Rhiannon Jenkins scrutinises an article in the Daily Mail by Dr Martin Scurr, who argues that GPs have too many privileges to justify taking industrial action
GPs are ‘playing a dangerous game’, according to Dr Martin Scurr. The Daily Mail’s resident GP isn’t talking about reading the Mail, but rather the profession’s ‘threat’ to take industrial action.
A Pulse survey revealed nearly a third of GP partners would consider taking industrial action by withdrawing their services for a week if funding is not significantly increased for 2024/25.
Dr Scurr, who is considering returning to the NHS after a long spell in private practice, says GPs have become ‘so arrogant’, and threats to strike could see them lose their ‘remarkable privileges’. But are any of his comments valid?
‘Their pay, hours, conditions and options for earning extra income are generous, especially in comparison to the privations suffered by most working people and pensioners over the past year’
Yes, GPs are well compensated for their work, with the annual partner/salaried pay averaging £112,000. But one of the reasons for this level of pay is that there are fewer GPs, so the money is more concentrated.
As a result, the hours have become far worse. Pulse’s survey of 1,400 UK GPs in 2021 revealed they work 11-hour days and deal with an average of 37 patients in that time – far more than the BMA’s recommended safe limit of 25 patients a day. Furthermore, if Dr Scurr is right about the huge privileges of being a GP in terms of pay and conditions, it begs the question, why is there a recruitment crisis in the profession?
‘Recognising that a health service without doctors was no service at all, Labour’s minister of health Nye Bevan — the driving force behind the NHS — agreed that GPs could keep their unique independent status. As Bevan infamously put it, he “stuffed their mouths with gold” to silence their complaints’
This comment is often thrown around, but Nye Bevan was talking about consultants, not GPs. Besides, as we noted in response to Bevan’s current counterpart Wes Streeting (Pulse, February 2023), the comment was made 75 years ago and has little relevance today.
‘Today, at around 7,000 GP practices across Britain, roughly 35,000 GP partners still enjoy that status as independent sub-contractors’
This is incorrect. According to NHS Digital, there are only 19,000 GP partners. It is also becoming harder for those remaining GP partners to ‘enjoy’ that status. Labour recently said it wanted to abolish the partnership model in favour of a salaried service.
‘Perhaps the most financially rewarding source of extra cash comes from locum work. Barely a day goes by when I am not offered up to £1,000 a day to work a 12-hour shift at a surgery, slogging through a backlog of prescriptions and routine examinations’
Many GPs do locum work to boost their income, and Pulse has reported that some are offered lucrative contracts by agencies.
But day rates are rarely as high as £1,000; the average is £600 to £900 (with higher rates usually offered by remote practices). And for partners, this is a drain on scarce resources.
‘GPs no longer make endless home visits, work late into the evening, or face being called out in the small hours. Few surgeries offer even a limited service at weekends’
First, GPs still do home visits but due to time constraints, these are usually reserved for patients who really need them, such as the housebound or the terminally ill. The ever-increasing workload means GPs still work late into the evening, too. Anecdotal evidence suggests GPs are working later than ever post pandemic with the boundary between work and home blurred now that practice systems can be accessed remotely. As regards being called out in the small hours, out-of-hours services are still provided by GPs. Finally, service at weekends is better than it ever has been thanks to extended access. Until 2018, routine weekend appointments did not even exist.
‘They also have the luxury of setting their own hours — working a three-day week, for example’
In theory, they do, but the GP contract specifies the hours and days that must be covered. So, if a GP chooses to work a three-day week, their colleagues must either work longer hours or employ additional staff. Given the shortage of GPs, it is unlikely that many have this ‘luxury’.
While Dr Scurr’s claims don’t all bear scrutiny, he is right to say GPs have some privileges. Sadly, the lack of funding means they can no longer enjoy them – and that’s why so many are voting with their feet by leaving the profession.
To read more from Pulse’s Behind the Headlines series, click here
Looked on GMC register and only one Martin Scurr.
Age at least 73. No licence to practice and not on GP register. Not sure how he sees that he’s qualified to make a judgement. I suspect is another Meiron Thomas. Re privileges, yes pay is good but it should be for my 70 hours a week and not seeing my family and for the responsibility I carry.
I wonder how much the DM is paying “Dr” Scurr for his vile propaganda. The last time a patient brought that nasty fascist pseudo bog-roll into my surgery I binned it for him.
The role of a GP and especially a GP partner is not well understood – I don’t think we’re very good at explaining what we actually do. For example, as a half time partner, I work 4 clinical sessions over 3 days. Each session generates at least a session of admin, in the form of referral letters & the subsequent hospital responses, prescriptions & their regular reviews, results of blood tests & investigations & so on. In addition to the patients booked into my sessions (around 16/session or 32/day – mostly FTF) there are also the additional calls to discuss results & patient or internal messages & emails – probably the most time consuming part of my hidden workload. We are shortly going to a more formal triage system which will be another layer of work. On top of this are the partnership duties, these include supervising & training clinical staff, general staffing issues, finance, complaints, clinical meetings & a multitude of practice & partnership meetings – at least one meeting a day that can last up to 2.5h. I am also heading up our new premises build, due to the critical situation with our current premises. The cost of the will be covered by a private provider due to the estimated £9 million needed, so no financial benefit to us. This has taken months of my time over the last 5years& we haven’t even got to planning submission. As a HT ‘4’ session partner, I actually work around 40h/ week or 8 sessions. As work comes in daily, including weekends, log in from home everyday (up to 4 hours/d) on my non working days to keep up. I estimate the hourly rate for a FT partner earning £112k is around £27/hour. When NHSE or the DM look at GP income, I suspect work done out of core hours is not included – ie done for free. Compared with hospital doctors who are paid in PA’s, their rate increases if they work outside 9-5, ie a late shift from 5-10pm (regularly worked by GPs) could be paid at 2PA’s (ie double time) and meetings & non clinical sites are timetabled into their contract. Finally, whilst hospital doctors salary is not adequately keeping up with inflation rates, GP partner income is actually falling year on year as our costs continue to go up with inflation. GPs are not only misunderstood, articles such as this on in the DM & other broadsheets, misrepresent us & lead to a lack of appreciation which, I suspect, is one of the main reasons for our recruitment crisis & very sadly, the number of experienced GPs taking early retirement.
Anne – you are much more erudite than I. It appears to be government policy to piss us off to the point of retirement. I intend to comply with that policy extremely soon. And of course the DM is merely the print edition of the Tory Party. Read it to know what they really think, what they don’t dare say in the House. Lee Anderson not withstanding of course. It’s not hard to work out what sort of person he is.
If GPs have any privileges at all, that would certainly be remarkable!
If the writer in the DM is ‘bringing the profession into disrepute’ perhaps he should be investigated by the GMC, but I dare not admit to the GMC that I have actually read the DM in case they strike me off for being ‘too kind’, so I am not going to tell them…..
Oi! Scurr! You and me now, outside. Cage fights seem all the rage right now. I’ll take you the fuckin’ cleaners mate. Fuck you and Fuck the Tories.
When you are self employed , you don’t count how many consultations and how many hours you worked. You work hard and you earn more money. It is your shop and manage it the best you can.
If you want to start counting unpaid work etc then sacrifice independent status. You can’t have it both ways.