To think this budget will finish us off

[BurnoutGP]

I am a GP Partner of over 20 years. I am now senior partner for the last few years. We have seen year on year below inflation funding increase. With an explosion in demand and massive shift of work from secondary care. We have issues wirh recruitment.
Our partner income is shrinking year on year. We are now always overdrawn and this gets worse every month.
We just cannot soak up the MLW and NI without adequate resource uplift.
I think we will be done. I'm so very tired of the constant battle and the demand and anger while working "part time" 60hr weeks.
We will have to hand back our contract. And we wont be the only one. That will leave one surviving practice in my area.
I'm done.

I spent many years as a partner in a law firm

I get the model.
It just makes no sense for GPs to be funded by the govt and use vast time and resources negotiating with other bits of the NHS regarding leases and contracts etc
(I mean, it makes good money for us lawyers but seems a daft inefficiency for the public purse)

Ok, so should your brother be running a law firm? Are legal skills complementary with running a practice? The joke has always been lawyers make terrible managers.

You are making a sweeping statement.

Doctors deal with acute situations that are very difficult to plan, manage or turn away.

Lawyers on the other hand can afford to be pickier. And someone is not going to literally die if they turn them away due to lack of capacity or not being able to get started with a case straight away.

Lawyers can also earn hefty sums. My brother works on a mental health board one day a week and can supplement income from his practice.

Being a doctor is also more emotional.

Practically, and emotionally, they are two entirely different beasts.

I think this budget is necessary to fix the irresponsibility of previous budgets. The last government didn't work for me, it appears this one doesn't work for you. One thing is for sure, we couldn't have kept going the way we were.

This.

it’s a confused and confusing model. And the amount of time that gets wasted from a lack of communication between systems is criminal.

if a patient can’t advocate for themselves and ensure transfer of important info it often just won’t happen.

it doesn’t make sense.

Does the same apply for dentists?

I agree with this. GPs can make good money from their practices unrestrained by the strictures of the NHS and how healthcare is delivered in the UK. It is the antithesis of a private healthcare market like in other jurisdictions.

Absolutely

I am, but see my recent response for why they are different fields.

my brother deals with very stressful cases. But he still loves his job at 57 and he is never burnt out from it. He is paid fairly and the admin of running a practice is WAY less complex than managing a mini healthcare system that doesn’t speak properly to the rest of the health care system.

Do you have alternatives? An example is a friend who does full time GP out of hours. She can pick & choose her shifts & I believe she earns more than the average practice GP & with less hours,although understandably she doesn't disclose this. She doesn't have the overheads involved in running a practice & is generally happy with her decision to follow this path.

Is another option starting again & opening a rural practice where you don't require the same amount of staff etc?

As a last resort would you consider moving to a country where your skills & expertise are highly respected & where Doctors are paid accordingly?

I have members of extended family in the profession & although they appear happy I have no idea what lies underneath. I sincerely hope you arrive at a solution OP. You definitely don't deserve to feel like this given the importance of your contribution to society. Stay strong.

I would not say so. I grew up in a country with a completely private medical sector. The doctors build up their private practice reputations and can start to choose their patients and charge their prices. They can earn hefty sums too. They charge for dealing with those acute cases. Not sure about emotional.

I get that. But plenty of solicitors’ firms go bust or run into trouble. And part of the business model is frequently to work trainees and NQs like slaves. The beasts are certainly different but I think you’re overestimating the business sense and employer skills of lawyers.

It’s been widely talked about that people in the medical profession have high levels of depression, alcoholism and burnout because of the emotional toll.

nice for the private doctors being able to choose, but what about the patients that can’t afford this? In this country, we don’t have private healthcare as standard. We have the nhs, where everyone is entitled to free treatment for a certain standard.

im not getting into the private vs free debate as it’s too late now.

It depends on the lawyers.

of course some go bust like any business.

but at the end of the day if they are good they will likely build a good reputation and a good client base.

which is again very different to doctors - you hardly want repeat clients!

it’s comparing apples and pears.

Even if the GP in the op is on £150k, but can pick a 3 month old with meningitis out of a list of 40 urgent cases, surely they're worth every dime?

But this person will quit, due to pitiful government policies.

Not sure what to say really

Agree with previous posters on both this thread and another, about businesses who can't afford to pay their employees the new minimum wage, aren't viable businesses. They will sink, and make way for others.

I can't shed a tear I'm afraid - all this bleating as if you're running a charity, not a business, as if you're living on a pittance balancing on a shoestring, when the reality is your take home pay will never leave you struggling to feed your kids.

Anyone who begrudges 'unskilled' (as people refer to them, though it's far from the truth) earning enough money to not keep on struggling as they are, is an insidious beast. So you recognised (as is your job to,) meningitis in a child - how many suffer under austerity currently?

