High-earning GPs who will have to pay the top rate of income tax should not see it as a punishment, says Jaimie Kaffash
The Chancellor’s announcement about the reduction in the threshold of the top rate of income tax from £150,000 to £125,140 was one of the best-read stories of the week, and the comments were unanimously warning that this will affect GP recruitment.
At the risk of making me unpopular, I really believe this is a battle that GPs should not fight. Unlike the pensions tax fiasco – where GPs are having to pay to work in some cases – this increase in thresholds is not a punishment for GPs.
Indeed, all it does is highlight that, generally speaking, GPs are well paid. Of course, this is often used as a stick to bash GPs with, and excuse the bad press they get – ‘how can they complain when they are on six figures?’. When you are a profession on the edge, the natural reaction is to go on the defensive.
There are also plenty of arguments in favour of GPs being paid a lot. In a free-market economy that is beloved by the UK Government and most of the press, high numbers of vacancies suggest that the pay is not too high and that the £142,000 a year partners get paid isn’t enough. If it was, we wouldn’t be losing GPs at a time we want to increase numbers.
Far more important, however, is that pay is inversely linked to the numbers of GPs in the workforce. In danger of sounding too much like David Brent, there is a pie of GP funding, and the fewer people taking slices, the bigger those slices are.
One of the main reasons GP pay has increased is because GP numbers are going down. In order to earn the amounts bandied around, GPs have to work 13-hour days of intense work, do admin in their spare time and inevitably face burnout. Unlike professions such as hedge fund managers or investment bankers, money is not the principal motivation for the vast majority of GPs. I would hazard a guess that the vast majority of GPs would happily take a smaller share of funding if it meant their workload could also be spread.
Which brings me back to the message from the profession. Because not only is an acknowledgement about being well paid accurate – with all the caveats that entails – it might actually help. Right now, pay is one of the few positives about the profession. Decent money might not be the principal motivation for new GPs, but it certainly doesn’t do any harm.
I have argued before that I am not confident that it is possible to increase GP numbers and the failed focus on recruitment has allowed other potential wins – such as addressing demand – to be overlooked. But we obviously can’t give up on recruitment. If I were a trainee or medical student, the message ‘general practice is in a mess but at least we get well paid for it’ is more enticing than ‘general practice is a mess and we don’t get paid enough (and we get taxed a lot)’.
If all goes well, and we are successful, then individual GPs will be paid less. The irony is, everyone would be happy with that.