50% tax rate - unexpected consequence

Jumpjockey - our GPs are inadequate. It is recognised locally and complaints have been made. However, in truth, it is difficult to prove GP mistakes and none have stuck as I understand it (although rumour is that one warning was given recently and there has certainly been some improvement in attitude by GP concerned which suggests it may be true). To be honest we all have ways to adapt around the problem such as our excellent nurse practioners. Also there is the OOH service where you see a gP from another practice or whereever, so a lot of us deliberately go OOH if seriously worried about something or feeling very ill (particularly with children - we always use the OOH or wait till the weekend to use the on call service). Where theres a will there is a way. But it is frustrating that they are paid so much for a totally inadequate service.

GPs do not get paid overtime

this is the norm for a professional job.

JJ - the hours you mention seem perfectly reasonable for the 76k ish that is the average salary of GP's.

just not hust!

"puts them just into the 50% bracket"

if they are hust in it, how much of their wage would actually be taxed at 50%?

if they were earning £150,001 for example?

PPP - What do MOST doctors spend MOST of their time doing? Making life or death decisions that stretch their abilities to the limit? No. It will be applying protocols in the same set of situations over and over and over again. The same as the rest of us.

Even doctors who routinely work with life threatening illnesses will see the same things over and over again.

We shouldn't need to pay them that much to do that. They shouldn't be reward extra for running surgeries, because I don't WANT them to run surgeries I want them to work in them.

We need more 'levels' of expertise - Nurse Pracitioners are a step in the right direction. But these are seen as Nurses Plus, we also need some Doctors Minus.

whatname - doctors hours, see my post above for a typical day for my dh. However some docs only work part time, or do some specialist surgeries (eg one of DH's colleagues does a knee clinic) - as with many jobs there's no standard week, which is why the assumption that they're uniformly earning 250k is daft.

frogetyfrog if you geniunely feel that your GPs are dangerous, why haven't any complaints been made about them? You shouldn't put up with care that is genuinely substandard.

GPs do not get paid overtime. They are given an amount of money by the PCT with which they run their practice.
Out of this money they pay all staff including nurses, pay building rents and maintenence, pay for staff training, pay for locums to see their patients while they are completing their complusary training (which they also pay for) and all other costs associated with running the practice - for example my practise subsidise counselling for their patients as there is none available on the NHS locally.
They are able to attract top-up money for reaching government targets on things like vaccinations.

Once everything has been paid for, then the GPs in the practice divide what is left as their salary. There is no 'per hour' rate, the money is what it is, but the GP must work until the job is completed. There is no-one to delegate to, no-one to push back on and say sorry this workload is too high I refuse to do it - because they are essentially self-employed and running their own business. So it is very misleading to talk about hourly rates and how many hours a GP might or might not work.

In lots of areas useage is very high - eg. areas with large proportion of ageing population, or deprived areas where general health awareness is low. GPs in those kind of areas are taking home much lower salaries than those who have practises in largely middle-class areas where useage is relatively low.

I think that many doctors would like to see more doctors around, with the possibility to work fewer hours for a corresponding pay cut.

The problem is that as already mentioned there is an imbalance between supply and demand. Some well paid posts are empty because no-one will apply to do them. So other doctors work more hours than they ideally want to rather than see patient care suffer.

Our nurse practioner takes a doctor surgery slot so has exactly the same time slots as the GP. She is just simply far better than any of the GPs we have!! Which is why people will wait for ages to see her. It is a running joke that if you suspect you are seriously ill you see her and not one of the doctors as you could well be dead before the GPs diagnose you correctly !! We did have an excellent female GP but she left unfortunately.

ooj I think that would be wrong and could lower the calibre of candidates..

IMO 'modern' professionals cannot handle the stress of the patients and paperwork - they don't want it - they would rather earn less for an easier life

personally i take issue with your final comment

beanlet - I work in higher ed so appreciate the points you've made (and have also got a PhD and don't earn very much). There is so much competition for post-docs that they can pay very little. There are always more people wanting the posts than spaces available - and of course higher ed funding is being drastically cut all the time, my institution is only expecting to have the money to fill one of every five posts that comes vacant over the next three years.

As bigstripeytiger reasonably asks, why aren't there more people training? Because being a GP is not the job it used to be; it's not about seeing patients and building relationships, it's about meeting targets and filling in blasted forms. They get so much stick from certain ends of the press, patients assume they're all on 250k for a 35 hour week, and all the time they're having to make potentially life and death decisions about the treatment people need. It's a very major responsibility; I don't get paid much but the decisions I make will never be that significant.

Professional footballers on the other hand are well paid as they are a genuinly scarce resource.

PPP - And why is this? As with all the professions it is to raise barriers to entry, therefore restrict the supply, and maintain their price in the Market. The doctors mentioned in the thread who would like a better work/home balance, and can't find any doctors should be asking the BMA and the government to look at ways to restructure and reform medical education and practice in order to reduce costs and improve results. If the NHS is to survive this MUST happen.

We need more doctors so we can pay each one of them less and not work them so hard. This is not an attractive idea for those who are now senior and have money and balanced lives, nor to those who aspire to that. Not every doctor is brilliant, and actually we don't need them ALL to be.

What this thread suggests to me is that we need better career advice in schools. So, if kids are capable of getting 4 A grade A levels (at least 2 science) and are up for medical training - they know that they could be earning £100k plus by their 30's. Then it's up to them to make an informed choice!

how many hours does a GP work?

Nurse practitioners tend to have longer appointment times than GPs, which could influence availability (and possibly also patient satisfaction).

the students wanting to do medicine these days have to get a helluva lot more than 3 low As

any minute they will be 3 A* for a start
they need shit hot gcses - to have worked voluntarily for a couple of years etc etc etc - i could rant for hours - its damned hard to get offers from medical schools and students have to outshine the peers to get one...

3 As is pretty easy these days - getting into medical school is bloody difficult
( and no my child is not a medic)

I am just pointing out that they don't get paid lots because they work long hours....

GPs are overpaid - especially as I believe it is the NHS money (correct me if I am wrong). Of course they deserve decent money because they are clever and have long training. But there is no doubt in my mind that when it is public money it should be significantly less than they get. I have no problem with the Chief Exec of a successful private company taking what he and shareholders feel he/she deserves. Footballers are paid from private money - not taxpayers. GPs are paid by taxpayers so therefore should be paid less than they are - and certainly should not be paid extra for overtime. My poor mate working for local government is on grade 6 (approx £35000) and therefore cannot claim overtime as apparently paid too highly so is expected to work evenings till 2am on a shift basis and weekends as required for no extra. That is pretty standard in a lot of local government jobs apparently.

In our surgery there is always a waiting list to go to the nurse practioner but spaces to see the GPs. She is paid less but deserves more.

Yes, GPs do have to get 3 As at A Level, but plenty of people get that, especially these days.

As for capable people being in demand and therefore earning megabucks more than £150K. . . The starter salary for a junior trainee manager at McDonalds the year I got my PhD was £5000 more than the salary for my unbelievably competitive Oxbridge fellowship. I remember distinctly because I had a letter published in the press about it. Go figure.

don't know why you lot don't retrain if its such a doddle