Evidence exaggerates practice income

DoH evidence sent to the Doctors' and Dentists' Review Body (DDRB) exaggerates how well off practices are, a medical accountant has warned.

Dr Chaand Nagpaul: Rising expenses mean GP income must be uplifted to achieve a pay freeze (Photograph: M Case-Green)
Dr Chaand Nagpaul: Rising expenses mean GP income must be uplifted to achieve a pay freeze (Photograph: M Case-Green)

The DDRB will not recommend a pay award for GPs this year because of the public sector pay freeze imposed by the government. But the DoH submitted background evidence to inform future DDRB decisions.

The evidence makes clear that practices may be expected to make efficiency savings as part of the 2011/12 and 2012/13 pay settlement.

The outcome of negotiations between the GPC and DoH over ‘the contract uplift, if any, that will be applied over these two years to achieve a pay freeze’ will be made public shortly, the document says.

The evidence says GMS doctors can increase their net income via sources other than uplifts to contract payments, citing income from non-NHS work and enhanced services.

But specialist medical accountant Laurence Slavin said the evidence portrayed a picture that is ‘too simplistic’.

The DoH said additional income from non-NHS work was an average of £22,000 per year for a full-time GP, amounting to 8% of total income.

But Mr Slavin, a partner at Ramsay Brown & Partners, said this was now outdated. ‘I would say it’s about 4% not 8,’ he said. ‘GPs earn less from outside interests now.’

The DoH evidence also said rising investment in local enhanced services – from £250m in 2007/8 to £339m in 2009/10 – is equivalent to a 1.1% average growth in pay.

Practices in England also earned an extra £28m from the pandemic flu vaccination programme. This was equivalent to a 0.4% growth in pay, the DoH evidence said.

But Mr Slavin said any extra money came in as a result of more work being done.

‘The growth in local enhanced service income will be from extended hours.  For most practices, that involves getting extra help to run it, which costs, or doing the extra work themselves,’ he said.

The GPC has also submitted background evidence to the DDRB. GPC negotiator Dr Chaand Nagpaul said doctors’ expenses meant an uplift was needed. ‘Failure to uplift would be a pay cut,’ he said.

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