In charts: The 10-year decline in real-terms GP income

GP income rose sharply following major contract reforms in 2004 before sinking into a 10-year tailspin. That decline has now levelled off - but how far is GP pay in real terms from where it was a decade ago?

In real terms, GP income has fallen over the past decade (Photo: iStock/Caymia)
In real terms, GP income has fallen over the past decade (Photo: iStock/Caymia)

Responding to figures on earnings and expenses published this week, GP leaders welcomed evidence of rising pay across partners and salaried doctors alike.

Average income before tax for GPs in partnership or salaried roles in GMS and PMS practices across the UK hit £92,500 in 2016/17 - a 2.7% rise from the year before, NHS Digital data show. The rise took GP income to its highest point in cash terms since 2012/13, with the rise for partners outstripping the increase for salaried GPs.

But GP leaders warned that despite the increase revealed in the latest figures, real-terms pay in 2016/17 remained nearly a quarter below the level it reached a decade earlier - leaving the average GP the equivalent of nearly £30,000 worse off in terms of income before tax.

Meanwhile, the increase in pay in 2016/17 may have been artificially inflated by the rapid decline in numbers of GPs, the BMA has warned.

Around 1,400 GP partners were lost to the profession in the 18 months leading up to the end of the 2016/17 financial year - around one in 17. The government agreed a £220m funding increase through the GP contract in 2016/17, but this sharp decline in numbers of partners - alongside a rapid fall in the wider GP workforce - makes it difficult to tell to what extent that extra funding is responsible for the rise in pay.

GPC chair Dr Richard Vautrey warned on Thursday: 'It is likely that the falling workforce accounts for a significant proportion of the apparent rise in an average partner’s salary.'

GPonline reported at the start of 2018 that many practices had 'given up' on trying to recruit GPs - with one in three facing long-term vacancies. Dr Vautrey said this week that partners were 'spreading themselves more thinly' because of this inability to fill posts.

Figures on GP earnings and expenses are put together from tax returns, so don't provide an entirely up-to-date picture. Following the 2016/17 increase in GP contract funding, further rises were agreed for 2017/18 and the current 2018/19 financial year.

But the impact of this extra investment is likely to be exaggerated in a similar way to the figures for 2016/17 - workforce data published this month revealed that general practice lost 500 full-time equivalent GPs over the past three months alone, and that partners are evaporating at a rate of 100 a month.

And with 40% of the workforce facing mental health problems often related to workload, according to a recent poll by the charity Mind, the price GPs are paying personally as the long-term erosion of income slows is clear.

Meanwhile, the pay increases are not being felt equally across the UK - rises in England are greater than for other UK countries, with GPs in Northern Ireland seeing pay continue to drop.

Despite all this, looking at GP income over a longer period suggests that real-terms income for many GPs is still in a far better place than it was around 40 or 50 years ago. In 1971/72, GP partners across Great Britain earned income before tax worth £65,883 in today's prices - around two thirds of the 2016/17 UK figure for all GPs.

Nonetheless, GPs will be looking hard at how the government allocates the £20bn funding increase for the NHS it has pledged to deliver over the coming five years. That could be key to determining how soon a new generation of GPs can be attracted into the profession to ease strain on the current workforce.

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