Dr Zoe Rog reflects on the role and treatment of GP partners following the Budget
I saw a patient recently who has been registered at our practice for 35 years. After our consultation she told me that she wanted to thank everyone at the practice for providing a consistently excellent service. She said that when some of the previous partners had retired, she had been worried that the service might suffer. But, she continued, she had been extremely impressed that over the years – no matter what the challenges had been – we had continued to provide health care to a high standard.
I was buoyed by this at the time. Like many practices, we have a team of GP partners who work incredibly hard. We are passionate about caring for our patients and it is very motivating to feel valued. We have invested time and energy in GP training, welcoming our trainees alongside us in salaried posts when they become newly qualified GPs, to ensure that we have a cohesive and enthusiastic team. We are good employers; providing experienced clinical leadership and responding with swift changes at practice level where the team feels this makes sense for patients and for them. Our employees are offered flexibility, kindness and understanding, since we work under the same pressures and know how this feels. GP partners are good value for the taxpayer also because as independent contractors we ensure efficiency whilst maximising quality of care.
My own practice partnership felt initially positive when the Government accepted the DDRB recommendation for a 6% uplift this financial year, feeling that it would go some way towards properly remunerating our team for their unfailing toil and effort. However, after on-cost calculations, it became clear that there would be very little left for a GP partner pay rise from this money.
However, maybe there were still reasons to feel positive. The Darzi report spoke about re-engaging staff and harnessing their talents and hardwiring financial flows to expand general practice. Maybe, finally, the balance would be redressed and we would be given both the financial means to provide sustainably excellent care and the recognition for doing so.
Now that the Budget has been fully announced though, I think it is safe to say that the outcome is sadly likely to be a masterclass in further demotivating and disengaging GP partners. The rate of Employer National Insurance increase (with no exemptions or compensation), the shift in NI threshold, and the increase in the National Living Wage, will all mean that the financial position of practices will become even more precarious. Two hundred practices will be lucky enough to receive funding for estate upgrades, but no doubt, it will be GP partners assisting their managers to write detailed bids for this money, and who will oversee the practicalities of the work involved.
Our patients will have heard that the NHS is receiving billions of pounds more in funding. The majority of patients think that GPs are part of the NHS and could be forgiven for thinking that our practices and the care we provide for them will benefit from this. If they are angry to discover this is not the case, it is GP partners who will ultimately have to painstakingly respond to their complaints in writing.
The Government said they would not increase taxes for working people. The Chancellor defined working people as ‘strivers who graft’ and as people who ‘go out to work and work for their incomes’.
GP partners are working people by any definition. Many partners start work at 7am providing advanced access appointments. Lunch is squeezed in whilst issuing prescriptions at our desk or during meetings. We work seeing patients and supervising other staff until the surgery closes at 6.30pm and for hours after this to complete a huge volume of administration. Emails are checked and responded to during weekends and annual leave.
Now that the Government has chosen to ignore that GP partners are ‘working people’ they do so at their peril. Once we are gone, they are likely to find that they need an awful lot more working people to replace us.
Dr Zoe Rog is a GP in Runcorn, Cheshire
