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How to save the NHS England £150 million per annum.

There are broadly just over 7000 GP practices in England. Each one is a business owned by the partners. Now it has come to light that as well as being paid for the services provided it seems that such businesses have the rent of their premises paid by NHS England.
How nice it would be if all our customers paid our rent and Business Rates (yes NHS England pay that as well) on top of the fees we charge for our services/goods.
If the property occupied is owned by the practice then a notional rent is paid.
So treat them like any other business and save £150 million per annum (or thereabouts).
Does anyone find this just a little OTT?

UK, United Kingdom

The problem with changing so many of these arrangments is the extent to which they are entrenched. Partners consider this effectively part of their income, and so would argue a contractual breach, and require an increase in their salary. Changes can be made from the ground up, but how do you “give” some partners rent free business accomodation, while the new kids not. The Easyjet or BA model of very different packages for the new kids is the way forward, but only if you continue to attract enough people into the profession. Medics, rightly or wrongly, based on at least 7 years training, see themselves as equivalent to lawyers and accountants who probably on avergae command higher earnings than the average GP. Consultants in the NHS are already considerably behind lawyers and accountants at equity partner level in the larger firms.

But they are not paid a salary. They are paid per patient on the books plus whatever additional work they are authorised to do. The more they work the more they earn, just like most of us really.

UK, United Kingdom

GP’s also have bonus paid targets I think. One I was speaking to another time explained how she more than made up for the wage decrease in the new deal (giving up 24 hour care) by coming in 10 minutes early each day and sending letters or ticking boxes to / for repeat prescription people.

It seems as if it pays for GP’s to game the system for maximum reward. Then retire with a the comfort of the index linked government backed excellent pension.

It depends what you mean by a salary? I agree the arrangements are complex, most are technically self employed, but there has been an effort to increase the number on salaries. However, semantics aside, the reality is the basis of the arrangement is the IANR set by the review panel which defines what a GP can expect to earn, whether the business trades as limited company, partnership or the doctor is an employee. However you cut the cloth and whatever names you use, if you turn the tables on the practices and require them to pay their rent out of gross income, of course you make the remaining pot smaller, and so the IANR must fall in turn, which would not be accepted I suspect as a change to the fundamentals of their undelying contract with the NHS. It is not that I dont have some symphathy for your proposition, but I dont see how you could remove a signifcant component of their overall remunerative package and not expect this to be seen as simply a way of reducing their income with obvious consequences? It is a bizarre commercial arrangement, but like many, contractual packages are often made up of a complex arrangmeent of components for various reasons including orginally some straight forward tax avoidance. Is the average GP too well remunerated – well that is I think a different question. As I suggested earleir, it seems to me in terms of the time taken to train, and the risk and reward involved, they are toward the top end, and more to the point the spread is nothing like the spread of other professions, so the arrangement they have is very sheltered from how well they actually run their practices and their perceived level of skill.

However, I think however you put together the package, ultimately we all make decisions on the basis of our take home pay, and if you change nothing other than to deny the benfit of rent free accomodation, then their take home pay would also fall by a similiar amount. That bit must be straight forward economics?

Last Edited by Fuji_Abound at 21 Jan 21:34

There is already a major problem with GP recruitment and retention, particularly in less salubrious communities. We run a real risk of exacerbating this.

EGCJ, United Kingdom

And the relevance to aviation is what, exactly ??

You got it.

Looking around this country right now, the people most deserving of our critical judgement at this particular time are GPs.

I dont think we shoud beat up anyone for a little discussion. This is the non aviation section as I understand it, and while there may well be more important topical issues at the moment I think anyone is entitled to raise a little topical discussion from time to time. In fact anything not to do with Brexit some may argue is a welcome relief. :-)

172driver wrote:

And the relevance to aviation is what, exactly ??

Reducing the cost of Part-MED I guess?

Fuji_Abound wrote:

In fact anything not to do with Brexit some may argue is a welcome relief

I had the impression Breakfast vote was mainly about some NHS money

Last Edited by Ibra at 22 Jan 10:10
Paris/Essex, France/UK, United Kingdom
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