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 missed that. I suspect history will judge even those figures as optimistic!

Yes they all will.

So in the other words the same as the last fourteen years, then?

I’ve calculated that the NI adds an extra 3 percentage points of cost increase to our lower paid staff. Even more for part time staff.

No minimum wage staff but low enough that we pass on the increase to keep high enough above it. So 6% from the min wage increase then 3% for the NI is 9% cost increase on our biggest part of our costs.

I’m off to rock in a corner.

I think GP surgeries are quite unique in that they can’t significantly increase income and have other compounding factors like severe shortages in GPs.

i imagine that surgeries like yours will end up bought out by larger surgeries who will benefit from economies of scale? I have a friend who is a partner and they are doing really well but have mergered a few times with other GP surgeries.

universities though- no. Pretending it’s NI that’ll finish them off is madness. They’re going under either way.

Because it was a year ago it increased and it increases every year, same time of year
I pay student loans still despite being on min wage and I'm also salaried so can't pick up extra hours (also because health issues)

Trying to live on roughly 23k, pay a mortgage, bills, car etc by yourself is tough

Not really. In any case I thought these lot were going to be so much better!!!

So up to 10% increase in costs associated with your lower paid staff? For all but the smallest of businesses

We just had a few years of inflation running rather high - so I guess it's just a bit more of the same ?

mass unemployment resulted from those years .... well it didn't , so hopefully most will manage to make things works

I mean how do people think they could make things better without raising some money and with the promise not to hit your pay packet ?

Some but not many GPs are on high income. But practice profit share doesn't equal income. £150k "profit share" will then lose both pension payments (employer and employee) plus NI etc and the "take home" income is significantly less. But no either way I am not on anywhere close to that. We are struggling now every month to cover staff costs and outgoings. We are not the only ones. The misinformation and beliefs about high earning partners is staggering. I earn more in my "other portfolio jobs" with far less stress.

I’m so sorry, OP. Thank you for all the care you have given over the years of your career.

The move is expected to fall entirely on the private sector, with public ­employers such as government departments and the National Health Service being reimbursed to avoid having to make cuts.

www.reuters.com/world/uk/uks-reeves-raises-employers-national-insurance-contributions-2024-10-30/

Did you really thing 14y of austerity was going to be overturned in 3m in one budget? With billions wasted during Covid, with Brexit?

GP specifically excluded from this reimbursement.

I was pointing out that some public employers would be reimbursed.

I don’t have an answer to this as I’m not clever enough but just wanted to say thank you for your dedication and service and brilliance and please don’t give up xx

But not general practice specifically.

Rummly posed a broader question.

GP practices should have been nationalised when the NHS was formed, it wasn't done to keep the BMA happy. I think now would be a good time to do it.

However the NHS as a whole needs a massive re-organisation, the wastage is on a biblical scale (I say this as an NHS supplier who sees the peeing of cash up the wall), but they are giving it more money, which is frankly daft.

Thank you.

I can see that there may be a lot of fallout from this.

Yes. Anyone who employs anyone. That’s why it’s called employers NI.

It's time to get rid of the GP private model and move GPs onto employment contracts with the NHS. If the existing financial deal is so bad they'll jump at the chance... Right?

I pay my cleaner more than nmw so I think most people would expect a gp to pay employees a living wage.

i am concerned about the impact on small businesses unable to absorb the NI increase, so that would include gp practices.

It would be far better to lower the cost of living instead of increasing the national minimum wage or employer NI.

More council housing would make a significant difference - and do far more to help people manage than an increased minimum wage.

It would also save the economy billions. Billions is needed for benefits to pay for private rentals (and substandard temporary accommodation). And bad or insecure housing damages health (for example, as a study published in the BMJ noted, private renting is more harmful than smoking).

More council housing of decent quality would mean fewer people needing benefits (saving the economy loads of money) and lower demand on the NHS.

GP practices should have been nationalised when the NHS was formed, it wasn't done to keep the BMA happy. I think now would be a good time to do it.

I agree. Not only because of the NI issue, but also because GP practices being private is one reason why there's so much variation in quality of care between different practices. But I'm not a GP and interested to hear views from GPs on this. Would you support this @BurnoutGP ?

You could give Labour 100 years and there would only be one direction of travel re the economy.

Ah so you have an issue with democracy re Brexit! Labour have the luxury of not having to cope with a global pandemic.

In opposition all Labour did was slag off the Tories and blame them for everything- seems like it’s all they can do in Government too! Roll on 2029.