What do you think about the debate over GP hours/pay? Watch

No Future
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halátnost
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I think, ok yes, GPs get paid a hell of a lot (I think the average is around £106,000 a year, about £123,000 if with pharmacy attached to the surgery...someone correct me if I'm wrong...), but they do a valuable and stressful job. I know it is easy to think of it as just an office job with more face to face interaction but they do work hard and obv have a very crucial role in society's wellbeing.

As for working longer hours, hmmm, it's a toughie. I'm sure happy doctors make the most effecient and effective doctors and keeping them away from their families until 8pm each night does probably not a happy doctor make. I think (although I am loath to say it) that GP drop ins in supermarkets etc, like the one being trialled in Superdrug atm, are probably the way forward. However, as temporary emergency measures. I'm not too keen on the more general polyclinics. I think it is important for doctors and patients to have a good relationship and for patients to feel comfortable and familiar with their surgery.
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Renal
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(Original post by halátnost)
I think, ok yes, GPs get paid a hell of a lot (I think the average is around £106,000 a year, about £123,000 if with pharmacy attached to the surgery.
GPs aren't paid any more, the practice receives more money so that the partners can employ a pharmacist, pharmacy assistants, stock the pharmacy, etc.


I think (although I am loath to say it) that GP drop ins in supermarkets etc, like the one being trialled in Superdrug atm, are probably the way forward.
Compare a GP practice with Superdrug. Both receive a certain amount of money to provide a certain level of GP cover, why is it acceptable for Superdrug (and it's shareholders) to keep what's left after paying GP and associated staff salaries but not acceptable for practice partners? Moreover, who do you think cares more about providing an acceptable level of service - the shareholder or the practice partner?
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Elles
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(Original post by No Future)
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That it seems to be manufactured by the government (who underestimated the work GPs were doing/could easily do, despite being warned = now peeved about the cost of the new contract) & areas of the media to try and undermine primary care to smooth the way for a change in the system, either to all becoming salaried employees with more centralization or going dentist/optician-esque private.

The hours thing - in decent surveys something like 84% of patients are completely satisfied with their Practice opening hours?! It seems to be something of a non-story to me.
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Wangers
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it peeves me off to read of the Goverment attempting to bully GPs into opening on saturdays and longer into the evenings - they have families and lives outside of work tooo - indeed thats essential in such a stressful job.

Imagine the uproar if the Goverment tried the same thing with the paper pushers at HMRC - they only do it to GPs (and the only reason they can) is because GPs refuse to strike.

There was a letter to the Times published yesterday - a GP calculated that after costs the practice would get something like just under £50 for the effort.
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ninaabbey
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(Original post by halátnost)

As for working longer hours, hmmm, it's a toughie. I'm sure happy doctors make the most effecient and effective doctors and keeping them away from their families until 8pm each night does probably not a happy doctor make.
8!

i think just regular hours wil suffice. i'd like to be able to go to the doctors, but it's not that easy because they're not open until 10 am and then close at 3pm...they're never at work!
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Elles
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Practice appointment open hours do not = hours the GP is working.

The standard in the last practice I was placed in was appointments from 8.30 - 12.30, then 2 - 4.30pm.
Easy life... only they were in before 8.30 to deal with correspondence/messages; the leisurely lunch break included telephone consultations, house visits, dictating referrals and meetings; after the last standard bookable appointments were private ones (but for things a patient would expect their GP to do e.g. medicals/insurance stuff), any 'emergency appointments', telephone consultations & more paperwork.


Anyhow, if you're in a city could you change practice to one with open hours that better suit you? Is there a feedback system for you to tell your current practice how inconvenient you find the opening time (mine are quite keen on surveys...)? Could your query be dealt with over the phone? Is it an emergency that warrants out of hours/walk-in centre care? Could you consider arranging time off to go?
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GarageMc
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(Original post by Elles)
Practice appointment open hours do not = hours the GP is working.

The standard in the last practice I was placed in was appointments from 8.30 - 12.30, then 2 - 4.30pm.
Easy life... only they were in before 8.30 to deal with correspondence/messages; the leisurely lunch break included telephone consultations, house visits, dictating referrals and meetings; after the last standard bookable appointments were private ones (but for things a patient would expect their GP to do e.g. medicals/insurance stuff), any 'emergency appointments', telephone consultations & more paperwork.


Anyhow, if you're in a city could you change practice to one with open hours that better suit you? Is there a feedback system for you to tell your current practice how inconvenient you find the opening time (mine are quite keen on surveys...)? Could your query be dealt with over the phone? Is it an emergency that warrants out of hours/walk-in centre care? Could you consider arranging time off to go?
Those hours might not seem like much, but they are only for appointments in the GP surgery. Housecalls take up a lot of time, waste a lot of money and annoy a lot of people. I've heard that most of the housecalls aren't by old & immobile people, but rather young & lazy.

The fact is its not our place to judge, whether GP's are good value for money, as there is much more they have to do then just take appointments. Just like any other profession. Am I annoyed by the fact they earn so much of taxpayers money? Yes, but that annoyance is irrational.
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Renal
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(Original post by GarageMc)
Those hours might not seem like much, but they are only for appointments in the GP surgery. Housecalls take up a lot of time, waste a lot of money and annoy a lot of people. I've heard that most of the housecalls aren't by old & immobile people, but rather young & lazy.
It's a mix. Care homes, the chronically ill elderly, paliative care, the young & lazy and the worried mummies.
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ali567149
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All that has been asked for is 3 extra hours per week.
Not a lot to ask.
Considering since the last pay deal GPs are paid more to and are doing less work according to the report released earlier this year
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Huw Davies
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How would you feel if your employer unilaterally decided to increase your hours by 3 hours per week? GPs did well from the new pay deal because the government underestimated the proportion of targets that would be met; that can't be used to justify un-negotiated and uncompensated imposition of additional workload.
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jgupta
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My parents are GP's and I can say this:

yes they take back a fair bit, but they are *not* salaried, they are given £X budget to run the whole surgery. As the rest of the NHS is ineffective, as hospital owners etc do not get to keep the surplus money, GP's get their budgets based on the 'going rate' if you get me

So the budget is too high because GP surgeries are run like a private business, so will actually work to minimize costs / be economically efficient, whereas there is no incentive for any other branch of the NHS to do so.

In effect, yes maybe they do take too much, but they do run the practice more efficiently than other parts of the NHS, and I don't believe it to be the real point - the point is that both parties agreed to the contract, so the government should not go back on it now. All the things in the news about GP's taking more than they deserve is just propaganda, putting public pressure on GPs to take more on - but in reality it misses the point that you cant go and change a deal afterwards.
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halátnost
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(Original post by Renal)
GPs aren't paid any more, the practice receives more money so that the partners can employ a pharmacist, pharmacy assistants, stock the pharmacy, etc.

This link from the BBC says the following:

This contributed to the hike in pay GPs received, with average pay totalling £106,000 - up 30% on the year before.

Family doctors working in practices with a pharmacy earn even more with reports of some earning over £200,000.

Accountants predict the amount earned in profit in 2005-6 was between £110,000 and £120,000.

I'm sure I read somewhere on the BBC once that £124,000 was the average wage for a GP working in a surgery with a pharmacy attached.


I'll respond in more detail etc when I'm not half asleep.
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halátnost
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(Original post by Renal)

Compare a GP practice with Superdrug. Both receive a certain amount of money to provide a certain level of GP cover, why is it acceptable for Superdrug (and it's shareholders) to keep what's left after paying GP and associated staff salaries but not acceptable for practice partners? Moreover, who do you think cares more about providing an acceptable level of service - the shareholder or the practice partner?
well what jugpta has said seems to contradict this? I was always of the opinion & my docs tell me that their surgery is run like a business. The surgery has a budget & chooses how to spend its money, for instance which types of drugs to prescribe, for instance paying something like £22.06 for a pack of escitalopram under patent or £2.01 for citalopram. there are incentives for them to keep the budgeting down & prescribe the cheaper medications. or at least this is what 3 of them have told me. however it is a centralised surgery decision from the budget the PCT allocates them, they do not get individualised budgets. don't know whether this is a nation wide thing. i suspect each surgery is different? obv you know more about this than me.

Oh, and i agree that i don't want polyclinics or GP surgeries in supermarkets to become the norm, but i think in emergency situations or desperate situations, GPs in supermarkets is better than nothing, but that the primary port of call should be a fully fledged surgery.

http://news.bbc.co.uk/1/hi/england/m...er/7274453.stm
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Renal
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(Original post by halátnost)
well what jugpta has said seems to contradict this? I was always of the opinion & my docs tell me that their surgery is run like a business.
jgupta's parents are practice partners and not salaried GPs - there is a difference.


