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.

That is how being in opposition generally works.

I'm not sure why you need to make a profit?, so long as you as partners are being paid and your staff are being paid there need be no profit. A business doesn't need to make a profit, its nice, but breaking even will do.

But why is a gp partnership focusing on ‘profit?’

I thought our country ran a non profit health care system

I feel for you OP. I can't imagine the stress of running a GP surgery both financially and clinically.

I work in an advanced practice AHP role in the community and the level of responsibility we have to take gets greater each year. Now getting people accepted by secondary care is nigh on impossible yet secondary care seems to get all the budget.

I don't begrudge any GP earning £150k. The long hours, huge knowledge, responsibility, high stress and huge workload definitely justifies proper remuneration. The years of study, high insurance etc why shouldn't GP's be paid properly?

A million quid - that's better than nothing.

Our senior partner is doing out of hours GP hospital work. Another GP working at police headquarters, doing nights too.

In the next town two GP practices combined in a new building ten years ago. They've both handed back the keys. The health board is now running the surgery.

I've a friend with a cafe who's now got a second job, they've left the staff to run the cafe. While they work elsewhere.

We're in a retirement area so our council heavily burdened financially requiring many carers. They've cut everything to the bone already.

It's really not that simple. What about the buildings ? The staff? The hours?
I nominally work say 2 sessions a day. On a salaried contract that's 8 and a half hours. I usually work 11 hours in the practice then an hour or 2 once my kids are sorted. As does almost every partner I know. So that's at least another 4 hrs a day per GP Partner to find (ha good luck) and fund.

Agreed, ours is absolutely shit and totally inefficient. I think most of them are badly managed tbh. Complaining about not making a profit when your job is to provide healthcare services as well jusr leaves a nasty taste in my mouth

It does, but the GPs are private practices working as sub contractors to the NHS, if they were nationalised it would solve that problem. Nye Bevan who founded the NHS wanted that from day 1.

I get it that you're never going to walk away because you are making a good living from it. And that's because, yes, you'll have to pay a little bit more NI but definitely won't cripple you. Let's be honest.

The shareholders won’t see it that way. Profit margin being cut by 50% is a major disaster.

I am so over having sympathy for employers who can't afford to pay their staff the NMW but expect them to scrape by with top ups from the government or food bank. Especially when those employers are drawing a very decent salary themselves.

Do you really need to employ so many staff? Have you looked at outsourcing, for instance?

But there’s a penny off a pint! If your regulars drink 100 pints every night they could save themselves a whole pound.

They might put a bit of strain on the NHS after that but I’m sure it’d cope, what with its extra funding and all.

It is, when the NHS took over, for example our local hospital they acquired the building, and the staff - the building became NHS property and the staff NHS staff.

It's tricky because the GP's begged in the first place back in 1947 to remain independent and self employed. They then begged to be released from.providing house calls out of hours and patients got worse health care services as a result. I do believe most GP's are pretty left leaning and anti Conservative.

Whilst I want to have some sympathy for you @BurnoutGP, the GP's have had their own way for a very long time, are increasingly inaccessible and employ a high proportion of hellishly rude supppprt staff alongside offering standards of service that are designed for their needs rather than the needs of patients. Whilst I don't think bringing GPs fully into an already dysfunctional and failing NHS will improve services, the current status quo had to change.

Personally, I think we need to adopt a Continental model of healthcare where some money changes hands and the nature of the service reverts to a more customer orientated model.

I use my NHS GP only for repeat prescriptions now. If I need to see a Dr, I pay to see a GP via my local private hospital. It's £140.00 for 20 minutes. I get an appointment within 48 hours, the staff and the GPs are polite. All the GPs offering private appointments local to me are also part-time NHS GPs from local practices.

If I need a cholesterol blood test, I do it via thriva - £100 and fast and efficient. That same blood test via my GP means, a portal request and text exchange. I then make the phlebotomy appointment at my local hospital. It takes, 25 minutes to drive there, 25 minutes to queue for a parking space, and has to be dine during my working day. If the results are squeaky I get a message to make an apt to see a Dr which can take me 30 minutes because none are ever on the NHS App and I get an appointment in about a fortnight but only if I can ring on the dot of 12.

The above may have been hard to read but it's even harder for a full time employee to do. My time is worth more than the £250 it costs to effect privately.

The system is not working. The public is sick of it, and I'm afraid I don't support this version of the NHS having any more money.

I pay my cleaner £17.00 ph. She calls me Roses. My GP pays their support staff minimum wage and insists on being addressed as Dr Pompous-Pants by staff and patients alike.

Sorry op, but I'm not playing any more. You are free at the point of delivery rather than free. It's time to join the 21st Century, to be a little more respectful of others and to provide an honest, integrity based service. I'm sick of having to pay twice. I'm sick of listening to doctors whinge.

Seems a bad model. Focusing on profit is just not the point. If you are being paid fairly as an individual that should be enough. And if you don’t want to or can’t work more than allotted hours, just don’t. I know it’s hard when you are a gp but a burnt out gp is no use to anyone.

@shuggles so I put 25k in, with standard tax code, 5% contribution to pension (auto enrol) and plan 1 student loan
That gives me £1730 take home using the salary calculator
These are some of my actual figures rounded for ease

Mortgage/rent £600
Council tax £130
Gas/electric £120
Car insurance £40
Water £30
Food £250
Broadband £30
Phone £40

£1240 already and I've been v low on the rent
Put that up to £900 and I'm at £1540 and that gives you £190 for

Fuel/bus/train fares
Haircuts
Car tax, car repairs, MOT, servicing, tyres
Christmas and birthday presents
Prescriptions
Glasses or contacts plus eye tests- even with specsavers I had to pay £130 recently
Dental - because no NHS facility recently
Contents and buildings insurance
Pets if you have them
House repairs
Clothing
Debt repayments
Netflix/amazon
A coffee, takeaway, meal with friends
Cheap gym membership or sports club

Then you've got the big stuff like being able to save for a new carpet or light fitting or bed or sofa because it breaks

That’s not how it went down. A 50% loss of profit practically overnight is a big. deal.

This is a valid point in that there’s always knock on effects of one action that has a ripple impact elsewhere.

The case of increased NI for employers coupled with NMW will also have a ripple effect far and wide. It just creates a chain reaction.

The major problem is that Labour promised that they were going to be the party of growth, but the reality is different. You need growth as the key driver of everything. Imposing greater costs on businesses stifles growth.

Finance Director here - in education - rerunning our already dire numbers tonight. We were already struggling. Teachers pension contributions already up 5%, NI up, minimum wage up. Staff demanding a 5% rise and angry with me for saying no. Board telling me that the situation must be my fault and telling me I’m not doing my job properly. Yep I’m packing it in too. Somebody else can add 1 and 1 and make 3, it’s the only way to make it.

It's convenient for you to say that but one GP currently costs the NHS a lot more than one hospital consultant. You wouldn't have the buildings or staff. You'd be an employee working out of bigger clinical premises.

You'd also be accountable for the service provided in a way GPs currently aren't. Susceptible to PALS.

I really don't think people understand the impact this budget will have on businesses.

My DH looks after finances for a number of hospitality businesses, most of them are likely to close next year with another big increase in NMW, increase in ers NI (huge rise with the reduction in limit also) and also the fact that the rates relief is reducing in April. Not sure what the 1p per pint reduction in duty is going to do to help that. Many small to medium businesses will be closing in the next year I think. Esp hospitality who were stitched up during lockdown and many still haven't recovered.