To wonder why we don't force GPs to work as NHS employees like every other doctor

[OptimismvsRealism]

They're the weak point for the entire health service and they make a fortune while hospital doctors pick up their mess

Oh lordy, when I used 'we' in my last post, I was publicly stoned because people couldn't tell the difference between the collective 'we' and being accused of something as an individual (the auguement being, "i am not undertakingvthis, therefore I am not part of this 'we'")
So
Interesting to see if there is as much hysteria about the we in this post too!

But yes, GPs have always been against being an nhs employees; indeed, they were anti-nhs. The governmentchad to tie itself into all sorts of knots in order to get it off the ground (hence their being on a totally different contract/way of working)

The only issue I have is where a GP is an independent contractor/business, they should not have access to the NHS pension scheme which I believe they have? Happy to be corrected if this is wrong.

Every partner I know earns less per hour than their salaried doctors. Have a look at what percentage of the week a FTE consultant spends actually seeing patients and compare that with a FTE GP partner. You'll be surprised.....

It is absolutely soul-destroying working in a system that is going up in flames, you're right.

Hahahaha what a fantastic idea: try and pay doctors even less when the workload is unmanageable and leaving the country is already massively attractive. I just choked on my coffee.

I suggest we take the same approach with trades as well. The self employed ones need to be brought to heel and stop taking the p_ss

Forty!!!!! Five per hour and then all the paperwork on top. Plus, if you drop a ball it has big implications.

I imagine I would feel wrecked after a morning of that.

I feel a bit sorry for the GPs at our local centre. They've gone to all telephone and online consults. My ds is 5, under two consultants for various issues but has NEVER seen a GP in person, they just go through my form online and prescribe/refer. Even the consultants were surprised he's never been physically seen and it's caused some issues to be missed.

They are just telehandlers now, after all that training! It must be miserable. The role they have done for us could have been a self-service AI form.

If GPs changed to being private as the majority of dentists have, would our attitudes change? £100 for an appointment anyone?

As someone who has seen behind the curtain of how NHS senior managers are treated it makes me laugh to read comments about how much they get paid for doing nothing. Obviously some of them are not very good, just like in any job, but they get no luxury treatment. The office of one very very senior manager, little better than a cupboard had an office chair taped together with silver duct tape and a lap tap on the desk so old I couldn't believe it still worked. This manager like all the others apart from the finance director was a working doctor who did ward rounds everyday. By the way other senior staff worked in a sort of hideous massive one plan space. This was at a huge city hospital not a smaller district general.
I am starting to think whenever I see that tired old trope about fat cat managers, that the writer is deliberately spreading misinformation in an attempt to discredit our NHS. Apologies for being a bit harsh I am getting to be a right old grump!

What about dentists? A large part of the shortage in NHS dentists is choosing not to work for the NHS because there's more money in private dentistry.

Weekend opening is often nurse led

Where I work, there's a small number of primary care nurses who work at different GP practices, depending on which weekend it is

This is, as you said, for flu, 'catch up' child and travel vaccinations or smear tests

You are talking utter BS. You really don’t have a clue what you’re talking about. I have family members who are GPs. The youngest who has recently gone into practice couldn’t get a full time job for 18 months because of the cheap use of PAs. He’s definitely not earning a fortune.

This option already exists

This needs to happen for people to understand what they are asking for. And doctors would have a better quality of life.

Of course there are lots of additional tasks for a GP to work on as well as just doing appointments, but it's no different than any other job or profession. Your decorator has to go and buy the paint, do her tax return, service the van, not just paint all day. Again, it's a normal part of any career, not a GP specific issue.

You're kidding, @Frogpole , right?

In no way can painters, be compared with people whose incorrect decisions could harm or even result in the deaths of their clients

With the pressures of student loan debts as well, GPs are some of the worst paid doctors in the system

Remember, as they work, they trigger the threshold for repayments even as they incur more debts

www.bbc.co.uk/news/uk-68534953

I think GP should eat a lot more considering what their job involves.
I think MPs and people in finance should earn a lot less.

