Intended for healthcare professionals

Rapid response to:

Observations BMJ Confidential

David Mitchell: US drug price warrior

BMJ 2018; 362 doi: (Published 05 September 2018) Cite this as: BMJ 2018;362:k3411

Rapid Response:

Re: David Mitchell: US drug price warrior

Each week the BMJ has an interview with a leading doctor, and there is usually a question on doctors' pay, where they usually either reply that it is good enough, or evade the issue.

As I read these, I wonder how many are fortunate enough to be receiving CEA awards, and note that none of them are GPs, who have seen their income fall every year for the past ten years. Not just fall behind inflation, but actually fall. For many GPs, pay now is less now than it was in 2004, a time when the problem was acknowledged to be so dire that a radical New Contract was required.

Does this matter? Well, if we could buy petrol for 69.9p a litre, and the GMC would content itself with £295 a year, and if everyone else accepted 2004 prices, then perhaps not; but with costs 30% or more higher than 2004, it is a problem. For those of us who are the sole or main earner for our families, it matters very much.

In the 2015 General Election, 5,000 'extra' GPs were promised; the first move in this campaign was to CUT pay to GP Registrars by 10-15%. Who could have foreseen that this might adversely affect recruitment? Anyone with any degree of common sense would have seen that one.

Of that promised 5,000, we are about 1,000 short of where we started, or 6,000 short of target. And who can blame young doctors, saddled with large students loans and looking at the prospect of ever dwindling income, for voting with their feet? Market forces: they have an effect, you know.

Until this issue is tackled head on, and General Practice is made financially attractive, Market Forces empty rather than fill the void.

Until then, perhaps Simon Stevens is correct when he says General Practice should look to Canada or New Zealand for its future; but the direction of travel may be opposite to what he hopes.

Martin Mayfield
New Zealand

Competing interests: I rely on my earnings to support my family. To me medicine is more than a 'privilege': it is my living.

08 September 2018
Martin P Mayfield
General Practitioner
Wellsford, New Zealand