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Last Updated: Tuesday, 18 April 2006, 12:40 GMT 13:40 UK
Are doctors earning their crust?
By Nick Triggle
BBC News health reporter

Some GPs are earning up to 250,000 a year after expenses, according to reports.

If true, it means the best paid family doctors now get more than the prime minister. But are patients getting value for money?

Image of a GP
Average GP pay is now about 100,000

Within hours of opening on Tuesday morning, after the Easter weekend, College Surgery received nearly 200 calls from patients asking for appointments.

Under government targets tied into the new GP contract, the practice in Cullompton, Devon, had to deal with them immediately.

Two thirds of the queries were answered over the phone, but scores of patients still had to be offered appointments for the afternoon or next day at the latest.

But access is just one of the areas of GP care that family doctors are judged on under the performance-related pay system introduced two years ago.


Dr Jeremy Jacob, one of 10 partners at the practice, said: "There are many more demands on GPs than there used to be.

"We are doing much more than we used to - blood pressure clinics, chronic disease management. I work over 50 hours a week on average, starting at 8am and working through until 8pm.

"What is more, practices are also businesses. The partners have to have business meetings these are done in the evenings and at weekends.

GPs have done very well, but we have probably paid too much for these gains as important as they are
Professor Chris Ham, of Birmingham University

"However, I would say those earning 250,000 are a minority. The average is probably about 100,000 to 120,000 and that is what we are approaching."

No doctor earning anywhere near the top figure is prepared to go on record.

But experts suggest it is likely the GPs earning the big bucks will run large practices in rural areas, perhaps operating as a dispensing doctor which means they provide the dual function of doctor and pharmacist.

Alternatively, they could run a practice with tens of thousands of patients and employ salaried GPs - traditionally paid around 60,000 a year - who do not have a stake in the practice. This would allow them to maximise their profits.

While not everyone is getting the 250,000, it seems clear that average GP pay has increased.

Before the new contract came in pay was about 65,000 and the British Medical Association, which negotiated the contract with the government, estimates it is now around the 100,000 mark.


Dr Simon Fradd, a part-time Nottingham GP who earns 66,000, said: "It is true that doctors pay has gone up, but it had to to redress recruitment and retention problems.

"But we are also providing much more sophisticated care. We are offering all sorts of health advice on smoking, weight and exercise on top of the standard care. This is what people say they want."

The government has also defended the pay rises, saying they have helped increase doctors in training by two thirds.

And Dr Hamish Meldrum, of the British Medical Association, added: "Research demonstrates that the new contract is yielding health improvements for patients.

"In the area of raised blood pressure alone GP care under the new contract means that over a five year period 8,700 patients in England will avoid having a heart attack, stroke, angina or heart failure."

Nonetheless, the pay rises have still been partly blamed for the spiralling deficits in the health service - over recent weeks 7,000 job losses have been announced as trusts struggle to balance the books.

The King's Fund health think-tank has estimated that 40% of the 4.5bn extra earmarked for the NHS in 2006-7 will go on pay rises - consultants and nurses have both received above inflation salary increases as well.

Liberal Democrat health spokesman Steve Webb said: "In negotiating the new contract for GPs, the government has once again failed to get value for money.

"It set the quality threshold far too low, which meant that almost all GPs have qualified for a large pay increase, substantially in excess of what the government had budgeted for."

And Professor Chris Ham, a health policy expert at Birmingham University, added: "GPs have done very well, but we have probably paid too much for these gains as important as they are."

A GP explains the changing nature of the job

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