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