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GPs to "desert" NHS for being made to work for their wages

Story.

GPs, whose average wage often now tops £100,000 a year, are throwing their toys out of the pram because the Government is considering making them have extended surgery opening hours, with the possibility of weekend opening.

I mean, how dare the Government make doctors work for their money? Their wages were practically doubled five years ago, at the same time the responsibility for out-of-hours services were taken away from GPs. And now the Government wants the GPs to do some work for their money they're all going off in a sulk.

It's a real shame that there isn't the manpower to sack these overpaid and underworked whingebags and get someone in who's prepared to work for their exorbitant wages.

Still, the GP's concern for their family life must come as something of a relief to those of us who work all hours of the day to pay for their grossly inflated wages. Traditional opening hours are no longer relevant to society and if GPs want to be paid by society they should muck in. I bet they'd do the extended hours if they were paid by the client.

And before anyone compares GPs to solicitors, etc, the average publicly-funded solicitor earns about £35,000pa- about 1/3 of that earned by a GP).
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Comments

  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Pay them less and make them work less. They deserve family time just like everyone else, but surely the government could do some system that involves each doctor doing one weekend a month, then getting two weekdays off.

    I could never be a doctor (not clever enough) and one of the reasons would be the lack of time for yourself and your family.

    I think if the government's determined to do extended hours at weekends & evenings, they should give the doctors less pay & give them time off in the week instead.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I think all doctors should be open at least one evening or Saturday morning a week. Even if it was just one single doctor, and people who could go in the week, such as pensioners of stay at home Mums, are not allowed to use those slots, it would help.

    For the last few months, I've been temping, which means if I don't go into work, I don't get paid. In order to get a doctors appointment, I've had to take a whole afternoon off work. There does need to be more consideration for people who work full time.

    I do find it hard to have sympathy for people who earn so much.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    katchika wrote: »
    I do find it hard to have sympathy for people who earn so much.

    I don't have a problem with people who earn so much per se (they worked and studied awfully hard to get there), but I do think that doctors ought to rota themselves over weekends. The NHS Walk-In Centres are not quite the same as seeing your doc.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    None of the GPs at the practice I'm at earn anywhere near what the media likes to suggest. And partners seem to be being phased out in return for regular salaried doctors, so the picture of the fat doctor playing golf on his nice little £250k year job is a bit moot for the majority of GPs out there.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Teagan wrote: »
    I don't have a problem with people who earn so much per se (they worked and studied awfully hard to get there), but I do think that doctors ought to rota themselves over weekends. The NHS Walk-In Centres are not quite the same as seeing your doc.

    I agree.

    Rota-ing them seems so much more sensible considering that all other health workers have to do weekends too and get paid a hell of a lot less for it
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Hum yeah, I don't begrudge doctors their wage, they do work hard for it, I just think GP services should be more flexible to fit society. Even banks open on Saturday mornings now.

    The walk in centres are ok but aren't they only staffed by nurses, and you can't get appointments, you just have to wait.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Doctors seem to have a huge sense of entitlement. We saw it a few years ago when it was announced the NHS wouldn't have enough jobs for them all. This meant some of them would have to go abroad or into the private sector in order to be a doctor. Yeah, and since when is anyone automatically entitled to a job on the NHS?

    If GPs do "desert" the NHS, as Kermit puts it, I have a simple and practical solution. We import doctors from Poland. They will happily work for around a quarter of the £100k that GPs demand, they'll work longer hours and they'll have no qualms about working six days a week.
    katchika wrote: »
    Hum yeah, I don't begrudge doctors their wage, they do work hard for it, I just think GP services should be more flexible to fit society. Even banks open on Saturday mornings now.
    Even so, that's pathetic, frankly. Firstly, most banks aren't open on Saturdays at all. Banks still seem to exist in a 9-5 world when society has long moved away from that. If Tesco only opened from 9.00am - 4.30pm, Monday to Friday, they'd soon go out of business. The moment that banks open 12 hours a day, 6 days per week, I'll be happy.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Well, you do live in the middle of nowhere. Most the banks in Wolverhampton open on a Saturday up till 2/3pm.

