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Are doctors ruining the NHS?

April 16, 2007

A number of bloggers have recently suggested that doctors are an overpaid interest group who have only their own interests at heart and as a result are hindering rather than helping the NHS. I must say that I believe there is some truth in the basic premise that doctors are resistant to innovation in the NHS, and that we have relatively comfortable salaries, cast iron pension rights and job security that people in the private sector would die for. I believe we should be subject to more competitive pressure and more performance related pay (however that can be measured), BUT I don’t believe that all doctors are grasping self-interested charlatans, as some people evidently do. So here’s a question:

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1) How much do you think a GP is paid

2) How much do you think a hospital consultant is paid?

And what do you think would be a fair salary for each?

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8 comments

  1. Welcome to the blogosphere. I look forward to your contributions. I don’t think doctors are ruining the NHS, but I think that they are running the NHS.

    I think the average GPs pay now stands at about £100k. I think that a GP working a 37.5 hour week should be paid about £60k, but weightings are probably appropriate for those working in expensive/undesirable locations. I have no idea re hospital consultants (because that can encompass a wide range of activities), but imagine that they are generally paid more and should be.

    I think that the way doctors are renumerated is worth examining. I’m interested in whether budget-holders get paid more and whether efficient management of these budgets is rewarded. I’m interested to hear about perverse incentives in the system and I’m also fascinated about how under-performance by doctors is addressed. Sorry about the length of my wish list.


  2. Glad to see such a post. When I asked Iain Dale on 18 Doughty Street to guess how much a junior doctor gets paid straight out of medical school he said £80,000 per year.
    Glad to see your blog.
    Michelle


  3. PT I am glad to say that I agree roughly with your figures. I reckon a GP should probably earn 50-100k, with a few exceptonal cases earning more. I am not going to comment on what consultants should be paid, as I have a vested interest, but my feeling is that a consultant has more specialist and longer training, and probably should on average earn more than a GP. (This is not the case currently, BTW)

    How they achieve that earning however is another question. Why not pay consultants in mainstream specialties nothing at all (having to provide NHS with a free service in exchange for the right to practice private medicine). This was the old pre-NHS system and is probably not appropriate for todays society as insufficient people have health insurance to make such a system work.

    I think I’d better cover some of the other issues in a separate post


  4. I now need to work out how to turn off comment moderation!


  5. Hi Mens Sana, a common misconception is that my criticism is about doctors pay per se.

    I think it is pretty absurd that some footballers and film stars get £20 million a year. But they are very few – a lucky handful.

    If every major league footballer or very ‘top film’ film star were paid £20 million the film industry & soccer industry would soon be out of pocket.

    For sure some (maybe even most) doctors deserve every penny they get from the NHS – or earn elsewhere.
    But you cannot expect the nhs to keep raising their pay (because of market forces?) and then criticise the nhs because it cannot afford to employ another 20,000 junior doctors. Costs escalate.

    We talk about patient expectations too high.
    I think doctor expectations are too high, their opinion of their worth – if doctors pay in the uk were half of what it is today we could have twice as many doctors working on the nhs – and then we could provide better patient care – which surely was what medicine was meant to be about.

    The argument that doctors can earn more somewhere else (US or Australia), clearly holds no water, when at the same time we have 20,000 junior doctors crying that the government cannot offer them a posityion on the nhs.

    And the argument that they could earn this or that working in The City or Wall street holds even less water. If someone could make a million on Wall Street or as a socker star, does that justify paying him a million to be a doctor? – Why not try pop idol.

    So I’ll not say they should be paid less. I’ll say their pay should be frozen for three to five years. Let’s give the rest of society a chance to catch up.

    A lot of people out there still having to make do on £20,000 or less – and we are having to subsidise affordable housing for key workers earning £30,000?
    Does anyone see the absurdity that someone earning £30,000 still needs help to get on the housing ladder.

    And finally, one last thing – a GP coming into the job is clearly not going to feel as rich as a previous generation who may have been set up in practice by their fathers (or family) – or the generation who ‘bought’ their private practices for peanuts at todays prices (the benefits of investment in property and price rises) – no matter how much you pay him or her.

    Just as someone with a £200,000 mortgage on a shoe box or one room studio, is going to feel that the dream three bedroom detached home with front and rear garden and a garage – is increasingly becoming a dream too far.

    There was a time when doctors, road sweepers, miners and nurses could aspire to a three bedroom home with a garden and a garage – regardless of income. Not anymore!


  6. So I’ll not say they should be paid less. I’ll say their pay should be frozen for three to five years. Let’s give the rest of society a chance to catch up.

    I’m sure this is what will happen. I suppose that as a doctor what I don’t want is that pay is locked down for so long that it falls too far behind other comparable professions.

    I don’t think that we should necessarily compare ourselves with City workers or foreign doctors, but I would have thought other professionals working in the same area would be a fair comparison. For many years doctors pay lagged far behind these levels, which is why a significant uplift was necessary.

    It is a scandal, however, that the government/DoH negotiators understood the system and the way people work so badly that they have allowed the current situation to arise. It is difficult for me to criticise the doctors side (self-interest apart), as they have a duty to negotiate the best deal they can for their members. You may with some justification argue that it was not in the national interest, but in their place what would you have done?


  7. I think the supply side of medicine should be privatised at least in substantila part, and that if it were, supply and demand would take care of how much doctors “ought” to be paid…..and the range of what what doctors actually were paid would widen considerably, and that that would be a good outcome.


  8. Potentilla Hi.
    I agree with this. I think if we depended on being good doctors for our living we would be better doctors. At the moment good enough is good enough, and I don’t think that it is



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