Findings announced today by the National Audit Office (NAO) show – alarmingly if not surprisingly – that the government’s cure-all contract to improve GP’s pay and efficiency has failed. Or rather, it’s failed for the patients, and for GPs employed on a salary basis, while those with their own practices have achieved an impressive double whammy – 58% pay-rises coupled with an end to having to provide 24-hour cover for their patients. And it’s scarcely worth noting that, as ever, nurses come out worse, with a real-term decline in pay.
Productivity has fallen for the second consecutive year, and although the average appointment with a GP is now longer (having increased from 8 to 12 minutes), this is because a third of these appointments are being carried out by nurses.
Where has it all gone wrong? And why have our doctors – traditionally held in such high esteem – been so swift to feather their own nests? And more to the point, perhaps – why has this been allowed?
In financial terms, the scheme failed, coming in £1.76bn over budget. According to the NAO, the Department of Health underestimated its spend in three key areas: GPs’ salaries, the cost of switching out-of-hours responsibilities to primary care trusts, and the cost to primary care trusts of administering the contract.
In staff morale terms, cutting their salaries and landing them with work which would traditionally have been a doctor’s is a sure fire way to prompt yet another nurses’ strike. And salaried GPs can’t have been too impressed by their bosses’ latest pay rises, either.
And in terms of patient satisfaction, there are always going to be people who would rather spend eight minutes with a doctor than 12 with a nurse, however qualified.
But let’s not write off this initiative as a complete failure. GP recruitment and retention have apparently increased – but then, that’s hardly surprising … the thought of a £113k pay packet is almost enough to prompt me to retake O level biology and head down the medical school route myself.
