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My 2017 prediction: Locum GPs will have to record toilet paper use

It looks as though 2017 will be a tough year for locum doctors, after an unprecedented attack from the Government. A joint statement from the Department of Health and the Treasury will confirm the introduction of the new measures on taxable locum income. These include a punitive tax rate of all earnings made by locums above the ‘Capped Re-indexed Allowance Payment’ (CRAP) rate, the current set maximum locum rate.

The controversial measure, nicknamed the ‘Loo Tax’

Under the new measures, an 80% taxable rate will be applicable on any income that exceeds this rate, irrespective of the client’s personal tax band. The ‘Crap Tax’, as it will be dubbed in medical circles, will attract widespread criticism. Health secretary Jeremy Hunt will defend these measures, saying ‘Locum staff make a valuable contribution to the NHS. But it is time we introduced effective curbs to cut excessive pay.’

Further measures will include a requirement for locum staff to record all consumed goods including biscuits, coffee, teabags, as well as medical equipment such as disposable gloves, earpieces for auroscopes and even includes essential items like toilet paper. The controversial measure, nicknamed the ‘Loo Tax’, will be received with equal amounts of ridicule and incredulity from medical staff.

Dr L Rant, the chairman of the Locum Doctors Group, will be particularly critical: ‘The Government are being short sighted in terms of the incredible importance that locum doctors contribute to the NHS workforce. To expect staff to record how many pieces of toilet paper they used after moving their bowels is an insult to their dignity.’

Some doctors will take their opposition further, with a lawsuit to be filed by a doctor diagnosed with Irritable Bowel Syndrome against the Department of Health for discrimination due to having to record excessive toilet paper usage. 

Among grassroots doctors, there will be concerns that these measures will be brought in to ensure the reduction of the locum pool of medical staffing, which had been growing in the past five years. ‘The goal seems to be forcing staff into either unpalatable tax regimes or unpalatable lifelong salaried contracts,’ Dr P D’Off, head of the BMA locum subcommittee, will write.

The health secretary will be asked by Pulse whether this is a wise plan given the number of doctors leaving the profession. His reply will be quite revealing of his long term strategy: ‘We understand the need for high quality care throughout the week which is why we are increasing the number of front line staff by 10,000. We are currently negotiating the consultant contract to facilitate better seven-day working. Furthermore, we are exploring various avenues for staff recruitment, which have become possible due to Brexit. For example, we currently have several recruiters in Mexico for GPs after the American freeze out of staff after the erection of the Great Wall of Trump. In addition, we are looking to repealing the European Working Time Directive, so we can redefine what safe working hours entails. It is a fantastic time to be working in the NHS.’

The secret locum is a locum GP in northern England

Read more of Pulse bloggers’ light-hearted look at the year ahead: