'We should have capped GP pay'
The government should have capped the amount of money family doctors can make from their practices, the health secretary, Patricia Hewitt, said today.
Her comments come after it emerged in November last year that GPs’ average pay had risen to 106,000, a rise of some 30% in just one year.
Family doctors have been able to make much more money since a new contract was introduced by the government in 2004 which paid them more for providing services under a points scheme.
In an interview with the BBC published today, Ms Hewitt, who became health secretary after the May 2005 election, said that in hindsight ministers would have wanted to ensure doctors did not make such large sums out of contract.
She admitted that the government had failed to predict the extent to which doctors would respond to performance-related pay.
Responding to her views, some doctors said Ms Hewitt was “denigrating” GPs while the Liberal Democrats said it was clear the government had made a “hash” of GP contracts.
Some commentators have http://society.guardian.co.uk/societyguardian/story/0,,1986179,00.html that the GP contract could become a symbol of the Blair government “throwing money at public services” and failing to get good enough improvements.
Ms Hewitt told the BBC news website: “I think if we anticipated this business of GPs taking a higher share of income in profits we would have wanted to do something to try to ensure that the ratio of profits to the total income stayed the same and therefore more money was invested in even better services for patients.
“When we were negotiating the GP contract we had GPs taking early retirement and very large numbers of new doctors refusing to become GPs.
“Now it is quite true that neither the government or BMA [British Medical Association] anticipated how much GPs would do in response to performance-related pay.
“GPs in England are doing more for their patients in terms of prevention and giving support for long-term conditions than almost any country in the developed world.”
In May 2005, Valerie Martin, the national director of medical services for accountants PKF revealed that she knew one GP who earned 250,000 a year, who was working under the personal medical services scheme.
John Reid, currently the home secretary, was health secretary in 2004, though the GP contract had already been signed off by his predecessor, Alan Milburn, who was health secretary between October 1999 and June 2003.
Statistics from the NHS Information Centre show that GPs took 40% of their gross earnings in profit once expenses were taken away in 2003-04, but this rose to 45% the following year when the new contract started.
Ms Hewitt noted that doctors had accepted a pay freeze for this year and the criteria for performance-related pay had been made “more challenging”.
The new contract, designed to give practices additional funds to invest in developing services to patients, included incentives to reward GPs and their practice teams for driving up the quality of patient care.
Laurence Buckman, deputy chairman of the BMA’s GPs committee, was unhappy with Ms Hewitt’s comments.
He told the BBC: “Is the secretary of state saying she wishes GP practices had not performed so well on quality targets thereby improving the delivery of top quality care?
“The government signed off the contract which ties income to quality performance.
“She should be proud of the achievements of general practice, not denigrating doctors for delivering quality patient care.”
Opposition parties said that the government’s poor handling of pay negotiations had contributed to the deficits the health service was currently facing.
The shadow health secretary, Andrew Lansley, said: “The government underestimated the number of points GPs would get for treating patients, which in a way is really sad because it means the government underestimated the good job that GPs do.
“For Patricia Hewitt to distance herself from the GP contract is a show of how low her own performance has sunk.”
The Liberal Democrats’ health spokesman, Norman Lamb, told the BBC: “The government has clearly made a hash of negotiating the GP pay contracts.
“It is not helpful for them to admit incompetence after the event when the problems in the NHS are already mounting.
“We need an urgent review into the government’s approach to such pay agreements in the NHS.”
A Department of Health spokesman said that Ms Hewitt was simply reiterating previous comments that neither the government nor the BMA had anticipated how much extra work GPs would do.