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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.’