Helping yourself first, the disgrace of general practice

The target of my ire are GP Partners. Privately, and in a whisper, GP partners admit they have never had it so good. Less work and more money certainly doesn't make Jack a dull boy. Although the work that is left is dull. You can't expect to take home £250,000 plus a year without having to fill in a few forms, or rather fill in the blanks and adjust the data on a computer screen. Worse still, you can't expect a locum to stay late to maximise your practice income. You have to do that bit yourself.

The outcome of primary health care is to score the maximum number of QOF points. The highest scoring GPs in the Super Mario Nintendo game of Primary Health Care get the most points. Points mean prizes and prizes mean higher salaries, better premises, longer holidays, less work and most popular of all straightforward cash.

Too late, the government spotted its mistake. So no more pay rises for the newly made millionaires. Unfortunately, GPs practice expenses have increased slightly, so a gap in the exponential growth of GP income looms. Self interest is a wonderful thing. No sooner does someone try to limit self interest in one direction than self interest rears its ugly little head in another direction.

GP Partners response to the Government's 'we think we overpaid you last year' beggars belief. Under the guise of 'Safeguarding patient services, maintaining cost effectiveness' the British Medical Association (the doctors trade union) offers the following advice

1) Do not do anything you do not have to (hereinafter known as 'non-obligatory' work)
2) Do not do anything for which you will not be paid (hereinafter known as 'unfunded' work)
3) Do not do anything where you don't think you are being paid enough (hereinafter known as 'underfunded' work)
4) Do not do anything which you might reduce your money from other sources (hereinafter known as 'the correct resource stream')
5) Do not do anything that is 'Not beneficial for patients'. ie do nothing that has not been approved by 'NICE' or has a protocol attached. That cuts out lots of things from syringing ears to home visits. So if hasn't got a 'NICE' guideline or protocol , don't waste your precious money earning time on it.
6) Think carefully before taking on new patients. They may cost the practice more than the income they bring with them. Grannies and asylum seekers be warned, you are not cost effective.
7) Charge more for non NHS work, like signing a passport photo and medical reports. In short do whatever you can get away on this side of the law. And if you do break the law, don't get caught and don't mention where you got your ideas.

Well done BMA ! your suggestions reduce work sufficiently to give GP partners a relative pay rise thus allowing the exponential income growth curve to be supplemented with other more lucrative activities.

The organised self interest of the medical profession beggars belief. Please if the nice Sun journalist is reading get a copy of 'Safeguarding patient services, maintaining cost-effectiveness' I'll even send you a copy. Then expose the medical leadership for who and what it is. These are the same kind of doctors who are responsible for MTAS, the GMC fiasco and Modernising Medical careers, as well as selling off the NHS to the highest bidder. For the sake of the few jobbing doctors left who do the job not for the money but for the love of it.




Copyright (c) Dr. Liz Miller

http://www.drlizmiller.co.uk