The proposal following this year’s contract negotiations that English GPs will have to publish their income from their GP contracts from April 2015 is divisive, and is not in the best interest of general practice or the public.
If there were a fair comparison between GP income with other clinicians and senior managers GPs would be proven to be the cost effective resource that we are. The GPC says that the comparison will be on a ‘like for like’ basis, but are we confident that this will happen?
GP income not derived from the core contract includes private income from various activities, income from dispensing, providing other NHS services through enhanced services and other contracts, from premises, and the loss of opportunity due to the amount of money partners have tied up in their practices. Once these have been taken into account I would suspect GP income would be more comparable to a Staff Grade rather than hospital consultant levels of pay.
Besides, why shouldn’t GPs be granted the same privacy regards their pay as other NHS workers? Unlike senior hospital consultants and other NHS body employees, GP principals are not directly paid for by public money, but receive funding to provide services on behalf of the NHS and keep any profit.
GP funding should be transparent, and the public have the right to know how much general practices are funded nationally and what services are provided for this. Little attention has been given, for instance, to the fact that the proportion of NHS funding supporting GPs in England has fallen from 10.4% in 2005/6 to 7.47% in 2012/13, with an absolute reduction in average profits.
The current situation must change, as the annual beanfeast by the Daily Mail and other newspapers when the HSCIC publish the latest GP income figures only undermines the profession, even though the typical reaction from my patients is ‘hope you are earning that doc, as you deserve to’.
If the Government really wanted the public to have a true picture of GP income they would have already insisted that the HSCIC replaced the annual disingenuous report with one that took into account all of the above factors.
So what is the purpose behind this? Does anyone really believe it is purely because the Government wishes to provide transparency? I suspect that this policy is purely due to the politics of envy. Every time I have heard an MP trying to justify their inflation busting 11.1% increase they have mentioned ‘but we will still not be earning as much as GPs’.
The only obvious true purpose is yet another attempt by Government to deliberately undermine GPs in the eyes of patients and the public in general. Following A&E-gate and CQC ‘maggot’ scare stories, if we publish our practice income we will practically be writing ‘greedy GP’ headlines ourselves.
And why does the Government want to undermine the most respected and efficient part of the NHS? Simple – it’s the fastest way to persuade the UK public that they no longer want the current model of GP services. If the public rejects us, the Government will assume their support for a replacement model, provided by centralised large primary care centres with little or no continuity, and run by private conglomerates.
General practice funding should be transparent, but must relate to how funding is received, and the amount of services that are provided. Insisting on GPs publishing their individual income is a breach of our privacy and will serve no beneficial purpose for healthcare
Dr Grant Ingrams is a GP in Coventry, GPC member, and vice chair of Coventry LMC.