    And if you seriously think doctors from Poland would work for 25K while English doctors get more, you're crazy.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    katchika wrote: »
    Well, you do live in the middle of nowhere. Most the banks in Wolverhampton open on a Saturday up till 2/3pm.
    Even when I'm over in Manchester, I still struggle to find a branch of NatWest that opens on a Saturday.
    And if you seriously think doctors from Poland would work for 25K while English doctors get more, you're crazy.
    Oh, don't get me wrong. I'd be happy to see Polish GPs earning £100k a year as well. Difference is, they'd actually deserve the money.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    That's your fault for banking with Crapwest.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    katchika wrote: »
    That's your fault for banking with Crapwest.
    Hey, I used to be with HSBC and they were even worse. But that's a topic for another thread.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    stargalaxy wrote: »
    Doctors seem to have a huge sense of entitlement. We saw it a few years ago when it was announced the NHS wouldn't have enough jobs for them all. This meant some of them would have to go abroad or into the private sector in order to be a doctor. Yeah, and since when is anyone automatically entitled to a job on the NHS?

    Well it's a bit of a waste of taxpayer's money if they don't get a job with the NHS.. Studying medicine takes a long time and costs a massive amount of money. Medicine - more than any other discipline is hugely subsidised. (Top-up fees nowhere near cover the actual cost). If they go abroad the NHS and the public don't benefit.
    stargalaxy wrote: »
    If GPs do "desert" the NHS, as Kermit puts it, I have a simple and practical solution. We import doctors from Poland.

    Poland needs doctors too. Polish doctors who wanted to move to Britain are probably already here anyway. 'Importing' people from Poland is not a solution to anything. Poles have come here and some will stay permanently but a lot won't. Some are here just to make some quick money... As opportunities increase in Poland a lot of people will go back. People have their ties and Poland is a nice country, it's not a basket-case... Medicine is oversubscribed, there is no shortage of British students willing to pursue a career in medicine. Long term, 'importing' people from abroad is absolutely unnecessary.
    stargalaxy wrote: »
    They will happily work for around a quarter of the £100k that GPs demand, they'll work longer hours and they'll have no qualms about working six days a week.

    Um will they? So we should just get whoever we can to do the job who will do it for the lowest salary and will work the longest hours? Show some respect for the existing, well-trained and hard-working GPs that we have... (For the record I think doctor's surgeries should all offer a basic service for emergencies at weekends... and some evening services for people who work. With a bit of compromise I'm sure this could be achieved without resorting to 'importing' doctors from abroad.
    stargalaxy wrote: »
    If Tesco only opened from 9.00am - 4.30pm, Monday to Friday, they'd soon go out of business. The moment that banks open 12 hours a day, 6 days per week, I'll be happy.

    :rolleyes: And if banks open 12 hours a day, 6 days per week it'll cost an enormous amount of money... And we'll all pay for it in the form of higher fees and charges/interest rates/etc. In most countries 'free' banking doesn't exist, overseas banks charge their customers for cheques, maintaining a current account, withdrawals over the counter, etc.

    In most of Europe you won't see any supermarket open 24 hours and you won't see supermarkets open on Sunday. Carrefour which don't open on Sunday's are bigger than Tesco. Tesco and the other big supermarkets here would not go bankrupt if they scrapped 24 hour opening and closed on Sunday's. Broadly speaking regardless of how long supermarkets are open people buy the same amount of stuff - longer opening doesn't make us need to buy more milk, more meat, more fruit, etc. I'm quite sure that for what it costs supermarkets to open longer, ridiculously long opening hours don't make sense... But the supermarket business is so cutthroat they all want an edge over each other and longer hours was one route the supermarkets went down - and now we've got it, they won't go back. It's us that pay though - do a big shop in a German or a French supermarket and it's a lot cheaper than it is over here... Long opening hours, Sunday opening (paying staff Sunday premium) etc costs money and we pay in the form of higher prices....

    If everybody else in Europe can survive without going to the supermarket on one day a week and can cope with not being able to buy junk food at 3am I think we can. Our obsession with 'convenience' is one of the reasons we have higher prices.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Medicine - more than any other discipline is hugely subsidised.

    :yes: It costs £250,000 to train each person. There are about 340 people in my year group alone...
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    And instead of being grateful for the subsidy doctors get the BMA throws its weight around yet again. Clearly an organisation too used to talking from a position of power.

    The last pay settlement with GPs was astronomical, and the rest of the NHS is going to be paying for it for a long long time. Northumberland at one point had one out-of-hours GP; the county covers about 700 square miles. Even now the out-of-hours service is based in Newcastle, which is a good 90 minute drive to the top of the county.

