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150k reasons to ignore the 150k rule

150k reasons to ignore the 150k rule

I hate to remind you high earners out there. But the deadline for declaring £150K+ annual earnings is looming, and hits well before the BMA’s deliberations on industrial action will have solidified/melted away.

So what should we do? Well, if it wasn’t time to scream ‘outrage’ when the idea was first slipped into a contact revision (and it was, and I did), then it certainly is now. There are 150,000+ reasons to refuse to comply, but I will offer my top three, in reverse order of importance.

3. The declaration is stupid. It doesn’t take into account sessions worked. Naturally, those with the most sessions per week will tend to be the highest earners. So it discriminates against full/near full-timers, with the result that GPs will, in future, cut their hours to fall below the income threshold.

2. The declaration is vindictive. The Government’s justification for publishing these figures is ‘greater transparency’. But what’s really transparent is that this is simply another opportunity to put the boot in. Having all GPs’ individual earnings paraded about would have been bad enough. But restricting it to those earning over an arbitrary amount is just bullying. It carries the clear implication that those above the threshold are somehow screwing the system. And that, instead of being lauded for maximising effort though high QOF, enhanced services, long hours and so on, they should be named and shamed for exploiting the system.

1. The declaration is dangerous. We are currently working in a truly toxic environment. Every day, we are on the receiving end of abuse ranging from snide comments through verbal and written tirades, to potentially having our heads staved in by the disgruntled. Adding fuel to the fire is utterly irresponsible, making the Government an accomplice in GP hate-crime.

On my first day as a houseman – a 1:2 rota where the weekend duty started on Friday morning, ended Monday evening and involved, without exaggeration, about nine hours sleep total – I left the ward after my first standard ‘9-5’ day shift at 11pm. I have not stopped since. In 37 years as a doctor, working above and beyond for the NHS and its patients, I have half killed myself.  But I’m not going to let the bastards finish me off now.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at



Please note, only GPs are permitted to add comments to articles

James Cuthbertson 8 November, 2021 1:59 pm

Why GPs? Surely this can be challenged in the courts as discrimination…

Subhash Chandra Bhatt 9 November, 2021 12:10 pm

I don’t understand purpose of such exercise. It help no one, 99% patient don’t know or have no wish to know what gp earns. If I was to earn this I would gladly let every one know.
I asked one patient few years ago what she thinks about gp earning over 100k , she said you all deserve that as I see you working 7 days a week , so why not
Why are all gp , bmj etc are wasting time and energy on this topic?

Mark Pasola 9 November, 2021 2:35 pm

Well said Tony…particularly the last paragraph.

Here’s a to p tip for anyone worried about having to declare income above £150k


Corprorate bodies and their employees are exempt from the earnings declaration rule. Yes, limited companies can hold GMS contracts and partnerships and sole traders can incorporate without risking the continuity of their contract. And I doubt that the earnmings declaration rule will be expanded to include incorporated practices because that would expose so many powerful aPMS providers to embarrassing scrutiny (and on occasion shame).

Merlin Wyltt 11 November, 2021 11:44 am

Don’t declare your private income. It is private information, not public.

Truth Finder 14 January, 2022 10:29 am

We have worked hard and should not be ashamed of being a high earner if you topped your school and worked almost every day of the week. Junior lawyers now ear £150k just qualifying. £250/h average–anyone earning this? Bankers eye watering numbers that would not fit the space here and not to mention footballers. What have they done that is so worthwhile?
Do not be ashamed as lots of doctors are emigrating for other countries value us more without the nasty underhanded below the belt bits.
Would patients like to see us reduce sessions? Thought not.