The surgery has a budget & chooses how to spend its money, for instance which types of drugs to prescribe,[/quote]Treatment costs are paid by the PCT, practices pay staff costs and ancillaries. Hence, PCTs, with NICE guidance, can suggest which treatments should be prescribed.


paying something like £22.06 for a pack of escitalopram under patent or £2.01 for citalopram.
What's the difference?


there are incentives for them to keep the budgeting down & prescribe the cheaper medications.
Indeed, one of the chief incentives is that if we don't piss away money on expensive treatments with dubious results, we can treat more people more effectively. This is basic economies of health.


GPs in supermarkets is better than nothing
There has never been any need for GPs in supermarkets.


This link from the BBC says the following:
Again, the BBC are wrong. They are (deliberately?) confusing the earnings with the practice income.
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halátnost
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[QUOTE=Renal]jgupta's parents are practice partners and not salaried GPs - there is a difference.


The surgery has a budget & chooses how to spend its money, for instance which types of drugs to prescribe,Treatment costs are paid by the PCT, practices pay staff costs and ancillaries. Hence, PCTs, with NICE guidance, can suggest which treatments should be prescribed.


What's the difference?


Indeed, one of the chief incentives is that if we don't piss away money on expensive treatments with dubious results, we can treat more people more effectively. This is basic economies of health.


There has never been any need for GPs in supermarkets.


Again, the BBC are wrong. They are (deliberately?) confusing the earnings with the practice income.

Thanks for the info.

The difference between escitalopram and citalopram is that the drug manufacturers supposedly "realised" just before the patent on citalopram came to an end that, actually, only one of its component enantiomers worked, the S+ one I think, and the R- one was not only redundant in terms of positive effects, but also it was apparently the source of most of the bad side effects. So escitalopram is just citalopram with the R- removed. ie. 20mg of citalopram = 10mg escitalopram, because it only includes the S+ enantiomer (eg. EScitalopram). The pharm companies could thus get a patent on escitalopram as it was, under definition, a new drug, despite it actually just being citalopram with something taken away.

I knew that citalopram was cheaper than escitalopram because its patent has expired. But my GP and I were both really shocked when we realised to what extent, a 10 fold increase almost. In fact it might have been nearer £25 than 22 but i remember citalopram was definitely a penny or so over 2 quid.

I guess it all depends on whether the surgery then believes, under the NICE guidelines as u say, in the research that escitalopram is more effective and has less side effects. Personally I have been on escitalopram and have had nil side effects, who knows whether or not this would have been different had i been given citalopram? i think the pharm company are trying to persuade people that it would. but it's very suspicious that they only discover the ineffectiveness of the R- side just before patent expiration!
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Double Agent
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Dont know much about this issue, but i have a few thoughts. Firstly i am sick of people having a go at people who earn a good salary. Its not like they wandered into the job and sit around all day, its a demanding job as are others of a comparable wage. Yes its a lot, but its a job that in my opinion should earn a lot. Just because it is a good wage doesnt mean that you can start saying well they earn loads they should do all this other stuff as well.
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Renal
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(Original post by halátnost)
The difference between escitalopram and citalopram is that the drug manufacturers supposedly "realised" just before the patent on citalopram came to an end that, actually, only one of its component enantiomers worked, the S+ one I think, and the R- one was not only redundant in terms of positive effects, but also it was apparently the source of most of the bad side effects. So escitalopram is just citalopram with the R- removed. ie. 20mg of citalopram = 10mg escitalopram, because it only includes the S+ enantiomer (eg. EScitalopram). The pharm companies could thus get a patent on escitalopram as it was, under definition, a new drug, despite it actually just being citalopram with something taken away.

I knew that citalopram was cheaper than escitalopram because its patent has expired. But my GP and I were both really shocked when we realised to what extent, a 10 fold increase almost. In fact it might have been nearer £25 than 22 but i remember citalopram was definitely a penny or so over 2 quid.
Cheers for the info. What you will most likely find is that GPs are not barred from prescribing escitalopram, but are asked to use citalopram as a first choice.
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Titch89
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The pay is disguating. What about nurses? Or do they not matter?
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Renal
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(Original post by Titch89)
The pay is disguating. What about nurses? Or do they not matter?
If doctors were paid less, nurses would be paid more? I doubt it.

Or is this just another one of those teenage-socialist-drag-everyone-down-to-minimum-wage-and-call-it-equality posts?

So what do you think salaried GPs should be paid Titch? Say, newly qualified, 14 years of training, 1000 patients on the list, 55 hours a week plus one night a month co-op? A number please, you may round to the nearest thousand.

Additionally, how much do you think you you would pay to see a GP for a 10 minute consultation? Again, a number please, round to the nearest tenner if it helps.
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