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.

Complaining about not being able to pay staff or costs is the issue. The profit is what we get what's left behind. If it's nothing then we get nothing. Do you work 60 hrs a week with people's lives for free? Should I? Who will pay my mortgage?
Practices are shit because their funding has been reduced for at least 10years. So they can't find or employ enough doctors or clinicians. Or they are run by companies that don't give a fuck. I know you don't get it. And I am now so broken I am beyond caring.
But I'm still there. Still diagnosing the septic baby and the gynae cancer and rhe dementia. Despite the overwhelming demand and anger and hate. Neither of my children want to be doctors. I wonder why. And thank god they don't.
I used to love being a GP. Now I try to find other things to do so I don't have to be a GP. And attitudes like this is a pretty big factor.

Oh you sweet summer child. You think we're going to close our pub because we're making money from it?!

Ha ha ha. Because that is so much cheaper!

So what did you want them to do, raise wages for care staff but not for retail staff?

OP, thank you for all you do for your patients and staff. My brother is a GP in a deprived area. He works all hours and some months, the practice does not earn enough for him to take home anything. I fear his practice is at risk of folding as well. It will be such a loss.

Damn this government. I thought they were supposed to look out for the little people - instead, I am finding out smaller businesses are being hammered. Labour are destructive of value.

What relevance is that? Hopefully you are not going to suggest GPs should take a pay cut.

The profit is what the partners earn?! Their income. So say practice income is say 500k a year. Staff costs clinical and non clinical 300k. Outgoing costs (light heat waste consumables) 50k. 150k left. Profit. 2 partners. So their income is 75k each. Their "profit".
If the practice income goes up by 5% but costs go up by 10%. Partner "profit" /income goes down by 5%. Every sodding year.

How do you expect your staff to pay their rent /mortgages on less than minimum wage @BurnoutGP ? Maybe you could do what they do?

The only other thing I'm going to say is that I didn't vote Labour. Never have. Never will.

I did venture what might happen and took a MNet beating.

It's a lot easier to lay off retail staff than carer staff. Maybe there should be a different level?

How do you expect their employers to afford to employ them?

You've just said that you're 10k overdrawn every month, yet now you are making a profit? There's a big hole in your argument. And for me, this is where the argument ends. You are worried about your profit and not whether you'll go bankrupt or not.

How do you think a surgery ever improves or updates its premises?

Focusing on profit is just not the point. If you are being paid fairly as an individual that should be enough.

Yes but that isn’t how most businesses work. They need to constantly drive up profit to remain viable and survive. That’s why they shouldn’t be businesses if providing NHS services. Same for dentists.

It’s no longer sustainable. What we need are less private health providers including GPs/ dentists not more. Won’t be popular. We just need a government that’s brave enough.

I really feel for you OP. Our practice is not in a dire situation at present but I do know some that are. I think you've been brave to start a thread, as i don't think I could have the mental energy to read and reply to some of the posts you've had. People clearly do not understand the GP partnership model, the benefits that has including value for money for the NHS, the sheer volume of work on partners shoulders.

See my previous posts. RTFT.
Hardly any staff on minimum wage. Only inexperienced new starters. The wage differential and NI is the killer.
But I have 30 years experience. 2 degrees. Paid my student loan and many costs for many years. Work way over my so called hours. Work ina very demanding role with significant risk. Should be paid the same then? Minimum wage? Are my years of training work and experience not worth paying for? The last I looked we did not live in a communist state.

It would strike me as eminently sensible for GPs to focus on medicine rather than also having to be (rather amateurish in many cases) property managers, contract negotiators, and HR practitioners etc.

I will never forget getting endless clueless emails from a GP partner about their lease (in my professional capacity) in the same week I couldn't get an appointment for my daughter to see a GP at the same practice. What a waste of their medical training to spend it all that time dabbling in being business owners

Practices are worried about profit as that is what pays the GPs 😂 FGS what is so hard to understand.
If you've got £400k profit and 5 WTE partners, that's £80k each for the year. Your 'salary' is based on predicted profit for the year. You can absorb reductions in profit by reducing your take home pay.

I don't think you understand the partnership /small business model. And I can't really be bothered to explain. Profit is what is left, what the partners "earn".
But everyone knows how GP practices work/run . When most doctors and GP staff don't.

People don’t realise just yet the effect this will have on business. Labour certainly do, I doubt very much that this wasn’t a very calculated decision.

I mean, it certainly does redistributes wealth, in a way professionals won’t like, in terms of unskilled jobs on higher NMW. I wonder what the long term impact will be.

Op, I really want to sympathise with you as you sound so stressed, but if your figures are right, operating at a -10k every month is just bad business. I’m not sure you have the skills/resources available to you to operate efficiently and perhaps you should carefully consider your options over the coming weeks/months.

They've got a huge black hole to fill that has been left by the previous government. The money has to come from somewhere.

The other element to this is that the unskilled job person won't as likely have education loans to pay back, and won't be spending a number of years out of the workforce, not earning but still living.

There are compensations - the skilled person should be able to move up in salary in a way the US killer person won't typically. But it doesn't always work out that way, academia being a good example, increasingly people are spending whole careers in contract teaching roles.

Our options are too shut shop/hand back our contract. I'm not a fucking idiot. I've been a partner for over 20 years.
I can't magic money out of the money tree.
That was kind of my point. But the mansplaining is appreciated thank you.
I'll look at our options. For the hundredth time this month.

You've just said that you're 10k overdrawn every month, yet now you are making a profit? There's a big hole in your argument. And for me, this is where the argument ends. You are worried about your profit and not whether you'll go bankrupt or not.

🤦🏻‍♀️🤦🏻‍♀️🤦🏻‍♀️

If a company employed 30 people on £25k and 30 on £100k the costs for salary + NI will increase from £4,192,152 to £4,267,500 or by 1.8% in 2025.

I'd suggest if a 1.8% increase in staff costs are enough to put a company out of business then there are far bigger problems going on.