Dr Laurence Buckman: A Doctor writes

My profession is being vilified for doing what was asked


The other day, I heard someone on the radio say "Do GPs do any work anymore?" It made me so angry. I was driving between three emergency visits at the time, and I thought "Of course we do".

Family doctors are now being penalised for rising to the challenge of performance-related-pay by delivering the quality care the Government asked for.

The only pay rise that GPs got from the 2003 awards was for performance. There was a modest rise for general pay but that was only at inflation rates. GP pay since then has been completely static but our expenses have risen, so it is – in effect – a pay cut.

The Government said they would only give a performance-related pay rise based on the outcomes for patients. Now we've performed and people are saying GPs are earning too much money.

The workforce were initially unwilling to accept performance-related pay rises, as it was seen as something nasty that was deliberately done to hurt GPs. Many doctors thought it was a box-ticking, point-scoring idea but now they've seen the colour of the money they are not as hostile as they were.

We heard over and over again that GPs were rubbish and would not perform; now we have performed and delivered and people say we are paid too much. This is a pay scheme imposed by the Government and now they don't like it that we have done well.

Ultimately this large pay rise was for new work that GPs had not done before. We have to put in the extra work to get that money, which involves more time spent in more consultations and more patients; that takes time. Doing that at a highly professional level is very time consuming and requires a whole team of people.

GPs do not just sit around writing prescriptions. If you want to do that, you will not get any of the extra pay. There is a huge change in culture, workload and effort required. The pay rise that people are saying is a lot of money is one of the highest levels of performance-related pay of any professional grouping. Very few others are paid on performance, they are paid on time.

If you don't make the patient in front of you better, then you don't get the extra pay. So if your blood pressure doesn't fall because I haven't treated you properly then I don't get the money.

Alan Johnson says we work 9am to 5pm from Monday to Friday. My typical day is 8.45am to 8.45pm, and you end that kind of day pretty tired. I don't go off to play golf in my lunch hour or anything and I resent the implication that this is some dodge to rip off the NHS and the taxpayer.

There are less dead people as a consequence of performance-related pay. In the past year, 8,500 people that would have died from blood-pressure related illness have not. That consistent medical care is delivered to consistent high standards is of benefit to patients. Just because it also benefits doctors is not a reason to tear into us. Most of the increase in GP pay in recent years has come from the extra resources that GPs earn if they offer a higher quality of patient care. The outcome from this raised quality is a better standard of health for our patients.

The government propaganda that GPs are monsters who have stolen money from the NHS is very wearing. Now they are unable to say that we are rubbish because the quality and outcomes have proven we are not, so they go and call us thieves instead.

Dr Laurence Buckman is aGP and is the chair of theBMA's GP Committee

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