GP practices need to be reassured ‘swiftly’ that increased tax costs due to come into force from April next year will be ‘resourced’ by the Government.
This was the message in a letter from the BMA’s GP Committee for England to health secretary Wes Streeting today, urging him to ‘confirm unequivocally’ that GPs will receive a share of the £22.6bn extra budget allocation made to healthcare to offset their increased costs.
GPCE chair Dr Katie Bramall-Stainer wrote that planned April 2025 budget changes could push some GP practices ‘to close their doors entirely’, adding that the Government must to everything in its power to ‘support GPs’ rather than adding to ‘the extensive burden they are already facing’.
She wrote: ‘I would urge you to confirm unequivocally that GP practices will not bear the burden of hikes from the Budgetary implications, but that a proportion of the £22.6bn provided to your department in the Autumn Statement will resource this.
‘It is crucial that you deliver this reassurance as swiftly as possible.’
Since the chancellor’s budget announcement at the end of last month, 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.
But GPs have been excluded from this, as the funding to offset the increased NICs costs does not include support for the private sector, including ‘private sector firms contracted out’ – with GPs generally operating as independent businesses for this purpose according to the Treasury.
But Dr Bramall-Stainer wrote to Mr Streeting: ‘GPs and their practices across the country are reeling at the cruel anomaly of on the one hand, being denied funding to cover the employer NICs rise and NLW increases because – according to the Treasury – we are “private sector”.
‘Yet equally ineligible for any reimbursement open to small private sector companies because – according to the Treasury – we are “public sector”.
‘This unhelpful paradox will ultimately lead to NHS GP practices being forced to cut services and cut staff – impacting upon patient care.’
Yesterday, Pulse revealed that the changes could cost GP practices across England a total of £260m following the announcement of the employer National Insurance Contributions (NICs) rate increasing to 15%, as well as the National Living Wage (NLW) rising to £12.21 an hour.
This was based on a survey by Berkshire, Buckinghamshire and Oxfordshire (BBO) LMCs, which found that the average annual recurring loss per practice will be £47,000, with almost 68% of practices expected to make redundancies or staff layoffs ‘in order to remain viable’.
The BMA has already demanded that the Government reimburse practices for increased NICs, and asked GP partners to write to their MP demanding a U-turn from the Government.
GPC regional representative for Nottinghamshire & Derbyshire Dr Peter Holden has written to MPs in both counties, warning that the Budget changes will cause a ‘crisis’ for GP practices in their constituency.
His letter said: ‘Around 50% (and rising) of GP practice turnover is consumed by the pay of receptionists and practice nurses.
‘The very proper rise in national minimum wage coupled with the NI rises will hit GPs very hard indeed because many, for reasons of resilience employ part time staff who mutually cross cover holidays.
‘Some estimates for these two changes mean that the GPs will take another 20-30% pay cut next year in return for working even harder.
‘General practice is expected to behave to the same standards as NHS trusts and yet we will not see any trust management take a personal pay cut or any consultant take a personal pay cut because of the impact of the budget.’
Pulse has approached the Department of Health and Social Care for comment.
The DHSC has previously told 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.
Mr Streeting has said he is ‘well aware of the pressures’ on GPs and that ‘allocations’ for the year ahead had not yet been made.
Alongside tax hikes, the chancellor also announced £100m ‘earmarked’ for GP estates upgrades in the Autumn Budget statement.
For Pulse’s analysis of the budget, read: A Budget seemingly designed to punish GPs
Still trying to work out whether this was deliberate or an oversight.
Worrying either way.
At PMQs today in reply to a question from Ed Davey Starmer committed to confirming support with details to follow later in year I would hazard a guess will be used in contract negotiations with GPC and BMA
The BMA have repeatedly called for tax rises to support the NHS; why should GPs, high earners with generous pensions, be exempt?
Agree with DH, if high earners GP contractors are fed up with tax hikes (and ARRS, NHS funding, constant reforms etc etc), then why don’t they do something about it?
Even the self-employed farmers are planning a “strike” so what creative intellectual excuse have doomed GPs and the BMA still got for not striking?
Dave- because we are completely different to other businesses. Tesco, Waitrose and Sainsburys will pass on these costs to the consumers. GPs do not have this option.
Not only this, why should GPs be called out as not part of the public sector so not getting support as the hospitals are but at the same time not eligible for the change in allowance because we provide public sector contracts.
How does that work?
Above- perhaps the time to take things more seriously is upon us, the toothless weak pointless measures announced by GPC are a waste of time- until we cap and send absolutely everyone above 25/day to 111/A+E then we do not create any urgency at all.