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Last Updated: Wednesday, 31 October 2007, 12:29 GMT
Q&A: GPs' pay
GPs pay has risen again and now stands at 110,000 on average - the second year in succession that they have seen a big hike.

And the figures have added more fuel to the fire over the debate about the government-brokered deal which paved the way for inflation-busting increases.

A GP with a mother and child
GPs earn money for meeting targets in areas such as children's vaccinations

Why was a new contract brought in?

It was becoming increasingly difficult to attract young doctors into general practice, and to encourage those already working in it to stay.

GPs historically earned less than hospital doctors, and trainee medics were put off becoming a family doctor because of the perceived high workload and a responsibility for 24-hour cover.

The government agreed with the British Medical Association that a new contract was needed.

After detailed negotiations, the new contract was brought in from 2004.

What did it mean?

For doctors, it meant two significant things.

They would no longer be responsible for providing care to the patients on their list 24 hours a day, seven days a week.

Instead, they would be expected to work "office hours", with local primary care trusts responsible for healthcare at night and at the weekend.

But more significantly, in regard to the NHS's financial situation, the way GPs were paid changed with around a thirds of their income being linked to whether they delivered quality services in certain areas.

These range from record keeping to meeting targets for providing a range of clinical services such as cholesterol checks and flu jabs.

How did this result in more pay?

The targets are measured in points. And points mean pounds.

When the contract was being negotiated, the government estimated GPs would meet about 70% of the target.

Instead - and the BMA says it warned of this - GPs are hitting over 90% of them.

Critics said this mistake contributed to the problem with deficits that the health service has struggled with in recent years.

Doctors have also been criticised for taking more pay out of the surgery business.

Before the new contract came in about 40% of income was taken in profit - or pay - with the rest being used to pay staff and bills, but this has now risen to 45%.

The government said this should have been invested back into the practice to make services better.

Aren't some doctors earning over 250,000?

Yes, but only a small fraction. It stands at just over 300 on latest count which is double the figure the previous year.

These are likely to be dispensing GPs who work in rural areas and run a pharmacy as well as a surgery.

Average pay for GP partners in 2005-6 was 110,000, compared to just over 100,000 the year before and about 80,000 before the new contract came in.

However, there are some disparities when broken down by country.

GPs in England earned an average of 113,600, compared to 102,200 in Wales, 98,700 in Northern Ireland and 90,600 in Scotland.

The British Medical Association says this is to do with patient list sizes which tend to be larger in England.

Will we continue seeing rises?

No, well, not on such a scale anyway. In the most recent two years, the basic pay, officially known as the global sum, has been frozen.

The first time this happened in 2006-7 doctors agreed to it in a bid to nip in the bud the bad headlines.

But they were left angry when the pay review body ruled they would get 0% again in the current financial year.

The result is that there will not be a big hike in the next couple of years, although pay could end up rising slightly if doctors perform better on the performance-related aspect.

SEE ALSO
GP pay 110,000 after a 10% rise
31 Oct 07 |  Health
Are GPs worth 100,000?
29 Mar 05 |  Health
Is your GP worth it?
18 Apr 06 |  Have Your Say
Doctors cash in on new pay deal
28 Jun 05 |  Scotland

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