General Physicians (GP) are spending more time with their patients and the work they do has become more complex, GP leaders said in response to the National Audit Office (NAO) report on the GP contract in England.
Dr Laurence Buckman, Chairman of the British Medical Association’s GP Committee says:
“It has to be remembered that the new contract was brought in to address the severe shortage of GPs, to reduce the excessive hours they were working and to redress the pay imbalance ? before 2004 the UK’s GPs were among the worst paid in the world.
“General practice has changed and primary care is now provided by a whole team working in the surgery. The number of consultations has gone up, the time spent with the patient has increased and the work GPs do is more complex. In fact the entire way GPs work has changed so it’s meaningless to talk about productivity in the way the NAO has done. GP productivity should be measured in improvements in health, not the frequency of consultations ? and the early evidence is that the contract is leading to improvements in clinical care. Care for patients with asthma and diabetes has got better, more cases of raised blood pressure are being picked up and while it’s too early to give exact numbers, this will prevent many, more serious problems like strokes or heart disease.
“The NAO recognises that the new national GP contract is delivering benefits ? consistency of care has got better, more services are being provided in GP surgeries, patient satisfaction with access has improved and there are fewer problems in recruiting and retaining GPs ? all of which is good for patients. For the first time the contract linked practice resources to delivering higher quality for patients. GPs have exceeded the quality targets they have been set and this has resulted in higher pay.
“GP partners run a small business and aside from the risk associated with that and the extra managerial responsibility they shoulder, GP partners have also had to factor in two years of cutbacks in practice resources. Furthermore, the claim that nurses’ pay has fallen in real terms is based on misleading evidence put forward by the Department of Health. GPs value their hardworking staff and have honoured the pay increases put forward by the national body that decides nurse pay. The BMA has always supported paying practice staff well.
“The overspend on the contract is not the fault of GPs ? the BMA repeatedly told the government that GPs would exceed the targets they had set them. It was also well known that GPs had been subsidising out-of-hours care out of their own pockets, so the money taken away from them was never going to cover the costs of running the new service. Overspends of Primary Care Trust budgets are not within their control.
“The NAO recognises what GPs have been saying for a long time ? that Primary Care Trusts have not commissioned the extra services practices wanted to provide for their patients.
Commenting on GP earnings as a proportion of practice income, Dr Buckman says:
“The contract was not designed to set an intended level of pay for GPs. Practice expenses vary, as does the number of staff employed, which affects surgery costs. The move to practice based funding was always intended to give GPs more resources for running a high quality service for patients.”
Source: British Medical Association, UK