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.

No she’s not. If GP practices want to operate the business model they need to run them like a business. As a pp said, if delivery companies can offer a two hour window, it’s not unrealistic to expect it from a healthcare provider.

Looking at the Tory leadership candidates, I doubt they'll be back in in 5 years.

"To be honest my instinct is to shut up shop and obtain work as employee myself."
This is exactly what this HMRC pushed budget is supposed to do
It's this government's IR35
Drive everyone out of self employment or running a small business

I think partly Covid, partly Brexit, but largely fallout from Liz Truss' mini budget in September 2022 https://www.theguardian.com/business/2022/oct/20/the-mini-budget-that-broke-britain-and-liz-truss

Looking back, Tony Blair’s, but I suspect mainly because he did have the benefit of a decade of prosperity.

Maybe it’s rose tinted specs, but there were no riots or prisoners being randomly released early (why did they not just release all women on non violent offences and start repurposing those spaces?) or huge demonstrations all the time. Pre online world, eh?

Reeves admits she has no plan in place for the inevitable global downturn should Trump win in the US elections

I don't want Trump to win the US election but it's worth pointing out that Trump's period of the presidency saw a level of growth that Biden's hasn't — which is why some idiots may be tempted to vote for Trump again, because his policies did seem to give the economy a boost.

I'm sorry OP. It's shit - I'm hopefully qualifying as a nurse in July and it's pretty disheartening to realise I'd be paid effectively the same by working in Aldi. Makes you wonder why the slog and hell was worth it - but hey go, it's a 'vocation' so people expect us to do it for the love, never mind the bills to pay.
Clear on this thread there are still people who will always believe GPs are rich and overpaid. People can be blind.

I don’t know how people are struggling so hard to understand that when minimum wage goes up it still affects employers who pay over minimum. Aldi pay £12.40 - 96p over min. In April they will be 19p over so if they want to keep that competitive edge then they will need to pay something like £13.35 which is above top of NHS band 3 and under £2 less than a band 5 nurse who will have student loan repayments. Minimum wage has gone up 40% from 2020 to 2025. Aldi employ 45000 people in the UK - some will be part time but if we guesstimate that they work 30 hours average and get an average pay rise of £1/hour, then Aldi is out £1.35 million a week. Who is going to cover that? You are. Minimum wage workers will. That doesn’t even include NI increases. Loads of retail and hospitality workers do earn bang on minimum or only pennies over but their employers can’t just uplift the minimum wage earners and leave the supervisors and anyone with additional skills and responsibilities standing still. DP is a hospitality employer and pays the lowest paid staff over the current minimum but under the new one so by April we will have worked towards reducing hours. We don’t have spare money sloshing around - we still haven’t recovered from Brexit or covid and now Putin is screwing us over too. The cost of stock is through the roof - much of it 3x the price it was a few years ago, rent is up, utilities are up, and the government takes 20% VAT off the top before we’ve paid for anything. Atm We’re just coving bills but Dp is not actually earning anything like min wage - more like £5-6 per hour and I am working for free on top of my full time job. The employment allowance will help but the biggest headache is going to be suppliers who employ far more people than we do having to hike prices up when my margins are virtually non existent. One supplier told me last night he’s estimating £2.5k a week additional expenses in wages and NI costs - not including the costs his suppliers will pass on to him and he’s thinking about shutting down. There is absolutely no point in people smugly declaring that if you can’t afford to pay a potwasher more than a nurse then your business isn’t viable - we all know hospitality isn’t viable - 6000 hospitality venues closed in 2023. TGI Fridays shut 50 restaurants with no warning just this week and may well be bankrupt by Christmas. 1 in 40 pubs, restaurants and hotels went to the wall last year. 3.2 million people in the UK work in hospitality - we shouldn’t want the industry to crash and burn because all those people will be out of work and it will have a huge knock on effect on commercial property and our high streets and town centres will be even shitter than they are now. Tbh though, we could bear the brunt of this much better if we either had a substantial VAT reduction (remember VAT is off the top irregardless of profits - it’s a bigger expense for us than wages and nearly as high as stock) or significant VAT reform so every “cash is king” grifter on the high street also had to pay the same. The margins just aren’t there to pay 20% so the extra costs in this budget are the final straw rather than ruinous on their own.

I don’t really understand why GPs changed from being NHS employees to being self-employed. It feels as though surgeries have struggled since.

My last GP was lovely, but his surgery went from good to awful. It operated a greatly reduced service during Covid, then decided to keep this arrangement indefinitely. I’d wait weeks for a face-to-face appointment, only to find that the receptionist had booked it with a nurse or physio instead of a doctor. Who would then apologise for not being able to help me, and suggest I rebook with a GP. Naturally, this involved waiting a few more weeks.

This is a detour, but no, once the Covid period ended, Biden's outperformed Trump, and there's widespread economic consensus that Trump's tariff and immigration plans would be economically disastrous if carried out. (His tax plans are no better; it's just "tax cuts for everyone!")

Though the NHS is still paying billions in interest on the PFI projects he did. And the gold reserves were spent by his government when the value of gold was at an all-time low. And the Labour government in the worst recession in 70 years.

