Publication of Average Earnings
Government requires GPs to publish their earnings
Cranleigh Medical Practice provides this information, for those interested persons, in order to comply with requirements under the GP contract; however, we do not believe that publishing our earnings is either appropriate or relevant to the clinical care of our patients. In support of this, we provide some detailed background to this contract requirement.
Politics in the GP workplace
In September 2014, in preparation for the GP contract for the year 2015/16, negotiators for NHS Employers on behalf of NHS England had only one item on their agenda for discussion in determining the changes in the GP contract. One would think this might be adding some important clinical improvements, like enhancing the care of vulnerable patients, or perhaps some new targets for reducing serious infections, or possibly incentives to improve the care of those suffering from cancer, but no, the only new thing they wanted in the GP contract was an entirely political one, and it was that the salaries of GPs be exposed to the public. This year, therefore, according to our contract, average GP earnings must be published. The reason cited for this move is 'transparency', yet we are not seeing similar transparency being applied to every NHS worker or even other 'public servants' [although paid from the public purse and widely considered to be public servants, GPs are actually independent contractors to the NHS].
Consequences of such actions
Such a single-minded determination to do this clearly betrays the contempt in which GPs are held by those in power. This directive would have only come directly from the government; a government which has been intent (along with previous governments) on destroying the very fabric of General Practice and with it, the rest of the NHS. Unintended (or some would say intended) consequences of publishing income include, making it more difficult for practices to recruit doctors, continuing the downward pressure on salaries, widening inequalities between practices, localities and regions, further increasing the risks to the very business of General Practice and paving the way for an invasion of profiteering private enterprise [initial forays into this area by some such providers have already been proven to provide a poorer quality service, and contracts are often terminated early, leading to patients suddenly being without a GP].
For 2017/18, the government will continue this approach with General Practice, and is demanding that individual GP earnings must be published each year. Even without all the above misgivings, simply from the point of view of a basic right to privacy and confidentiality to which we are all entitled, the doctors at Cranleigh Medical Practice do not believe that doing so is in the best interests of patients, nor will it improve clinical care of patients in the slightest and we therefore strongly question its true purpose and value.
General Practice at risk
The single greatest asset of any workforce is actually its workers, and particularly more so with the NHS, which largely runs only because of the goodwill of its doctors, nurses and other hardworking staff. However, as aptly illustrated by its recent approach with the junior doctors, the way the government is treating its crucial staff reveals its true intentions towards the NHS.
As of March 2016, almost 300 GP surgeries in England faced closure because of financial pressures and nearly half have doctors planning to leave the NHS; in total more than 900 GP practices are in a weak financial position.
This is about 1 in 10 of all practices. There is therefore a very real risk that many thousands of patients will be left without a local GP surgery that can deliver the care that they need.
If you are at all concerned about the future of the NHS, and especially General Practice, widely considered to be the cornerstone of the NHS, you can write to your local MP or to the Health Secretary. As GPs, we have already repeatedly made our feelings known, in last ditch attempts to get the message across to politicians and the public about what is happening to General Practice. As patients, but also as voters, you may wish to do the same. You can find details of your local MP at They Work For You (link opens in a new window)."
Some Perspective and actual Transparency
Publicly available figures show that Cranleigh Medical Practice receives about £143 of funding to care for one of our patients for an entire year. For this, any patient can see us as many times as they need, including face to face, telephone or home visit encounters. Our patients see us, on average, about six times a year, with some vulnerable patients each seeing us 15 or more times a year.
From this £143 figure, as with other GP practices, we pay our heating, lighting, cleaning and maintenance bills, our staff wages, buy all our equipment and anything else that is required for providing care and running a practice. What is then left over is shared between the partners who own the business.
£143 per year equates to just 56½p funding per patient per working day, or £2.75 per week
Also bear in mind that with this level of funding (which realistically would only provide for two consultations in a year if paid at normal market rates), GPs do not aim to simply provide basic low rate care. The vast majority of GPs provide not only high quality care and but also, more importantly, safe care, whilst also working towards difficult and often irrational government targets; all of this is often at immense personal cost to themselves and their families. Regardless of what you might read in the papers and what you might hear from the mouths of politicians, GPs are dedicated professionals who have an innate sense of striving to do their best to help people.
Comparing the annual costs of everyday items:
- £143 is the cost of medical care for you for one whole year
- £150 is the price of the cheapest 4G phone contract
- £170 is a trip to the cinema every fortnight
- £179 is how much a monthly haircut would cost
- £203 is the cost of getting the Daily Mail† Monday to Saturday
- £209 is an average bottle of wine every two weeks
- £240 is the cost of a basic Sky TV package
- £339 is the average cost to insure your dog
† Only the financial cost can be quantified accurately, costs to soul and self-respect are likely to be greater
Disclaimer regarding Published Figures
The average pay for GPs working in Cranleigh Medical Practice in the last financial year was £91,306 before tax and National Insurance. This is for 4 full time GPs and 6 part time GPs who worked in the practice for more than six months.
“NHS England requires that the net earnings of doctors engaged in the practice is publicised by 31 March 2017 at the latest. However, it should be noted that the prescribed method of calculating earnings is potentially misleading because it takes no account of how much time doctors spend working in the practice and should not be used for any judgement about GP earnings, nor to make any comparisons with other practices.”
These figures have been calculated using BMA and LMC guidance.
So now you know, but more crucially, you now know why...
The above has been extracted and adapted from Ivy Grove Surgery