Chris Lancelot on…Capping GP profits

Patricia Hewitt and Dr Barbara Hakin, the chief DoH negotiator, are considering capping GPs' profits. Don't they know that the enormous incomes quoted in the press bear no relation to the average GP's earnings?

These crude statistics are based on income tax returns and don't distinguish between ‘normal' GP remuneration and money earned by working out of hours, dispensing, owning surgery premises which are then leased back to the practice, or from other sources such as media work.

A huge error in our quoted pay rise also occurs because of the way it's been calculated: the 14 per cent employers contribution (previously paid by the NHS) is now paid to us directly, only for us to return it immediately to the primary care organisation - yet this has been counted as a pay rise.

It hasn't stopped politicians from including it in our quoted percentage increase. Despite all this, the DoH reckons that some GPs are not ploughing enough of their profits back into general practice.

Why should we? There's no parallel requirement over NHS contracts awarded to private companies, and judging by the extortionate profits earned by PFI firms, that's surely much more relevant.

I wonder if Dr Hakin and Ms Hewitt realise what will happen if they cap GPs' profits? There will be a rise in the appointment of deputy practice managers, who are on very high salaries and who are spouses or family members of GP principals. This will increase practice expenses and will drive down the GPs' apparent profits, yet leave the same money in the pockets of the GPs' families.

Doubtless, a DoH edict will follow, preventing GPs from employing family members.

Nevertheless, this apparent reduction in the larger GP drawings will reduce average earnings and bring greater numbers of part-time practitioners and those with lower list sizes above the 66 per cent of average pay threshold for full seniority allowances. So by driving down excess GP profits, the DoH will be increasing the total amount it spends on primary care. Foot, oneself, shoot...

- Dr Lancelot is a GP from Lancashire. Email him at

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