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.
Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk
This is just the type of BS from someone who is NOT a clinician. Please go to medical school, do the junior doctor training, work as a GP and then come back to me and let me know if we are well paid or not.
Please come and spend a day with me and then tell me that I’m well paid. Salaried Gp
Good points made here, especially with the ‘cost of living’ crisis affecting many people more vulnerable than many doctors.
These people worry about whether to ‘heat or eat’. On the other hand, it can be a very unfair world for the vast majority of the population, including doctors; as an example, why are the Royals not subject to Inheritance Tax and did our lovely late Majesty pay any Inheritance Tax on her estate? No, I believe. It seems very unjust, when they make such a show of paying their taxes like the rest of us, ( and do they only pay what they agree would look good to the rest of us?)
but the reality is that some people, Rashy Sanuk (as Biden might call him) or Royals, do not live in the real world or face anything like the harsh realities of life that doctors including GPs see people desperately facing every day. The Royals, the Rashy Sanuks and the very rich are living on a different planet: do they need prescibed money to heat their homes? No. Some GPs prescribe.
Whilst I agree with the general principle that high earners should pay more tax during economic downturns (and those of us below the threshold aren’t effected any way), the real problem here is the major disincentive to take on extra work at a time of recruitment chaos and mass vacancies.
Why on Earth would a part-timer want the huge stress of working round the clock if most of the extra income will be increasingly syphoned off to pension/income taxes?
It may be an easy win for the Treasury, and one cheered to the rafters by >90% of voters, but actually deepens the NHS workforce crisis at the start of our worst Winter ever.
Poor editorial.
Average GP income in 2003 and average GP income in 2022? Roughly the same?
80% real terms cut in income.
My friend works in managerial role – we were earning the same in 2003. He has not promoted yet earns 150% more today.
I am retiring fully this year thankfully having cashed in NHS pension before too great a pension tax assault. Any work that would have been done by those retiring sadly will be added to the remainders for a pittance that will fall in the punishing thresholds where you lose basic allowance and then pay 45% tax.
The real headline should be that 45% tax is ok although not the 2 decades of pay freezes alongside huge amounts of unfounded extra work and being trapped with punishing tax thresholds and unfairly targeted pension tax.
Government propaganda is generally for the Daily Mail and Telegraph – not the GPs own news services.
Recruitment crisis.No new full time GPs.You either give renumerate accordingly of reduce work load.Currently the market forces mean thatwe are losing GPs faster than we can train them.Workload increases as stated pay freeze as stated,a punishing pension tax that encourges leaving the profession early as stated.A job looking after entitled aggressive punters.Bullying from state and media. A frontline workforce tahat is aging a pi@@ed off.We might be well paid, weve spent 5 years not earning in uni, and Juniour Dr years getting paid less than relatively poorly and abused.This country is currently fostering a public sector workforce which will become more militant and less tolerant of abuse from the state.I see a lot of industrial unrest.Medics and nurses will be in the melee.The fire that has been started by austerity has been fanned by the pandemic,Bexit and the cost of living crisis.Can it be extinguished ,Doubt it.There will be a price to pay.We will all be paying it.This government has ripped the heart out of the UK.Best thing that can happen is to cast them into the wilderness.
Sorry Jamie, but I disagree. like every other GP up and down the country I work very hard. Our contract funding and income is generally based on the idea of GPs working sessions. Those session are nominally 4 hours long , yet every GP I know works 6 hours or more. Partners often have additional responsibilities and practice commitments beyond the clinical work.
I know that many jobs require staff to work beyond their contracted hours. However, I struggle to find many jobs that routinely expect staff to work 33% of their working week unpaid. Deduct an additional 14% employer’s pension contributions from partners’ incomes (as no one else in the NHS including locum GPs seems to have to pay that) and the pay does start to look good at all for the stress and time commitment.
To decide whether a job is “well paid” you cannot simply look at the annual salary. The hours spent, on that job, stress and taxation all play a part.
If the job is so well paid you have to ask yourself , why then does hardly anyone want to do it? If someone earns £200k a year but has to work 100 hours per week to get it, are they better paid than someone who earns £74k a year for 37 hours per week? It’s an extreme example but illustrates the point where an hourly rate is the same.
There are many vacancies in general practice including partnerships and younger doctors are less wedded the idea of eternal servitude to the NHS than older doctors. They can easily analyse the cost/ benefit of taking a partnership role and in many cases they have decided that partnership isn’t well paid enough for what is expected and the impact that has on other aspects of the life.
The last time I checked, Consultants don’t pay for the speculums they use, nor the toilet roll in the hospital, nor the air freshener and laminating machine paper, nor the biro or paper and ink in the printer. They don’t pay for the staff canteen, nor do they pay for the crap drinks machine someone kindly put in reception and toys because the public wanted one. They don’t pay for the dressings pack, and they don’t pay for the AED defibrillator pads or sticky plaster and stupid ear syringe freebie cleaning tablets.
Regrettably, a very poor article I am afraid, which was surprising and lacking insight into being a GP. And only recently they stopped the absurd £10K indemnity – for which most senior GPs have paid more than £250,000 into – which few professionals will ever do – and are at a complete loss into that sick industry. Think you’ll need to remedy this article Jaimie.
My solicitor charges £295 per hour.
Nuff said.
I’m confused by all the moaning. This isn’t a GP specific thing is it? It’ll effect everyone in the country who earns this much. I’m a GP and I don’t earn this much. Lots and lots and lots and lots of GPs don’t earn this much. The recruitment crisis is NOT caused by ‘punitive’ taxation of people earning £125,000 a year. It simply isn’t. Listening to wealthy people moaning is a turn off. Please shut up. Yes your work is valuable, yes you do an important job. Yes you are valued by people who understand what you do but NO the entire world does not revolve are you and you alone, you are not struggling financially and you are not the group of people making up the bulk of the exodus of front line staff from primary care. They didn’t all leave because £125,000 simply wasn’t enough to become bankers and lawyers, they left because the job was shit and you lot were probably employing half of them. Enough already
The public wanted free furlough money, the NHS staff wanted useless PPE worth billions, the politicians wanted to fill their own pockets with millions for delivery of covid tests at scale by setting up sham companies and awarding themselves lucrative contracts.
Now we all need to foot the bill, or else the never ending UK debt will not be rolled. The debt is too high to even comprehend it. But what’s more shocking is every year we hand over around 30 billion pounds of interest to the banks just for them to keep us in debt.
Here Anonymous:
https://www.nationaldebtclock.co.uk/
The cash is siphoned of so well in the UK. But you are capped and work longer and get taxed and see more.
A non.
The point is lots of GPs should be earning that much as a highly skilled professionals carrying significant responsibility and huge risk – many don’t because practice income has been stagnant for.a decade whereas private sector peers have had significant increases.
It would be ludicrous to imply that the reasons forcing employed GPs to give up were the poor conditions by partners who were ‘employers’. GP partners operate in a system where they have little influence over demand,etc. Also, partnerships remain very unattractive for good reason – having to invest despite an uncertain future, intimidating liabilities and burdensome additional responsibilities, etc.
Dissatisfaction more due to frustrations operating in a failing NHS, uncontrolled demand, negative portrayal in the media, lack of pay rise, pension penalties – all of which exacerbate feeling undervalued, etc