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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