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 must apply to all businesses, surely. Solicitors, newsagents, florists, publicans etc.

The only ones who could fit everything in would be the lucky HR professionals who’ve converted from being surveyors and have taken a course in negotiation.

I work for a GP surgery and get NMW, as do my colleagues. We often work 10 hour shifts with 1/2 hour break. Patient facing so also stressful, sometimes people shouting etc. I am pleased at the increase to min wage as financially it’s very difficult to survive on NMW especially for single parents.
I know that dr’s work extremely hard and I really hope that surgeries don’t have to close.

True.

Although those with good sense obtain decent advice. And floristry skills aren't a scare resource in the same way as the skills of an experienced GP are.

But utterly bonkers when GPs could easily just be employees instead. Madness that they are often negotiating their lease with another bit of the "NHS"

Lawyers and surveyors making heaps of money out of the fragmentation

The OBR doesn’t support that. The black hole has become a phantom, like one of Derek Acorah’s spooky mates, i.e. fictitious.

So you’re saying that at the moment you are literally working for free, with no salary?

I had a business and was an employer before I retired, so I get it. I am hearing this from so many industries at the moment. You and all of your colleagues, including the cleaners, offer a valuable service that would cause the quality of life in the UK to plummet if you all stopped.

All these vital services that people need but cannot afford. The economy is in a spiral of decline after years of mismanagement austerity.

I’m afraid you are experiencing a level of financial misunderstanding that is so typical frankly I wouldn’t even bother to try and justify yourself. The level of skill and experience you need is huge and learnt over many years of training. It is entirely reasonable to expect to earn a reasonable amount. You will never win people over, just send the keys back and move on.

What people need is a 24/7 GP service.

That might happen sooner than people think because there’s going to be a time soon, when GPs are replaced by AI.

You will log in and talk to an avatar, who can prescribe. The prescription might need to be signed off by a human GP.

It’s possible you could have an AI , GP robot / machine that can take your vitals. Sounds ridiculous but it’s the most logical solution to the current problems we are facing.

People need to realise that in the near future, human jobs as we know them will cease to exist. Our focus will be on training machine learning models and configuring robots etc.

Gosh. Your attitude literally stinks. Why bother posting on here? We are not going to provide some magical solution for you, are we? And quite frankly, no one actually cares enough about your particular situation. But you already knew that, didn’t you.

Ok. Sorry, I misunderstood - profit is usually profit after staff costs; not actual salaries. If your salaries are dependent on profit then yes, it sounds like a totally broken model.

But also, you’re trying to essentially trying to be a CEO, a HR manager, a COO, a CFO from the sounds of it. As well as a doctor. That is just never going to work well. You can’t see the wood for the trees. It sounds like the model needs complete restructuring, moving from broken IT systems, shoddy cultures and inefficient ways of working to something streamlined and well managed.

im not blaming you for that, you shouldn’t have to do it all. But it does need to happen if this is going to be fixed.

We all may have to pay more for a better future, yes. Happy to do so.

🙄

Shareholder primacy is at the root of the rot much of the Western world currently finds itself in. I’ve some small sympathy with private businesses, who may find themselves struggling to stay solvent. But this mantra that society can frankly go to Hell, before the shareholders forgo their expectation of infinite growth is largely responsible for the huge inequality we find ourselves in today. Something has to change. It’s unsustainable.

Delightful.

GPs could be using A.I. now to speed up waiting times and booking systems. The issue is the time to invest time into training. And yes, potentially some human cost in terms of jobs

OP this makes for terrifying reading.

I wish you well, not sure that there is anything useful I can say.

I’m astonished that Reeves put the tax bomb under businesses like this.

I do think that it’s because it doesn’t directly affect the majority of people, that this is how she’s getting away with it.

Love an AI can't recruit any human doctors. And they can't really safely see more than 40 patients a day.
Where do I find one and how much do they cost please...

Do you really think the NHS would run the surgeries efficiently or well though?

I suspect it would be one size fits all, and lots of inefficient regulation, and you'd likely see the kind of centralization that would make local provision of care less effective.

It's interesting that typically, private practices are pretty well run. I am not convinced that most GPs don't have the ability to run a business, or don't know that they should hire a business manager.

But it can be difficult to run a business properly on a shoestring. You probably can't afford a good practice manager, for one thing.

I feel for this, we’re a company that supply to the NHS and we’ve realised a £250k hit from the change in NI, which means we can’t employ as many resources in the UK. It hurts companies.

It is not a 'broken model'. OP is a partner i.e. owner. She is not an employee. She does not earn a salary. She takes a drawing based on the profits depending on her partnership.

This is how a partnership works. As it ever was.

Many professional practices use this partnership model. Yes, accountants, lawyers, use this model, not just doctors. These people are not 'missing the wood for the trees'. They are running their own business. If they can they hire an office manager and staff. Otherwise, they just have to muck in. It is called managing a business. The product they are selling happens to be their professional skills.

Well you will care when you take even longer to get a GP appointment. But I guess you already knew that and no one could give a toss about you.

I cannot believe that you have actually had to type this out.

I was just reading through all of the posts before responding to explain how a partnership works. I see that several posters have asked what your salary is, when technically you don’t actually have a salary.

I agree with previous posters that the entire system is broken and personally have had some very poor experiences trying to access proper care. But it doesn’t take away from the fact that GP partners NEED to make a profit, or they do not take home any money at all. Also, if the partnership suffers a financial loss, the partners are personally liable for it.

I am extremely worried about the impact of this budget on all small business that we rely upon to keep things functioning, including GP surgeries, nurseries and farmers.

I get the model, my brother owns his own law firm.

My point still stands - trying to be a doctor whilst running a practice is just too much, and they are not complementary skills.

it’s not efficient.

Why would a law firm with, say, a criminal or matrimonial practice be any better at running a business than a partnership of doctors?

What about charities? I work for one and we are already cutting jobs as cost of living has really affected fundraising and costs. I fear we may fold if the gap widens further - like many other organisations in the third sector. But there has been no mention of an exemption for charities, even though they provide a public service.