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Part of the new GP renumeration package is for Out of Hours work, if they aren't doing the out of hours work, they don't get paid for it. Simple as.
Perhaps the prats who wrote the contract should have realised that once they were paying competitvely for the normal hours work, the idea of pulling out of hours shifts on top of regular ones would be far less appealing and many GPs would give it up.
Why would (most) people work extra anti social hours when the day job is paying enough.
Kermit, I realise you are almost saintly and do things for the good of society, but most of the population do their job for financial reward, rather than the general good.
The PCTs (I believe) are supposed to provide the out of hours care if the GPs opt out of it (both the work and the pay for it), yet for some strange reason, no one ever turns on the PCTs who are failing to provide the Out of Hours services, or the prats that wrote the contract that caused the problems.
It simply isn't a good enough arguement to say because one sector doesn't get something then neither should the other. Instead of bleating about the fact that GPs have fought for what they are due, you should be asking why the lawyers aren't doing the same.
Which isn;t the fault of a single GP. It's the fault of the local PCT and the fault of the numpty who negotiated the contract.
They did. It cost each GP an average of £6k.
No they aren't. They do not get paid for OOH work unless they actually do it. Some still do, some work for the new providers. most have chosen to finally have some family time.
Exactly. The responsibility for commissioning OOH services is the PCTs. You have a complaint about the cover then speak to them, they are at fault, not the GP.
But isn't all pay relative? So either GPs get paid too much, or everyone else doesn't get paid enough... it amounts to the same thing doesn't it?
Have to say, even with the amount of training involved, an average salary of £100k (I wonder if you exclude consultants though, I hear they earn much more?) is very high. The NHS is one of the biggest employers in the world or something? And spends the most on it's people...
I'm not saying doctors aren't worth the money - we'd be lost without them - but you're saying 'they've decided to have family time', can they do that and still earn that sort of wage? The £6K renumeration for working out of hours is nothing compared to their average salary, and why unless they were exceptionally nice would they take the extra work on? Even if they do nothing in the evenings but kick back.
I'm not saying that they're not entitled to family time, but having your GP available for out of hours service is extremely important. I know mine at least has had to hire an extra doctor at the surgery - before which he only saw people from 10 - 4 because of all his paperwork.
I know you know a lot of about all of this though, so I'm interested as to your input. There is a level where service expectations meet salary demands though. I think people expect a doctor who is getting paid that much to provide out of hours services.
As for the PCTs, they've got 'x' many resources but they're not going to be as effective as providing out of hours services as the doctors who have done for so long.
And for a doctor to be earning that much they are probably providing out of hours services, and all sorts of other things as well.
People need to remember that 'average' means at least half of all GPs are getting less than that, and that figure is not their salary, it's what they get to run the practise. Deduct receptionist wages, overheads, training and equipment costs and you're getting a figure that represents a skilled professional and business manager.
Average GP pay won't include consulatants, they aren't GPs, but it will include GPs who provide minor surgery at their practises.
No, they want more than value for money. They are getting value for money already. They just don't realise it because they focus on what they want but don't get rather than what they are actually getting.
1.1m GP appointments per day (or more than 80% of the whole of what the NHS does) for less than 6% of the budget. I'd say that was pretty fucking good service.
Exactly it's a thing of the past, but it's also what people want again. It's the sort of thing which is being argued here as "value for money".
Bit of a tangeant, but the comparison was professional standing. You can either argue that GPs are overpaid, inspite of what they do or you can argue that other professionals of similar standing are underpaid for what they do.
I would argue the latter.
That average is just GPs, not consultants.
To you, but you have just dismissed the GP having a life as being less important that their being on call for whenever you want to call them.
It's actually more importnat to have a GP full stop and the risk was that GPs were just not coming through the training programme because the hours were long and the pay poor in comparison. That is why the contract was changed.
That isn't a good enough argument, I quite agree.
But when every other sector of public funding (including the MPs, who earn less than half what many GPS get) are receiving no pay rises, why should doctors get a huge payrise for providing no added value?
They may not have had a payrise for 18 months, but the pay rise they got in 2004 more than makes up for that.
The contract isn't the fault of the GP, but the whingeing and the threats now that the Government is trying to correct the mistakes is despicable IMHO. The fact that GPs took the cash without wanting to put the work is in disgraceful IMHO.
Either they take the NHS money and get on with doing their job, or they fuck off out of the system and pay back the tens of thousands of pounds the state paid them to get the tools to do their job.
So those that don't do it lose the princely sum of £6000? Out of an average salary of about £100,000?
