you up......not

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  • T Roscoe

    Its OK people, we will all get a 7% rise when Steve Field closes down all those failing practices and we take on their patients. Simples

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  • Vinci Ho

    Very clever, quoting figures of pay differences over 10 years instead of last 3-5 years . No mentioning about taking on so much chronic disease management over last 10 years through QOF. Chronic disease management needs consistent funding increase especially because of ageing of population...
    Nah! These guys in NHSE would not even listen.
    Reminder to BMA/GPC- if somebody plays dirty politics to you , you need to play dirty as well .....

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  • VER, VER, VER...........

    What will they do when we're all gone?

    Just who will do the 8am-8pm Mon to Sun, elderly care plans, e-mail access (what, 24/7??) and all usual consultations, paperwork, visits, managing staff, IT, premises ???

    Not me troops. I'm off.

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  • hunt is a moron.....he really has no understanding of market forces......he is gonna kill the golden goose and say goodbye to the eggs.

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