GP leaders have demanded the Government reimburse practices for increased National Insurance contributions, following statements by a Treasury minister that seem to have created greater confusion around the issue.
In an appearance on the BBC’s Question Time last night to discuss this week’s Budget, chief secretary to the Treasury Darren Jones said GP surgeries are ‘privately-owned partnerships’ and will therefore have to pay increased NIC rates, but ‘how much they pay will depend on size’.
This morning, speaking on BBC Breakfast, the same minister clarified these comments, stating that a ‘small GP surgery’ will be somewhat ‘protected’ by a doubling of the Employment Allowance, which reimburses smaller businesses’ National Insurance costs by £10,500 (up from £5,000).
However, in a recent letter to Mr Jones, the BMA’s GP Committee chair Dr Katie Bramall-Stainer expressed ‘dismay’ at his comments, pointing out that GP practices are not eligible for this allowance as they are defined as providing public services.
She also called on the Treasury minister, alongside the Department of Health and Social Care (DHSC), to ‘provide absolute certainty at the earliest opportunity’ that GPs, as designated public authorities, will be ‘reimbursed in full for the NI employer contribution rise’.
‘Given it will cost businesses an extra £865.80 in NICs each year for an employee earning £30,000, the
cost for practices hiring multiple staff members, at varying salaries, could be astronomical,’ Dr Bramall-Stainer added.
The GPCE chair also said that previous government have ‘followed the principle that increases to practice employment expenses, including NIC increases, are fully funded’, and urged the Government to ‘honour the precedent’.
The Budget on Wednesday announced an increase to the rate of employer NICs by 1.2 percentage points – to 15% – from 6 April next year, and the Treasury confirmed that funding has been set aside to protect the spending power of the public sector, including the NHS, from the direct impacts of these changes.
However, it has been unclear since then whether GP practices will be eligible for this reimbursement, with the Treasury refusing to confirm this point in response to Pulse’s questions.
The DHSC confirmed to Pulse that further detail on NICs for GPs will be confirmed in due course, and that it is working with the Treasury to ensure appropriate compensation for the public sector.
But Mr Jones’ recent comments had seemed to confirm that there will be no reimbursement for GP practices, prompting criticism from the sector.
The RCGP has also hit out at this policy today, writing to health secretary Wes Streeting to ask for ‘urgent assurances that GP practices will be given the same protection as the rest of the NHS and public sector’.
RCGP chair Professor Kamila Hawthorne said the extra NIC costs ‘will be the straw that breaks the camel’s back’ for some practices, with some being forced to ‘make tough decisions on redundancies’ or even close their doors.
‘[GP practices] are working their hardest to provide quality care for their patients against a backdrop of significant budget constraints and staffing challenges – and this added level of insecurity will only compound these pressures,’ she told Mr Streeting.
The Liberal Democrats have also criticised suggestions that GP practices may face these extra costs, unlike the rest of the NHS.
Daisy Cooper, the party’s Treasury spokesperson, called on the Government to ‘scrap this GP penalty immediately’.
She continued: ‘After years of the Conservatives’ disgraceful neglect, our primary care services are in crisis and this could push many to reduce the number of staff they employ or just decide to shut up shop.
‘Instead of investing in our GPs and their staff, the government has put more pressure on them in a move that will make it even harder for patients to see a GP when they need to.’
Alongside tax hikes, the chancellor also announced public spending increases with an additional £22.6bn going towards day-to-day health spending, and £100m ‘earmarked’ for GP estates upgrades.
Always reassuring when the chief secretary doesn’t understand their own rules. I am unnerved at the lack of competence this government is demonstrating already 😩 time for politicians to be registered, re validated and deemed competent before they are allowed to stand 🤦🏼♂️
Bramall-Staimer has repeatedly called for increased taxation to fund increased NHS spending.
She’s got what she asked for.
Increased taxation on luxury goods, spirits and greater taxation of profits of the largest companies might have been a much better idea, especially from a Chancellor of a new Labour government. Instead, I think they’ve (Rachel Reeves MP) borrowed many Billions at huge rates of interest, very costly to the people and GPs of this country. (Most patients and GPs might have had a better idea of what a good budget looks like.)