NHS - safe in Labours hands?

Whoever in government negotiated the contract is clueless as nearly every doctor in Scotland opted out of providing out-of-hours cover, although many/most of them have "cashed in" on the new scheme.

The average in Scotland appears to be about £120 per hour, ranging from £60 to £180. £120 per hour for on-call sounds very expensive to me (that's nearly £1000 just for being on call for 8 hours) however without details on the number and timings of call-outs attended it's difficult to be sure just how bad value it is.

The whole way GP services are provided seems an absolute farce to me. If the government is ultimately paying for the service then it would make more sense for GP's to be employed as part of a salaried service, with an appropriate provision for out-of-hours cover (lots of other business's have to do it economically).

Here are a few quotes on the story:

"Ahh, the good old public sector gravy train just keeps on rolling. Presumably they'll still get that extra fee for writing a prescription or referral to the private sector on top of the £6,500. Wonder if it's pensionable - now that would be a perk. If you're going to draw comparisons with lawyers, accountants etc. just remember it's not the individual that earns £180+/hr - it's the firm."

"GP Doctors were not value for money before the changed working hours came in. Now as I have always suspected they have been shown to be no more than uncaring, money grabbing, self-centred egotists that think they are worth every penny! In any dealings I have had with GPs, I already knew the diagnosis, or had previously had it diagnosed by a nurse. It is elitism which artificially restricts the number of doctors and thus ensures inflated salaries. The politicians could easily legislate to destroy this enclave and allow more practitioners and thus increase availability and drive down costs like has been done every where else! "

"I think that the rates that have been set are a disgrace. The NHS management and deal makers should be held accountable, instead, this has slipped through quitely leaving the taxpayer to foot the bill for a badly managed affair. This seems like it's run by a select few who are looking after their peers with unreasonably high rates. I totally agree with the opt-out providing choice and flexibility."

"When will the public ever realise that nurses are NOT the same as doctors and should NOT be on comparable salaries!!!
Julie, Glasgow

To Julie, Glasgow. Indeed nurses are not the same as doctors but the average nurse earns £20-22k/year, 4-5 times less than a doctor. Do we see this gap in other public sectors - I think not. Can you imagine the uproar if teachers earned £60k/year all because they are not the same as classroom assistants and should not be on comparable salaries!!"

"Pay deals have to be honoured. Should the present deal seem generous, or open to abuse, then it should be renegotiated. Whether doctors or consultants realise it - the fact is many are being perceived by the general public (who are supposed to be their customers in modern parlance) as using their position/s to effectively hold the general public to ransom. This perception needs changing."

"GPs earning £180 an hour - they are certianly not earning it. Looks like we have a new breed of fat cats. No wonder the NHS is short of money! "

"Aside from the payment for out of hours work the fact that the average GP now earns £100k sickens me. There is no doubt that they provide a valuable service to the public and have a stressful job, but so do many other people and I guarantee that they earn no where near £100k."

"Dr's have always been amongst the highest earners in our society so nothing has changed. However, I am sick and tired of their whinging. They have group practices, practice managers and practice nurses, yet the moan constantly about their work load and responsibilities. There are many who work just as hard and would like just a whiff of their money, status and prestige. "

"I believe that doctors should be paid for providing out of hours cover. The problem is that because they are being such vast sums per hour, then people's perception of doctors as healers of the sick will rapidly change to one of money grabbing exploiters and damage their hard earned reputations."

"Maybe police officers and air traffic controllers should also be paid at similar rates for working shifts. I would have thought that night cover was part of a GP's occupation, and should be mandatory, fairly rostered and compensated for by shift allowances paid as part of the salary. Why are doctors treated differently?"

"It is absolutely disgusting that such people who are in effect paid by the tax-payer receive so much money. It must seem like an insult to many of the people that they are treating who may have to work a 40 hour week to earn just over such a figure. It must also be an insult to the many other nurses etc who have to work alongside. It wouldn't be so bad if they weren't then supported by such fantastic perks and pensions. "

"Incredible! Whilst conditions for most staff in the NHS continue to fall, GPs are allowed to sign a contract which is not inclusive of out of hours working commitments. We are being taken for a very expensive ride at others' detriment."

"For that kind of money - they SHOULD be working hard. We've heard them complain before about their hours - but if this is the rate of pay - I've no sympathy. No, it's not value - but a service must be maintained. I bet nurses don't see that rate of pay. "

"Fair enough people should be paid for out of hours work: but GPs are stretching the limits. They have us over a barrel and are quite cynically exploiting it."

" think it's ridiculous that doctors are getting paid such extortionate amounts for out of hours work. Every doctor that is practicing today knew what was involved in becoming a doctor, and that includes night work. The doctors are holding the government to ransom."

You're sounding remarkably like a long lost cousin, the Baird of Swanny-Munny. James Mc Will yew send me a leeter Mc Parry, innit.



Fritz Von TCP it's the one for me Jimmy

There is so much in that rant that is ill-informed, offensive and just plain wrong. I'll not honour it with a detailed riposte.

Two facts; GPs do not earn a penny extra by referring to the private sector. Utter b@ll@cks.

As for rates of pay I work 50 hours a week on average and I'm not even full time in my practice. I do not work OOH any more. My 'hourly rate' is rather short of £120/hr. Don't confuse this with what OOH are paying. Some GPS are exploiting the OOH payments, I have no doubt about it. Most are just saying they are too busy and want quality of life without 24/7 cover. If the OOH fees are so gross, why is almost every area struggling to fill shifts?

Steve, our views are equally entrenched, perhaps we should give over as I hardly think we are going to change each others opnions.

Bruce

PS I'm just dying to learn about the 'fantastic perks' we get. Business lunches? Corporate hospitality boxes at the test match? BUPA? Company car? I must be missing something.

quote:

Originally posted by Bruce Woodhouse:
I'm still waiting for an explanation that all these mythical docs have soaked up all the new NHS money.

Saying they soaked up all the SNHS money would be a tad harsh however:

In 2002 the average SNHS medical/dental salary was 64K, in 2004 it was £78K (nurses went from £22K to £24K during the same period).

Between 2002 and 2004 medical/dental staff salary increases accouned for nearly 43% of the increase in total staff costs, despite accounting for less than 10% of the total staff numbers.

Over that period increased staff costs accounted for 88% of the overall SNHS expenditure increase.

quote:

Originally posted by Bruce Woodhouse:
There is so much in that rant that is ill-informed, offensive and just plain wrong. I'll not honour it with a detailed riposte.

No point replying to me anyway as those were the postings of people responding to the story on the BBC website! At the very least it would appear (and this has been apparent to me through general conversations etc.) that the medical profession has a definite image problem at the moment.

BTW I don't have any issue with doctors being paid a decent salary as they do an essential and often unpalatable job.

What I do object to is such an increase in costs without an associated increase in the level of service. In Scotland at least there can be little argument that we're seeing large pay rises to doctors at a time when service provision is in freefall, with facility closures right, left and centre.

The answer would appear to be that we need a lot more doctors, which makes the fact that well qualified and highly motivated prospective medical students can't find university places all the more concerning.