Not a bad wage. Only puts them in the top 1% of earners.
I'm not quite sure how that lovely statistic illustrates value for money.
GPs, at the front line, will undoubtedly see the most people. But volume doesn't mean value, does it? Given that most GPs appointments are no more complicated than signing a Prozac script or explaining to some imbecile that antibiotics can't cure a cold, 6% of the budget seems a wee bit steep. Especially when you consider that most of the budget is taken up for medicine and machinery.
That isn't what was argued at all.
If a GP wants a family life that's fine, but he shouldn't get a salary that puts him in the top 1% of earners if he is not prepared to go the extra mile and
The issue is that GP pay is extremely high compared to the skill set that a GP requires. The issue is that GPs' training was funded by us and their wages are funded by us, and that the second the Government suggests flexible working practices that provide value for money they all go off in s strop threatening to resign en masse.
It wouldn't even necesarily mean more hours, just smarter working. I really don't see the problem.
Do the work and take the cash, or don't do the work and leave the cash. Either's fine with me. Just don't take the huge sackload of cash and then whinge that you're hard done to because the government expects you to work for your huge salary.
If that's true then it could be suggested doctors have the choice of either doing OOH call outs for the NHS, or OOH private consultations. I can guess which pays more.
I'm not suggesting that doctors are money grabbing soulless wretches - but in the UK compared with other public sector work they get paid so much more.
My point earlier about it being relative is that if everyone else got a payrise, then the value of the GPs salary would be less. But you're arguing it's value is alright at the minute, so then you must also argue that they deserve a salary 2x -3x of other professionals. So my logic is that:
Doctors wage proportional to all other wages is currently high.
Whether doctors take a income cut or everyone else gets a pay rise amounts to the same thing, that doctors wages will become proportinally average / above average.
The 'real' effect in terms of PPP or whatever you'd like to call it is that their salaries would become normalised to that of others. (Reduced)
Except they aren't getting a pay rise...
So because they finally got their due in 2004 they shouldn't get anything again for... how long?
NB They didn't get a "pay rise" back then anyway, they got performance related pay, so if they don't perform then they don't get the income...
Again, I think that you don't understand how the contract works. To get this mythical "pay rise", they have to work harder. In other words they do have to put in the work. Your problem is that this work isn;t the sort you want.
They have to perform clinically, you just want better access. Fine, if the public want shit doctors 24/7 they can have it. But first let me resign because I will not work in that type of health service.
Money which they have paid back ten fold, either through taxation themselves or through keeping people in work rather than off sick.
Out of interest, the offer on the table is 1.5% increase in practice income (not salary) for extra hours. More work for less pay - more so when you consider inflation etc. So the GPs are suggesting that they work to their contract and nothing more. Precisely what you seem to suggest that they do. Yet also complain about.
You don't. It means that they provide the vast majority of the services which patients access for a pittance of the cost of the NHS. How isn't that value?
Yet you seem to want them doing more of that "no more complicated" crap which actually isn't clinically sound use of their time.
You also clearly have no idea of what GPs do. Like I don't talk about lawyers, and expose my ignorance, I would recommend that you do the same.
The extra mile? You should start reading up on the impact on doctors lives of the work they do, the alcohol problems, the suicide rates etc, the ntalk to me about "extra miles". Yo uwant to see the GP in tears because his patient died and he knew them well, or because of the neglect they see regularly (both of adults and children by the family which is supposed to care for them)...
Doctors are in the top 1% of earners because they deserve to be and TBH you'd be pretty fucked if they weren;t there. Funnily enough it was the shortage of GPs which prompted the whole contract renewal anyway.
.. aren;t they taxpayers to? Infact as they are in the top 1% aren;t they significantly higher taxpayers than you?
If you think that value for money is asking GPs to take a pay cut, provide opening hours only for "routine" appointments (not urgent ones) even though more than 80% of the population are happy with the hours that already exist and where it's been trialled don;t actually turn up in the evenings, early mornings of Saturady's anyway then fine. Just gald that you don't look after the NHS finances.
They were already doing the work, they finally are getting the cash. Now you want more for the same. Exactly the situation we were in before.
This is the same GP who instead of having to cover 24/7 for his patients and having an obligation to do so (so no drink, no going out, only have leave booked well in advance), but instead have the choice to work, if they want to.
Some GPs do this for their £6k per year. Some don't do OOH at all. Others do it as and when it suits their family life and not have a family life when it suits their work.
Much like the nurses who do bank, the dentists who do emergency weekend clinics for another practise, the tfl workers who stay stay late for higher overtime when it's all gone tits up, the lifeguards who won't work early shifts unless they are offered double pay for them.....