    Rather than appreciate that doctors are paid a lot of money to provide a service, the BMA seem to expect the taxpayer to cough up ever bigger amounts of money with less and less in return. Working until 7pm a couple of nights a week isn't going to kill them; I have to do it as part of my government contract and I don't get paid a six-figure salary to do it.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Doctors are finally earning the level of money which recognises the work which they have been doing for years. Over 80% of all NHS work takes place within the GP practice, over 86% of the general public (in this years patient questionairre) stated that they were happy wit hthe practice's current opening time, evidence shows that even when GPs open on Saturdays the services aren't access by their patients.

    This is all about the Govt trying to cover up the fact that they fucked up the GP contract. They had no real understanding what GPs actually did, in terms of hours and services provided, they had no concept of how much it would cost to provide OOH services and, ever since the GPs started to make the most of their new contract, the Govt have mounted a scurrilous smear campaign to try and turn of patient satisfaction rates wit htheir GPs (which currently runs in the high 80% area). The way that GPs maximise dtheir income was to provide improved services in their practice - they have to now achieve a large number of quality measures which include screening for risk factors in heart disease, dementia, diabetics, asthma sufferes plus many others and then treat patients in line with "best practice". They aren't get money for just doing the same old same old.

    I have yet to meet a GP who works "normal" hours like the majority of the public. If you ignore the fact that many practices already open 8.30-6.30, ignore the fact that GPs will have morning sessions and afternoon/evening sessions, ignore the number of home vists, coroners reports, death certifications, hospitals vists etc then it might be possible to argue that they don't work hard enough.

    Of course, that is missing the number of other services they offer which prevent people from having to attend hospital for appointments (things like minor surgery, dermatology, cardiology, endoscoies etc)...

    This year the Govt have said that they want GPs to open for an extra 30 mins per week for every 1000 patients registered with the practice. For that the practice will get an additional 1.5% increase in income.

    You might note that MPs have already voted themselves a payrise greater than that.

    You might also want to note that I am talking about 1.5% increase for the practoce and not the GP salary. Out of that the practice will have increased costs (overheads for opening longer hours) plus natural inflation costs and of course increase wages for the staff which they employ.

    As an aside "people who pay their wages" - that would be themselves then, they are taxpayers too.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Has anyone ever had a problem seeing their GP? I was surprised that they were actually apologizing that they couldn't see me before the end of the day. I went in expecting an appointment some time in the next week ffs. GP's surgeries are great ime. And if everyone else has to work weekends, then you'll all have days off during the week to go to the doctors then, won't you? ;)
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Has anyone ever had a problem seeing their GP?

    Yes. On Monday (not the one just gone; the one before) I phoned up to make an appointment and had to wait until Friday to be seen as it wasn't an emergency. Also, last year, I had to wait a week to be seen as well. (although I was away for 3 days within that week)
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I have had a lot of problems getting to see a doctor and even being able to register with any at one point.

    Now they have 0845 numbers, once I spent £10 of phone credit trying to book an emergency appointment.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Doctors are finally earning the level of money which recognises the work which they have been doing for years.

    They would be if they still provided OOH services.

    But they don't.
    This is all about the Govt trying to cover up the fact that they fucked up the GP contract.

    Nah, its more about trying to rectify the mistake. The mistake was cutting doctors work by about 1/3 and giving them a payrise of about 50%.

    If doctors are going go to earn salaries that puts them in the top 1% of earners then they should have to work for the money. The OOH service is a disaster purely because all GPs opted-out of the system.

    I blame the GPs for taking the cash without putting the work in. But I blame the Government more for letting them.

    But that isn't the point. The point is that now the Government are trying to reset the balance the BMA throw their toys out of the pram. Let them walk away from the NHS, but make them pay back every single penny of subsidy they received before they do.
    You might note that MPs have already voted themselves a payrise greater than that.

    Aye, I did notice that.

    They're a set of cunts who want hanging. But then we all knew that anyway.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Poland needs doctors too. Polish doctors who wanted to move to Britain are probably already here anyway. 'Importing' people from Poland is not a solution to anything.
    Why then, have I never seen you complaining about the importing of nurses from other countries to work in the NHS?
    And if banks open 12 hours a day, 6 days per week it'll cost an enormous amount of money... And we'll all pay for it in the form of higher fees and charges/interest rates/etc. In most countries 'free' banking doesn't exist, overseas banks charge their customers for cheques, maintaining a current account, withdrawals over the counter, etc.
    Oh, don't be ridicilous. Banks rake in billions of pounds every single year. They could easily afford to extend their opening hours. Recently, a branch of Barclays in a nearby town had these huge posters up, boasting that it now opened from 9am to 5pm. Yeah, as if that's something to boast about. Longer opening hours might mean less time spent in bloody queues at city branches for the customers.

