Page last updated at 04:59 GMT, Wednesday, 26 August 2009 05:59 UK

Should GPs be more open on pay?

Mike Dixon
Dr Michael Dixon
NHS Alliance chairman

GP giving a childhood immunisation
GPs receive payments for care including childhood jabs

GP pay levels are controversial, with the average family doctor earning over £100,000 and claims some earn well in excess of that.

In this week's Scrubbing Up, Dr Michael Dixon argues GPs must stop simply disputing such figures and be more open about their salaries.

Mud sticks. When the Daily Mail claims that GPs earn "jaw dropping" amounts of money - some well over £300,000 - is it enough to simply dispute this?

Should we be more transparent about what we do actually earn?

The issue is not simply about how GPs want to be perceived.

Transparency may prove to be the only answer

We are hardly in the same league as bankers and no-one is suggesting, as in the case of one or two MPs, that we might have broken any rules.

My own pay from the NHS before tax is just under £100,000 pro rata, including a seniority allowance.

The problem is that, if GPs are seen as "fat cats", earning more than we deserve, this could seriously damage our relationship with patients, who may perceive us to be there just for the money.

This, of course, would have a negative impact on our ability to create a rapport with our patients which is essential if we are to fulfil our role as doctors, including being empathetic and able to comfort our patients.

Transparency may prove to be the only answer.

GPs, as advocates of patients and their local population, need to take the high moral ground.

To offer transparency before it is demanded of them may become a serious option for them and all those working in the public services.

'Taxpayers are our paymasters'

GPs don't need to be defensive.

The overall cost of their general practitioner and practice for each patient is just £120 per year, or £10 a month, which represents value for money, considering that patients have unlimited access not only to their GP but also to other services the practice may provide.

Is simply saying all this enough to convince the public and our patients that doctors are not overpaid?

It may be reasonable for the public to ask to see the actual figures.

After all, as taxpayers, they are paymasters.

They will point to assertions that the increase in money going into general practice since the new GP contract has only partially gone into paying for more staff and equipment.

Some practices have used the new income to improve the service, some have used it to significantly increase take home pay.

Others are deservedly earning more money because they are working harder and longer and running more cost-effective practices.

Should the public and their patients not be allowed to judge these things just as we have been allowed to judge MPs on their salaries and expenses?

Only fair

This is an issue that is bound to divide the GP profession.

Plenty will argue that their take home pay is their own business, as it is for most people.

A few will say that, if the public have a grossly distorted view of what GPs earn, then the only way to put the record straight will be for GPs and practices to open their accounts to their patients and the public.

GPs and their practices have a key role to play in their local community

Alternatively, it might be possible to devise an index, which would enable public and patients to know if a GP practice is ploughing back sufficient money in to practice and patient services.

Clearly, the issue here is not only about how much GPs earn, but what services they are providing in return for their salaries.

It wouldn't be fair to only compare GPs' income without considering how many patients they have, the services they provide and even the specific health issues they are having to tackle in their local communities.

Whatever road we decide to take, I would like to think that GPs, their patients, the public and the media will really consider our work as more than just a number crunching exercise.

GPs and their practices have a key role to play in their local community which is independent of how many patients they have and how much money they earn.

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