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Last Updated: Tuesday, 29 March 2005, 09:27 GMT 10:27 UK
Are GPs worth 100,000?
By Nick Triggle
BBC News health reporter

GP consultation
GP has earnings have doubled in six years
For decades family doctors have complained they have been underpaid and undervalued.

But if latest estimates are to be believed, those days are well and truly over.

Accountants believe average GP pay will burst through the 100,000 barrier this financial year for the first time.

The six-figure sum means pay has doubled in six years as GPs have taken advantage of the extra money available under a new contract.

It puts them ahead of hospital consultants - traditionally seen as the big earners - in the NHS pay stakes, and is four times more than the average nurse with four years experience can take home.

However, the leap in pay has also put pressure on GPs to deliver as the government places them at the heart of the health service.

GPs are being given the option of commissioning services from April, and they will also be responsible for helping patients to exercise choice.

Rise

GP pay rose steadily by about 3% during much of the 1990s and early 2000s.

It was not until the first of the extra monies became available under the new GMS contract, which two thirds of GPs are on, in 2003 that pay really started to rise significantly.

GPs on the other contract, PMS, introduced in 1998, earn even more than 100,000, but have always tended to be paid more as they offer a broader range of services.

The GMS contract, which also allowed GPs to relinquish out-of-hours cover, pays GPs extra for meeting quality targets for a range of disease from diabetes to heart failure.

Family doctors can also earn extra if they provide enhanced services such as minor surgery clinics.

THE PAY STAKES
175,000 - The prime minister
100,000 - GPs
75,000 - Hospital consultant
60,000 - University professor
57,000 - Backbench MP
35,000 - Plumber
32,000 - Train driver
28,500 - Journalist
26,000 - Nurse
12,000 - Hospital porter

Valerie Martin, national medical director for PKF, which does the books for more than 6,000 GPs, said the last two years had seen 20% pay rises - in excess of the 16% increase FTSE 350 directors have had in the last year and well above the national average of 4.5%.

"Their pay has certainly increased a lot, although GPs would say they have not been paid enough in the past."

"I think they are probably in line for one more good year, before levelling off to something nearer the average."

Laurence Slavin, a medical accountant for Ramsay Brown and Partners, said: "GPs have always been pretty entrepreneurial and with this new contract they have proved to be.

Pay packet

"I think they have taken advantage of the extra monies that are available to boost their pay significantly."

And Mr Slavin predicted there could be another rise of more than 10% in the next financial year.

But some believe the bulging pay packets mean family doctors will be scrutinised more.

Joe Farrington-Douglas, health and social care researcher at the Institute for Public Policy Research, said: "GPs are playing an ever more important role in the NHS with patients being given more choice about treatment, and extra powers being given to them to commission services themselves.

"What now needs to be seen is whether the public is getting value for money.

"With the amounts they are being paid the time has come to deliver."

The rising in wages has also come after unions spent three years fighting for wages to be increased for some of the lowest paid workers.

Agenda for Change, which was agreed at the end of last year, sets a minimum wage of 5.69 - a sum which is paid to many thousands of porters, cleaners, and catering and administrative staff.

Professional

A spokeswoman for public sector union Unison said there was a shortage of GPs - the Royal College of GPs estimates another 10,000 doctors are needed over the coming years - and it was important to pay wages which attracted professional people.

But she added: "Our only concern is if we were to see the gap between the top and bottom increase even further.

"It is important to see every part of the NHS as an important element."

Richard Vautrey, a member of the British Medical Association's GPs committee, said the accountants' estimates were "probably a little high", adding he would expect it to be around 90,000.

Nor did he believe GPs were earning as much as a consultant - whose average wage is 75,000 according to the BMA - because they would top up their earnings with merit awards and private work.

On the whole they provide a good service... and are worth the money
Michael Summers, of the Patients Association

But he added that one of the main factors behind the rise in pay was that GPs had been doing their jobs well.

"I think GPs have been good at meeting the quality targets, although taking on enhanced services has proved a little more difficult.

"Pay has gone up, but what has to be taken into account is that for years GPs have been undervalued.

"A GP is a specialist in their own right."

A Department of Health spokesman said the 100,000 figure was not unreasonable, adding: "Reported increases in GP income indicate that GPs are now being rewarded with new money for delivering more and better services for patients."

And it seems the most important group for GPs - patients - will not begrudge their doctors the extra rewards.

Patients Association chairman Michael Summers said: "When you consider what other professionals such as accountants, lawyers and barristers are earning, 100,000 is probably reasonable.

"On the whole they provide a good service, tending to our ailments, diagnosing disease early and referring us on when necessary, and are worth the money.

"There is also the shortage of GPs to contend with. In many areas practice lists are closed to new patients - this is because there is just not enough GPs to go round."




SEE ALSO
Many GPs 'snubbing NHS changes'
21 Mar 05 |  Health

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