Thursday, 13 November 2014

NHS consultants' pay vs NHS GPs' pay

Some NHS GPs call for a trade union that only represents GPs and not consultants too as the BMA denies NHS GPs a ballot on some form of industrial action as pay and working conditions for NHS GPs continue to deteriorate.

A NHS hospital consultant pays only 12% to the NHS pension yet NHS GP partners have to pay 27%! Here is the BMA published salary pay scale for NHS hospital consultants. Now note, that GP partners' pay is dependent on practice income and the government has taken away the 'minimum practice income guarantee' so we see GP partners' pay nose dive. But hospital consultants are guaranteed their NHS salary of up to £101k regardless of the NHS hospital revenue. And their pay reflects their seniority whereas seniority pay for NHS GPs has also been scrapped!

As if NHS GP partners are not suffering enough in this time of NHS austerity, NHS hospital consultants continue to receive banker-style annual bonuses to top up their guaranteed NHS salary! These annual NHS financial bonuses are called 'clinical excellence awards' as if private practice income was not bonus enough?

So a NHS hospital consultant may end up with a £101,451 guaranteed NHS salary + bonus of up to £75,796 + private practice income (£500k- £1 million according to a surgeon interviewed on Inside Harley Street) or a total semi-private income of well over £600k! Consultants may charge between £150 to £260 for a 30-minute private consultation and £1000s for private operations to top up their already lucrative guaranteed NHS income.

Contrast this with a NHS GP partner whose take home pay (drawings) is now, in many cases, less than the salaried GP. A salaried GP may earn between £57k and £78k or £44/hour. A GP partner has seen a drop in drawings between 20-50% due to government cuts to practice reimbursements and a GP partner's pay is NOT guaranteed but dependent on practice revenue. A NHS GP has little scope for private practice to supplement the huge loss in NHS earnings. And there are NO clinical excellence financial NHS awards for GPs. After pension outgoings of 27% and rising indemnity fees of £7-8k a year (vs NHS consultants get crown indemnity), there is little left over.

The BMA is chaired by a NHS hospital consultant and the BMA council comprises of both GPs and hospital consultants. Many NHS GPs now call for a trade union that only represents GPs as they are deprived of a BMA ballot on some form of industrial action on a unilateral contract, while many NHS GP partnerships are decimated, with many hard-working grassroots GPs driven to burnout and bankruptcy and we watch what may very well be the demise of NHS general practice.

NHS salaried GP, 'Shame on the GPC and BMA - you have failed to act, and failed to represent us. I resigned my membership and they couldn't care less.'

NHS GP Partner, 'We are supposed to be independent Contractors, but the (BMA) GPC does nothing while they impose Contracts. If this is far too much work and our mental and physical health is affected, we cannot close our lists. Sometimes I dream of a (BMA) GPC who can actually stand up for us GPs and say NO, instead of all this Yes, Yes, Minister. I wonder if they ever wonder what might happen if the (BMA) GPC said NO, instead of bleating to the newspapers about help to recruit new GPs. GPC can you not see your tactics meant hat you cannot recruit or retain GPs. You GPC are in charge of this debacle...the nation cannot do without GPs, for sure.'

Addendum November 25. The new NHS contract for 2015 will demand that NHS consultants work in house nights and weekends for pay no more than their daytime rates. This will prompt many NHS consultants to leave the NHS, emigrate or concentrate solely on private practice. Over 4,500 non GPs have obtained their GMC certificates of good standing as they plan to emigrate. In 2013, over 500 GPs made similar plans to emigrate.

Consultants' concern may well be that 8 hour working day managers may abuse them like some already are in America, working consecutive nights deprived of food and sleep, their basic human rights .

Only Australia and Canada stayed clear of U.S. subprime mortgages while the rest of the world's economies were hit by a global recession.