    But back to the topic at hand... have I ever found it difficult to see my GP? Oh god yes. The staff at the local surgery arrive at around 8.45am, and I have to make sure I call them at that exact time. Appointments get taken up very quickly. If I call after 9.30am, (on an 0845 number too, if you please) I get told there are no more spaces that day and to call back tomorrow.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kermit,

    Do you realise that the level of pay GPs get is related to the services they offer?

    So the high earning practises (who have to cover their practise costs) will be the ones providing out of hours services, and hitting all the performance targets and providing additional services. This pushes the average pay up, and the ones who no longer provide out of hours services aren't getting as much money.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kermit wrote: »
    Nah, its more about trying to rectify the mistake. The mistake was cutting doctors work by about 1/3 and giving them a payrise of about 50%.

    Except that isn't what happened.

    before the contract GPs got paid a fixed amount per patient on their list, now they get pad less per patient and the rest is performance related (including access), so if they don't perform then they don't earn.

    Again, that funding actually goes into the practice and not the GP, so from that income they have to pay staff and overheads etc. To date the value of the contractual payments has not risen in line with inflation, in fact last year there was no increase at all - yet all the costs of providing services increased.

    This year's negotiation is just an extension of the same apporach of clawing back based on a fuck up.

    Problem is that the Govt didn;t understand that people will perform better if you financially incentivise them and so come unstuck, not budgetting enough. To take attention away from that we've had a smear campaign, for which you have fallen hook line and sinker.

    Interesting how opning times weren't an issue until after the first year of the contract, isn't it?

    The OOH service is a disaster purely because all GPs opted-out of the system.

    It's a disaster because the Govt only reduced GP income by a small amount so many more opted out that perhaps would have done. It's a disaster because for year GPs were expected to offer the services for no additional pay. It's a disaster because staying up all night so that you can see little Johnny wh ocoughed last week just demoralises someone, especially when you can give it up and not lose much income. It's a disaster because when GPs did opt out the Govt didn't actually put enough monney into re-provision of these services.
    Let them walk away from the NHS, but make them pay back every single penny of subsidy they received before they do.

    They won't, it's an empty threat.

    What will happen though is that they will stop doing all those things which they currently do and for which they are not paid as part of their contract. It's still a huge amount, it will affect the NHS and it will cause the Govt to back down.

    Just as their did to deliver the contract in the first place.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Oh, and be warned, they royally screwed up the new dental contract too, so you may well see a similar smear campaign comin through on that in the not too distant future.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    stargalaxy wrote: »
    Why then, have I never seen you complaining about the importing of nurses from other countries to work in the NHS?

    I think I have before...

    Taking trained nurses and doctors from third world countries that paid for their training is a disgusting practice...
    stargalaxy wrote: »
    But back to the topic at hand... have I ever found it difficult to see my GP? Oh god yes. The staff at the local surgery arrive at around 8.45am, and I have to make sure I call them at that exact time. Appointments get taken up very quickly. If I call after 9.30am, (on an 0845 number too, if you please) I get told there are no more spaces that day and to call back tomorrow.

    0845 numbers are local rate. If it's urgent your GP will see you the same day. If it's not urgent I don't think it's outrageous that you call back the next day. In my experience, if I call at 9am I can normally get a same-day appointment. I think that's pretty good tbh...
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I havent seen my actual GP for years, but when I do need to go and thats only three/four times a year at most, if I phone between 8.30 and 9.00 I can normally get an appointment. Have had to wait for nearly a week to see a GP after making the appointment (for family planning), the one I wanted to see only works part time and it wasnt an emergency. I've seen GPs before and had a follow up, treatment booked at the time for normally a week later at a time to suit.

    The local council and the practise I go to have just built a brand new surgery as well, the old one was far too small and unsuitable. More GPs, more practise nurses and more treatment avaiable, worth every penny.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Has anyone ever had a problem seeing their GP? I was surprised that they were actually apologizing that they couldn't see me before the end of the day. I went in expecting an appointment some time in the next week ffs. GP's surgeries are great ime. And if everyone else has to work weekends, then you'll all have days off during the week to go to the doctors then, won't you? ;)

    Normally half the day is appointments and the other half is reserved for 'drop in' stuff.

    My doctor is quite good that if you ring him he will come out to you, has done on more than one occasion.

    Thing with doctors in general is it's hard to judge because not many of us are doctors. From my experience, professionally they're pretty good but not usually as friendly as joe bloggs i.e. see you as a customer rather than a human being with feelings. Never catch one hugging ya :p.