Aldi and Lidl are good employers, but that's besides the point.
As a teacher I get the whole annoyance about it being a vocation too. But when I started as a teacher, I was on £21k. I'm now on just over £50k. Not loads, but just fine for me. Someone who started at Lidl at the same time as I started as a teacher could be still on around £21k. Yes, some people will now run their own store- most won't.
I have a band 8 nurse friend who earns a fair whack more than I do. You will progress in your career, you are just at the start. Your pay will rise, and has the potential to be a very decent salary, and a lot more so under this sensible Labour government.

PFI was no bargain in the end. However, what I can say is that from the data and analyses I've seen, Britain is suffering from three things: 1) extended Tory austerity, 2) Brexit, and 3) the complete lack of productivity growth.

https://www.lse.ac.uk/News/Latest-news-from-LSE/2023/k-November-2023/Chronic-under-investment-has-led-to-productivity-slowdown-in-the-UK#:~:text=UK%20productivity%20is%20lower%20than,Economics%20and%20Political%20Science%20shows

One analysis claims the UK lags behind even Spain and Italy in productivity.

To be fair, I can pay for a Saturday delivery from John Lewis. I can drop my car on my car firm's forecourt at 9pm and pop the keys through the letter box, collecting it after work the following day. When I make arrangements the staff aren't obstructive.

In relation to time off for Dr's appointments being enshrined in law, it isn't except for maternity. The time has to be made up and that's the law. Some employers may be more flexible than others.

I don't think it's arrogant for patients' time to be as respected as that of the Dr or for their to be an expectation for those in charge of operational practice management to deliver services in a patient focused way. I think that's equality rather than arrogance. If my car dealer's reception or the retail assistant in JL were rude and obstructive, my business would go elsewhere. The difference is that in healthcare that is more difficult and no money changes hands. The operational set up is different and more respectful in much of Continental Europe, the Antipodes and Canada. Not all alternative systems mirror that in the US. No other country is trying to copy the NHS model.

I think people, especially younger new to the workforce people, forget the senior members of their company didn't land there on their salaries fresh out of school. There seems to be a current climate of entitlement to higher earnings by virtue of having spent time at university, I'm certainly seeing it in newer graduates. It's a good thing to know your value and be confident to ask for a salary but not when you are green and don't understand the politics of the workplace/industry you've just entered.

Yeah it's definitely the last three months and nothing to do with the previous 14 years 🙃

It’s rare for us to agree on this subject but in this instance you’re 100% right.

I see you've given away you're not in the UK
You really shouldn't comment on things you know nothing about

10 year yields are currently at 4.42% (vs 4.5% for the Truss mini budget of Sep 22).

The bond markets are not liking Reeves’s budget….

You'd be shocked. I work with the NHS; one Trust needed to send us a screenshot of an issue. You'd have thought it would have been a quick one-minute job via email. Not a chance. They took a picture of the screen with their phone, emailed it to themselves, and then attached it to a Word document, which they emailed us.

I never got to the reasons why they did it this way. Did they not know how to do a screengrab? Was the PC locked down so they couldn't do it? This was about 10 years ago but i still think about the wasted time this simple task took.

As for fax, we stopped using it about 12 years ago; previous to this, I'd say that 70% of our orders, etc, would come via fax from the NHS and the other 30% would be a mix of posted and emailed. During Covid, I ran a campaign to move completely digital in terms of POs, remittances etc. We still get 1 Trust sending us paper orders, which is not bad out of over 200 I manage.

I think you said something about there being Labour shortages but you haven't quoted the posts so it's harder to follow the conversation. I didn't say that there were no jobs but vacancies have undoubtedly fallen. We had Labour shortages in 2021, not now.
Yes of course SMEs have been struggling for some years. I expect these changes to be the final straw for quite large numbers and that this will compound rises in unemployment. I didn't say that all will close and no one will start one, simply that these things will not counteract the effect of businesses closing. Not at all, in fact.
You obviously understand that things have been going downhill for years and that SMEs have been under a lot of pressure. Why do you also 'believe' that new businesses will spring up? How will they suddenly become profitable?
The fact is that at least half the population has been getting poorer for the last 20 years. There has been a massive amount of reliance of ever increasing credit to keep spending going and, of course, the wealthy have got wealthier and continue to spend. In the last few years, even more people are poorer and there is only so much that can be put on the credit card before defaults escalate or further credit is declined. When you add in policies which are anti business, that will escalate unemployment and poverty, lead to less spending by people, reduced business profits further, etc, etc.

Typical left wing politics and economics of envy combined with no comprehension of business

Without profit, a business can't invest, develop new products and services, put some away for future bad times, pay taxes

Spectacular way to miss the point.

this was about an overstretched GP having enough experience to prioritise a child out of a totally unmanageable work load of competing priorities.

A PA or a nurse or a cheaper NQ dr probably wouldn’t have made the same call. With potentially devastating effect.

OP I’m so sorry that you are experiencing this and for the vitriol on this thread. You deserve to be paid well for what you do.

I've left now but the nursery I used to work at will be on their knees according to the colleague I spoke to yesterday. They are going to have to put prices up again to cover staff wages and senior staff will be on the same wage as non senior because they can't afford to pay them more.
Parents aren't going to be happy about prices going up again (even with funding) and I can see more nurseries than ever closing their doors. No childcare equals one parent not working.
I have to say that while I don't support Labour it's the Tories fault we are in this mess (I don't support them either).

I disagree.