They can. Most GP surgeries have a mix of salaried GP and GP partners (who employ them).

@OptimismvsRealism my Accountant produces graphs of average GP earnings every year. I can assure you we are not miles ahead of consultants and if practices were cheaper run by health boards what are they forcing us to take back control

You do realise figures published are before taking into account expenses. So yes I might look like I earn £200k but I have to pay my staff/ electric/ insurance etc out of that so way more than 50% goes out in expenses.

There are a few outlying practices that earn A Lot but they are few and far between

I suggest get some facts before you post

But a lot of gp surgery’s are owned by the actual gp’s so the “profit” is what they are able to take out. If they didn’t make a profit they wouldn’t get paid and would be working for free which they aren’t going to to do. Either need to pay them the going rate as a salary or allow them to make the equivalent in profit

I have mixed feelings about GPs.

A close relative is a salaried GP (always working part-time) and for many years in the 2000s and 2010s their life seemed pretty jammy. Work a few miles from home, turn up at 8, finish by about 1pm and no need to think about work at all until the next time they were in the surgery. Very little competition for jobs, a lot of professional respect and they easily found a job whenever they needed to relocate. Compared to the level of competition, long commutes, long hours (no option for half days!) and difficulty in getting part-time working arrangements in many other comparable professional roles (many of which also require years of postgraduate study and training) and being a salaried GP seemed like quite an attractive option.

There is also the matter of the historically downright offhand and unhelpful manner of many long-serving GPs - I used to have a male ‘GP’ who would open every consultation by barking ‘What do you want?’ It was a long time ago but how he got away with it is a mystery!

In recent years - as it has become harder to see a GP - I’ve often found that advanced nurse practitioners have exhibited higher levels of consultation skills and been far more helpful and sensitive than the GPs (often locums) whom I have encountered. I would always want to have the option of seeing a GP, but I don’t think the difference is the night-and-day that it is portrayed to be…

Things have certainly changed for my GP family member in the last seven or eight years - a lot more pressure in the surgery and difficulty in making referrals - and they don’t enjoy the job as much as they once did. Plus there is the creeping spectre of Physicians Associates, getting ready to undermine the nice professional salaries, employment prospects, terms and conditions of salaried GPs…Yet doctors were unbothered and nowhere to be seen when this happened to teachers! During the last twenty years teachers’ professional roles have similarly been undermined by the introduction of HLTAs, cover-supervisors and by government allowing academy trusts the freedom to set their own teaching pay and conditions.

Unfortunately, neoliberalism and the commodification of public services means that there are no sacred roles or causes. I don’t think it is right and would rather services were better funded, but doctors are simply undergoing the same painful process of transition to a lower-paid, higher pressure, market-driven environment as other public sector roles have done before them.

Er, yes. That's exactly what the OP is suggesting. Pay tthem directly instead of operating as self-employed business that need to make a profit.

Has anyone mentioned that many GP surgery buildings are owned by the GP partners too. So if those GP Partners become NHS employees who is going to provide the premises and maintain them?

Our surgery was already part time now it’s even worse. The two GPs are cutting their hours further to ‘avoid being in the next tax bracket’ (as stated at the Patient Participation Group) so effectively we will have a GP on two mornings and one afternoon a week, never have worked weekends. No evening surgery.
Moving to another practice? Well, the nearest one accepting new patients is 18 miles away, no public transport. All the closer ones have closed their books; our practice has be threatening closure for the last 8 months, they really don’t appear to give a toss about the local population. They’re a dispensing practice, the closest pharmacy is 8 miles away, only open 2 mornings a week.
It’s horrendous.

Sorry I wasn’t clear in what I was proposing. I know some GPs are salaried but they still work for practices that are run by self employed partners. What I was suggesting was that there should be NHS clinics that employ GPs. These would be particularly useful in poorer areas that find it difficult to attract doctors. And if they already exist (not sure) then there should be more of them.

Who did you think will have the best standard of living overall, throughout their life into retirement?
Passing on that standard to their children?
Cleaner or Doctor?