Despite an increase of 4,000 GPs employed by the NHS in the past five years and a £40,000 jump in their salaries, productivity has fallen according to a report out today.
A National Audit Office (NAO) study, NHS Pay Modernisation, said the number of GPs rose from 26,833 to 30,931 since 2003, largely as a result of the new contract for general practice which enables GPs to opt in to providing enhanced services and out-of-hours urgent care services.
But while the average pay of a general or personal medical service practice partner in England increased from £72,011 in 2002-03 to £113,614 in 2005-06, in the first two years of the contract, productivity fell by an average of 2.5% per year.
GPs are working seven hours less on average per week than in 1992, partly because of the removal of the responsibility for out-of-hours care.
Although the number of consultations with patients has increased, this is not in proportion with the increase in costs, the report found.
The contract also cost the Department of Health £1.76bn more than it had budgeted for.
Tim Burr, head of the National Audit Office, said: “There is no doubt that a new GP contract was needed and there are now 4,000 more GPs than five years ago. But in return for higher pay, we have yet to see real increases in productivity.
“The extra money flowing into practices has largely benefited GP partners rather than rewarding other important members of the practice team. Primary Care Trusts now need to deliver to patients the benefits that were expected in return for GPs’ increase in pay.”
In 2005-06 the annual average pay of a GP partner was £113,614, an increase of 58% since 2002-03. GPs report, however, that over the past year their pay has stayed the same or decreased.
Edward Leigh MP, chairman of the Commons Public Accounts committee, said: “A new contract for general practitioners in England was needed. But the bottom line is, GP partners are the real winners. They are being paid far more, are working less hours and their overall productivity has dropped.”
He added: “Progress has been made in linking GPs’ pay to performance, but many are simply being paid more for doing exactly the same job.”
Health secretary Alan Johnson recently urged GPs to provide more out-of-hours services.
Other key findings from the report
- Nurses undertook 34% of practice consultations in 2006, compared to 21% in 1995, leaving GPs to spend more time with more complex cases.
- Primary Care Trusts have not made use of all the levers in the new contract. Money for new local services has not led to improvements such as increased opening hours and some of the most deprived areas remain under-provided with GP services.
- 40% of GPs believe that aspects of the contract have not helped to tackle health inequalities.