Throwing money at GPs won’t make them more productive

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Nye Bevan of the Labor Party proposed a brutally effective method of treating doctors who opposed the creation of the NHS in 1948, saying: “I stuffed their mouths with gold.”

More than 70 years later, it seems that turning on the money tap is still seen as the best way to get more returns from the medical profession, NHS chief executive Amanda Pritchard setting an improved payment schedule for general practitioners participating in the Covid recall. program.

GPs will now receive £ 15 for each injection given to a patient from Monday to Friday, up from £ 12.58. Improved payments of £ 20 for a Saturday jab and £ 30 for jabs given to patients confined to their homes are also underway.

“We will ensure that they are properly rewarded for their efforts, especially when they take the time to visit vulnerable homebound patients who cannot make it to vaccination sites,” said Ms. Pritchard.

His decision to take a carrot rather than a stick comes as GPs across the country have faced a growing outcry from some patients over a collapse in the availability of face-to-face appointments, with allegations of ripple impact felt by emergency departments of already overcrowded hospitals.

Anyone hoping to hear a government minister take a tougher line with family doctors and simply demand that they restore pre-Covid working patterns and service levels should probably be prepared for a very long wait.

Because the truth is, politicians have simply lost the will and maybe even the ability to stand up to GPs in the court of public opinion. A quick glance at public attitudes towards both groups helps to understand why.

According to the Ipsos Mori 2021 “Truthfulness Index”, 94% of us would generally trust a doctor to tell us the truth. This compares to just 31 percent who say the same thing of government ministers. Only real estate agents, advertisers and “social media influencers” rank lower than politicians, while only local pharmacists and nurses rank higher than doctors.

The sanctification of the NHS and pretty much everyone who works there and the parallel bashing of politicians, much of whom huddle up on themselves, it must be said, has made it much harder for any government to put together a head of steam to improve healthcare productivity. Ministers are simply no match for physicians and their formidably well-organized professional associations.

It’s not that GPs are lazy – given our aging population and medical advances that offer more viable treatments for more complaints each year, the volume of work is on a steep upward curve.

Yet there are many reasons to believe that better productivity could be achieved through a more rigorous approach to management.

For starters, we’ve sort of reached a situation where 90 percent of the nearly four in ten GPs who are salaried, rather than contracted, work part-time.

That’s a huge number of expensive medical training places that only lead to part-time work. And contrary to claims that GPs need to be paid more, this could be a sign that wages are now at such a high level that more and more doctors can afford to cut their workdays for stylistic reasons. of life.

Last year the average income of GPs in England exceeded £ 100,000, so it is clear that it is now possible for many family doctors to reduce their working hours while still enjoying a higher standard of living. easy. It is quite right that doctors expect to be paid well given their immense expertise and vital skills. But it is also necessary to justify the rationing of the availability of part-time positions.

Another aspect of the GP shortage affecting patients is the skyrocketing early retirement rate in the profession, which has more than tripled from 401 in 2007/8 to 1,358 in 2020/21. Of course, some medical bodies will tell you that this is largely due to excessive workloads. Professor Martin Marshall, president of the Royal College of GPs, told the Guardian earlier this year: “These numbers reflect what we are hearing from our members in general practice. The intense workload and pressure on the workforce under which general practitioners and our teams have worked… are taking their toll. “

Yet the BMA recognizes that much of early retirement is driven by the understandable desire of general practitioners not to exceed the lifetime allowance from the retirement pot by just over a million pounds (1,073 £ 100 to be precise), after which additional tax penalties take effect.

“Repeated surveys by the BMA have shown that more than half of doctors plan to retire before the age of 60, with the majority citing the taxation of pensions as the main reason,” according to the chairman of the retirement committee of the BMA, Dr Vishal Sharma. Such good and experienced general practitioners are needlessly wasted years ago due to a combination of a generous gold-plated pension plan on the one hand and an ungenerous tax system on the other.

As long as we, the British general public, continue to view doctors as heroes and politicians as villains, we are unlikely to break the unhealthy grip that medical unions have on the healthcare system.

Ministers whose health care motivations are widely questioned will always be tempted to bribe general practitioners to do work for which they are already paid. Filling your mouth with gold can clearly get things going. But it’s a very expensive way to continue.


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