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The increase in practice income in 2004 was entirely attributable to the new work requirement, the Quality and Outcomes Framework (QOF).
There was in fact a shortfall in the new pay, which necessitated the top-up with Minimum Practice Income Guarantee (MPIG) that is going to be phased out over the next 7 years.
The MPIG was needed for 97% of GP practices, indicating virtually all practices would have lost money due to the new payment scheme. (1)
GPs do not receive a salary, they have a performance contract to cover 52 hours a week. There is no sickness benefit, no holiday entitlement, no study leave, no indemnity, no maternity or paternity pay and no employer pension contribution. (2) When a GP falls ill, they have to fund the locum to cover the surgery. Headline income figures can therefore be misleading.
Despite all this, the financial rewards are very generous for most GP's. Personally, as one of the 20% that voted against the 2004 changes, I would have rather had a deal that left me looking after patients instead of chasing targets and increasing administrative chores from a disintegrating and increasingly dysfunctional NHS.
(1) Gwion Rhys, Hendrik J Beerstecher and Claire L Morgan. Primary care capitation payments in the UK. An observational study. BMC Health Services Research 2010, 10:156. http://www.biomedcentral.com/1472-6963/10/156
More pay for more work is not a rise
Dear Editor,
The increase in practice income in 2004 was entirely attributable to the new work requirement, the Quality and Outcomes Framework (QOF).
There was in fact a shortfall in the new pay, which necessitated the top-up with Minimum Practice Income Guarantee (MPIG) that is going to be phased out over the next 7 years.
The MPIG was needed for 97% of GP practices, indicating virtually all practices would have lost money due to the new payment scheme. (1)
GPs do not receive a salary, they have a performance contract to cover 52 hours a week. There is no sickness benefit, no holiday entitlement, no study leave, no indemnity, no maternity or paternity pay and no employer pension contribution. (2) When a GP falls ill, they have to fund the locum to cover the surgery. Headline income figures can therefore be misleading.
Despite all this, the financial rewards are very generous for most GP's. Personally, as one of the 20% that voted against the 2004 changes, I would have rather had a deal that left me looking after patients instead of chasing targets and increasing administrative chores from a disintegrating and increasingly dysfunctional NHS.
(1) Gwion Rhys, Hendrik J Beerstecher and Claire L Morgan. Primary care capitation payments in the UK. An observational study. BMC Health Services Research 2010, 10:156. http://www.biomedcentral.com/1472-6963/10/156
(2) Boom to bust in the NHS: Income in general practice. BMJ 2006;332:1096. http://www.bmj.com/content/332/7549/1096.1
Competing interests: I am a GMS contractor