Source.
Kinda sinks the argument that doctors are underpaid and overworked, doesn't it? I'd love to get paid 58% more for doing less work. Salaried GPs have had a 3% pay increase in the same period, to be fair to them, so SOMEONE is taking the NHS for a ride. My guess its the practice partners who employ the other GPs.
I think I take you back to my earlier comments. They are finally getting paid for the work which they have already been doing for years. So of course you wouldn't see a rise in "productivity"... had there not been a change in the contract you would have seen a massive reduction in the number of GPs. IMagaine what the impact of that would have been. There are already some areas in the country without sufficient GP. That would have been a national problem (in fact it was, hence the change) and no doctors in training would have wanted to go into this role.
I also should point out that, as you are talking about partners, the reported 58% increase goes to the owners of the business - just as it would for shareholders in any other business in the world. To be able to achieve that level of income for their practice they must achieve a certain level of performance.
The NAO doesn't agree.
The only justification the Government use is that NHS doctors- whose training was paid for by the NHS- were using blackmail to get a ridiculously over-inflated pay deal.
And MoK - the 'owners of the business' are the doctors aren't they? I mean, it seems a bit dodgy to run a publicly funded health centre / surgery as a business where the owners would aim to hit their targets and then profit maximise, rather than providing the extra service to their customers (as is seen in the lack of willingness to do OOH work).
Who knows. Luckily I don't see them very often, but my opinion of doctor's isn't great. A lot of them now seem to be in it for a career and got dissillusioned with seeing the same illnesses al the time, so don't put the effort in they might once have dreamt they would.
Of course, as with anything, there are a rare few that are exceptional. But I've not had one so far.
It's the government and the NHS that makes it run that way, they wrote the contract with bonuses for hitting targets....
Perhaps you should read this analysis from your source
Holy Sweeping Generalisation Batman!
*sigh*
It was an opinion, based on my own experiences. Just look at the thread in health, it seems a fair few people on here are dissatisfied with the level of care they receive. Of course doctor's aren't miracle workers, but the quality does vary a great deal. My friend who's studying to be a doctor has a better bedside manner than any doctor I've ever come across. No doubt then, that's just me.
Out of the docs I've seen who've worked years in a field, it's not really a case of getting bored, as no two patients are ever really the same, and diseases, responses to those diseases and management plans can vary greatly. Morale is quite low at the moment, jr docs, GPs etc included, but for quite different reasons, from what I've seen, it has little to do with the patients.
She is married to ...a gp ...quarter of a million quid a year in wages!
I dunno, Kermit at least makes a point and backs it up. Dr Rant is so up himself it's ridiculous. Why should doctor's earn so much?
It's the class divide as per usual, upper middle class doctor automatically assumes people just get perfect jobs where they're not exploited and don't work ridiculously long hours. And of course, every other profession means you just go out and play football, smoke dope, and have dinner parties your whole life.
Kermit is a bit extreme but just read the drivel on there, I think it's practically insulting to compare Kermit to him
How much do you think they should earn, out of interest?
Well, they like using the word cunt a lot
- Sorry, I started rambling so I'm starting over.
I don't know exactly. But any other career where you put in an equal amount of work and give out an equal amount you aren't paid as much. It is simply because doctor's can threaten to "'do a dentist' and fuck off to work privately." that their pay becomes inflated. Even the NHS admits that the reason doctors get bigger pay is not because they deserve it, but because they were all emigrating / starting to do private care to get fatter pay checks.
I know Dr Rant isn't representative but his views of superiority or entitlement are shared by many doctors and med students I've met on the internet - which obviously isn't the best forum but it gives some indication. There is a genuine belief by many that they are the best - that they should be entitled to the best - and that the reason everyone else doesn't get as much is because they're not as good. Which is something I don't agree with.
Being a doctor does not give you the right to own a luxury car or two, a holiday home or two and so on. I think the money involved undermines the motivation behind it - unfortunately I guess that's a sign of the times we live in. Of course many doctors will be doctors because they love to help people. But there may be many in the NHS who do the bare minimum because they went into the career for the inflated rewards.
And I've not got laid at uni
I'm getting funny looks from people in the office from choking on my tea at that. Utter legend.
Still wrong about this, though. And he kinda proves my point, although obviously its exaggerated for comedic effect- he should get a 58% pay rise for less work because he "fucking deserves it" and anyone who complains is a "cunt".
I don't think anyone deserves a 58% pay increase for doing less work. But GPs did deserve some sort of pay rise because they used to be paid too little.