Sunday, 10 May 2009

Tax is taxing thank you very much Adam Hart-Davies

After all my ranting last week I was taken off RAC (Rapid Access Clinic) at the last moment. Phew. Doing it on monday though. Bollox. Honestly the rota at work is so borked its unbelievable. Its my understanding that a session of work for a salaried GP is taken to be 4hrs 10mins according to the BMA. That includes paperwork, visits etc... Well we seem to have so many urgent extras that our morning clinic now finishes at 12-1230. That leaves 10-20mins to do visits (normally 2-3 @ 20mins each at least) + any paperwork (referrals, form filling, letter reading, checking results etc).

I honestly have no idea how we are meant to do all this. Its not only me whos getting backed up on the paperwork front. Its fine for the partners to pop in on their day off or stay late and catch up as thats whats being a partner is about - hence the fat paycheck they reward themselves. I know some of the salarieds stay late to catch up and they are slowly (or not so slowly) heading towards burnout. Its really fucked up. I'm glad I am leaving in December to go to Liverpool (part of wife's PICU training). If i wan't I think I'd leave where I am working anyway. I could rant about work all day but frankly I guess its boring to read. Still it helps me get things of my chest I suppose.

When I went into General Practice there was a shortfall in the number of Drs going into GP-land. So for a double edged promotion of sorts the government offered a golden hello (£6000 I think) + GP contracts were renegioated . Funding for GP's was altered and linked to Quality Outcomes Framework (essentially points for reaching certain clinical and managerial targets), in addition GPs no longer had to do Out-of-hours (OOH) cover (for a £6000 pay cut).

So when I went in things were looking rosey. I got a golden hello, no OOH cover and pay for GPs was going up. An unforseen (perhaps) consequence of the new funding arrangement was that it was financially better for a GP partner to hire a salaried GP rather than take on another partner in the business. For example - new partner = £120k reduction in profits, salaried GP = £70k reduction in profits, remaining profit to be split between existing partners.

In addition the government did a spectacular U-turn on the OOH cover, demanding that GPs cover from 8-8pm (even though there was v.little demand from the public for this), for no extra funding.

So now I find myself stuck in a target driven GP-land with fatcat GP partners making the salaried GPs do the donkey work and potentially having to do OOH again. Brilliant. Not only this but the government seriously fucked up hospital Dr training (MTAS) with the result that hospital Drs have had their careers ruined as well.

Labour have majorly fucked up the NHS in a HUGE way. I know of no doctor anywhere who will be voting Labour in the next election.

Well thats all the ranting out of the way. Whats that got to do with the title? Absolutely nothing. Whats happened is that I have been on basic tax rate for my GP specialist work meaning I owe the tax man over £3000. Quite how this has happened I do not know as I spoke to him in Jan after getting a massive tax bill then too and he didn't spot anything. Doing Tax returns, even online is tedious and painful, especially when you get stung for a huge tax bill.


  1. wouldn't it always have been cheaper to hire a salaried GP? and, is the govt really to blame for some GP Principals' greed?

  2. Under the old contract you were financially rewarded for taking on partners. Not so now. I agree that the government cannot be held entirely at fault. I know of one GP who is earning £250k + by hiring multiple nurse practitioners and salarieds to do his dirty work. Sadly some docs are greedy bastards and have lost sight of why they became GPs in the first place.

  3. "Sadly some docs are greedy bastards and have lost sight of why they became GPs in the first place."

    I think you're wearing rose-tinted spectacles with this implication that the money has not always been a major impetus for many becoming a GP.