    Second is that there is an air of eliteness, superiority. When I decribed my symptoms to my GP he asked me what he thought it was, I said I dunno could be diabetes and he checked me over for diabetes and said I was ok, but I shouldn't diagnose myself. He asked me too! :rolleyes:

    (and the only reason I said diabetes was because I made a thread here saying 'I have xxx what should i do' and someone said 'could be diabetes get it checked out')

    He loves telling me I'm wrong :p.

    I think he gets paid exceptionally well, a few years ago when it was just him it was £300K for him, his staffing, premises whatnot and the other bits they need, per year. Has a new Jag every year :p. He's got another doctor working there now though so I don't know what his take home is.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I had to wait two weeks to see a doctor about a throat infection and at my practise i wasn't even waiting to see my own GP i could understand it a bit more if that was the case, but it was two weeks to see any doctor in the practise



    Just thought i'd throw this in on the whole problems seeing your GP thing
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Oh, and be warned, they royally screwed up the new dental contract too, so you may well see a similar smear campaign comin through on that in the not too distant future.

    An interesting issue. What you had there was a Govt wary because of how they fucked up and a group of professional who got greedy because they expected to get as good a deal as the GPs did, without realising that they didn't have the same level of support from the public (remember the GP contract was in part a reaction to poor recruitment and public clamour that "something must be done"), that they don't offer the same plethora of "other" services and that, actually, the new contract isn't a bad as they would like the public to believe.

    Problem with dentists is that they seem to expect the NHS to pay the same rate as their private patients do.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    actually, the new contract isn't a bad as they would like the public to believe.

    Problem with dentists is that they seem to expect the NHS to pay the same rate as their private patients do.

    Biggest problem with the new Dental contract is the way it screws over the public. It forces dentists to either try and cram all NHS work into less appointments than they need to do it (because they are on a quota limit of how many NHS units they can claim a year), to only take on a certain kind of NHS patient (the easy ones that don't pay charges) so that they can provide a complete course of treatment to them without running out of units that they can claim for, or to just give up on NHS entirely and decide that it's far simpler to run the practise their way and write treatment plans based on what's needed all year round rather than being restricted as to what they can do in the last 4 months of the year because they are running out of NHS units. It's also pushing more complex NHS work out of high street surgerys and into Community which is a far more expensive way to do it, and the referrals are going through because it's not economic for high street dentists to do the work on the NHS.
    /Side track onto Dentistry

    At the moment there's no restriction on what the GPs can do, and how many of the extra services they can provide, or targets they can hit. This means the good ones that go for it body and soul are getting very high practise incomes.

    What very few people seem to have linked up yet is that it's the good GPs who are getting the high salaries. The ones who take a fortnight to give you your appointment aren't hitting their targets and thus won't be getting the renumeration for doing so.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    The dentists lost all my sympathy fifteen years ago when they all deserted the NHS en masse because of sheer unadulterated greed. Which is why there are now no NHS dental services in most of Yorkshire- the greedy dentists could increase their salaries by booting the poor off their lists and making everyone else pay ten times as much. So much for caring about people- the only thing dentists have cared about for the last fifteen years is the size of people's wallets and how much cash they can crowbar out of them.

    Because of the sheer greed of dentists a lot of poor people are faced with a choice of paying upwards of one hundred nicker to have a tooth extracted, or doing it themselves with a doorframe. £100 is truly affordable for someone on income support, isn't it?

    I have no problem with GP pay per se. I agree that GPs should be paid for the work they do- the lack of extra funding for OOH services was a disgrace. But the lack of a "real terms" payrise for the last 18 months (following a huge payrise) doesn't make my heart bleed. A comparative professional, such as a criminal defence lawyer, hasn't had any sort of payrise since 1994, so GPs are doing very well from the public purse compared to their graduate peers.

    But the pendulum has now swung too far the other way. GPs have taken the cash and walked away from OOH services. It is now impossible to see an OOH doctor in most of Northumberland because all the local doctors have taken the gigantic pay rise without putting anything back in to society. As a result the OOH service is based two hours away from where people live.

    If doctors want to take the extra money they should put the extra hours in. They should have the funding pulled unless they pull their weight in the OOH services. I fail to see why anyone is against this, except GPs who will have to do some work for their payrise now.

    I don't care how good the "service" now is during the day, the simple fact remains is that OOH provision is a shambles at the same time that GPs are taking ever-increasing sums out of the NHS. They're being renumerated for a service they are simply not providing. A service they should be providing.
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