As an aside, all the benefits that people seem to think NMW earners receive, is utter horseshit - and you can tell the people who have not done a days work for NMW in their lives by the very insult, and if you ever did, it was a long time ago when NMW kept people afloat enough before the massive surge in food bank usage..

Out of touch tories, like someone above said.

Don't get me started on people being up the arse of GP's, either. I, along with many, many others have been dangerously fobbed off time and time again, and live with lifelong conditions as a result. Skilled workers? The ones who are competent at their jobs, yes. There's not quite as many skilled workers in your profession as you seem to the think OP. And far from being the exception, it's extremely common and happening far too often - it has been for the past 20 years of my medical care experience, as well as most other folks I know!

When you find a seriously good GP they're worth their weight in gold, absolutely. Sadly they're being paid the same as the GP in the room next door fobbing people off with mental health problems, blaming their weight on medical problems not associated with weight, or not even letting them past the receptionists in the first place.

We need to stop thinking of businesses so much, and start thinking more about people. Several hundred thousands suffer under austerity, and as another poster put it, the government is having to top up the wages as a result of their employers not paying them enough to actually live. This is ridiculous.

As for the healthcare in the UK? It's an absolute mess and needs a complete overhaul. It's not fit for purpose.

Lots of very much needed businesses have pretty low profit margins and high staffing costs as a % of income. Social care and childcare are two obvious examples which will be hit hard. If staffing costs say 70% of your income, and the NI hit is going to bump that up by 4-5%, NMW increase is going to have the same impact again because you have to give your staff that increase to keep the differential...suddenly your main cost has just increased by 10%. So now staffing is 77% of income. The business might not even have a margin of 7%, and in a small business the profit is literally the owner's income (and that owner is probably not some distant shareholder but someone who is hands on working in the business every day and who themselves needs an income.) So they literally cannot absorb that sort of cost increase without passing it onto customers. Care costs are going to be hiked considerably, ditto childcare, cleaning, education...

This doesn't just impact profit making businesses, it hits non-profits and charities who don't have profit to absorb it. If they provide a chargeable service they will have to increase prices, if they're charities who fundraise they may well have to cut what they provide.

Then there's the bigger businesses who are answerable to shareholders. They simply won't absorb it even if they theoretically could. They'll just bump their prices to keep their margin intact.

The impacts are going to be huge on many businesses who have been struggling against some quite massive energy bill hikes as well as increased cost of materials.

You can't scrape money from businesses without impact.
It's certainly not going to grow the economy.

I think upping the tax allowance to rise to pension level makes more sense. Let people earn a bit more and don't tax the state pension..that's just insanely crazy.

People need to spend more to keep the economy going and they need to feel better off. Letting people keep more helps everyone who needs it.

Growing the economy needs careful thought on taxes for business and I think this budget has completely missed the point.

Also bear in mind, that very many people, are only 'unskilled' workers, due to not having equal opportunities to education and general life, as many (though not all) of those 'skilled workers'. For example, very difficult to become a skilled worker when you're a full time carer for a parent as a youngster, because the healthcare system let them down, isn't it? Because there is someone at home to take the job off their hands? Or for those left homeless whilst young, or having to not pursue further education so they can financially support their family. Maybe women who became young mothers? People who suffer genuine disabling ill health?

Only when those of middle class stop looking down at those who are working class, as being less than them, will we sort the UK out. It's about time, frankly. You never know, you could become one of them, one day.

I am not debating private and public healthcare. My point is I don't see any difference in the inherent ability of doctors or lawyers to manage businesses. Lawyers also have high levels of depression, alcoholism and burnout. That is not exclusive to doctors.

I'd have preferred them to hit my pay packet, personally, rather than hitting employers. I would have been quite happy to pay a bit more tax but now I'm going to have to make good people redundant and cut essential services for vulnerable people.

I fear that there will be some unintended consequences for this decision. I really wish that they hadn't boxed themselves in during the election campaign in the way that the did.

This 1000%.

all the people who keep bringing it back to lawyers: the difference with the professions is also that if you are a shit gp, you will keep getting fed an endless stream of patients as there is an acute need for your services and people have nowhere else to go.

lawyers. People can decide where to spend their money and spend more to get better services. Your clients are not finite, you actually need to perform.

so yes you COULD be a shit manager and a lawyer. But your firm will go bust. Or you could be a shit GP / manager, and you’ll keep on getting patients, and getting away with shit practice.

Which is currently the norm I’m afraid.

GP practices weren't nationalised at the time of the introduction of the NHS because GPs and the BMA kicked up an unholy stink at the prospect of GPs losing their income.

That was, what, 80 years ago? Presumably you've had a long time to do something about it and yet...

What do you pay yourself op?

Not this person but on average…

Recruitment agency Menlo Park conducted a survey of 549 GPs, finding that GP partners are earning an average of £138,400 (FTE) this year, an 8% increase from last year. Meanwhile, the average number of hours worked per week decreased for GP partners, from around 42.1 hours in 2022 to 37.2 hours in 2023.