My Lords, in England, in 2012-13, the average income for a contractor GP was £105,100 and for a salaried GP £56,600—both before tax. A contractor GP is a practitioner who entered into a contract with the NHS as a single-hander or as part of a partnership. Eighty per cent of GPs are contractors.
I am grateful to my noble friend for that reply. In view of these quite respectable salaries, might it not be reasonable to expect a little bit of work in the evenings and on Saturdays?
My Lords, the Government recognise that GPs work hard but that some patients would like more convenient opening hours. We have invested £50 million in piloting improved access to general practice this year, which will benefit 7.5 million patients. A further £100 million of investment will follow next year, which will mean that even more patients can have access to longer evening and weekend hours.
Will the Minister confirm that the increased remuneration for GPs was part of structural and other changes in the NHS which took hundreds of thousands off the waiting lists, reduced the maximum waiting time from three years to 18 weeks, halved the incidence of hospital acquired infections and increased the efficiency and service in our accident and emergency units to 98% over a decade, and that, if all those beneficial changes have now been reversed, that cannot be placed within the context of doctors’ wages?
Certainly those changes under the last Government are well recorded but GPs wages have been falling every year in real terms since 2005-6. The expenses-to-earnings ratio increased from 62.7 to 63.7 and the additional funding announced at the end of last year will support general practice and out-of-hospital care more widely to improve infrastructure and pilot new ways of working.
I can tell my noble friend that today has brought good news. NHS England, Health Education England, the Royal College of GPs and the BMA today published a 10-point plan to boost GP numbers. As part of this, NHS England is working with the BMA and the royal college to explore a time-limited incentive scheme to offer additional financial support to GP trainees committed to working for three years in areas where it is hard to recruit GPs.
My Lords, in view of the answer that the noble Baroness has just given, I wonder whether she was listening to the Radio 4 report at lunchtime today—I am sure that she was not and has many better things to do—about the extreme difficulty that these schemes are having in recruiting trainee doctors into general practice. Indeed, the University of Leicester attempted to recruit 250 doctors, if I remember rightly, but fell about a third short of that number. In those circumstances, is it appropriate for us to be casting a jaundiced eye on what these people are paid?
I am not sure about the salary and I am sorry that I missed the programme. We are aware that there are certain areas where we feel that there are not GPs and there should be more GPs. We are working really hard and, as I said, this new incentive is in place as of today and will, we hope, be able solve that problem.
My Lords, can my noble friend explain why GPs in this country are paid substantially more than GPs in France, despite the fact that the standard of medical care in France is at least as high as it is in this country, if not higher? I speak as someone who from time to time receives medical care in both countries.
Does the Minister agree that sooner or later we will have to tackle the issue of developing a comprehensive primary care service in this country that operates for 24 hours, around the clock and seven days a week, which is a much bigger issue than GP salaries?
Community and primary services are being looked at in the round by NHS England with a view to seeing what changes need to be implemented to effect, I guess, the way in which we work in modern times.
Is the noble Baroness aware that the number of patients being seen by general practitioners is rising year-on-year? Is she also aware that the amount of bureaucracy is becoming overwhelming for GPs, who are spending up to 50% of their time uselessly filling in forms and papers? Could they not spend more time seeing patients?
Yes, indeed. Again, we are working hard with NHS England to try to reduce the sort of form filling and bureaucracy that GPs are currently having to do so that they can spend more time with their patients.
My Lords, does the Minister realise that many GPs are thoroughly demoralised by all the attacks on them by ill informed politicians? What is more, without mentioning which party it was, a certain group criticised GPs and said, “We know what you are doing. You are on the golf course playing golf rather than doing your work; so we are going to pay you only for what you do”. The GPs thought that that was rather a good idea and it resulted in a 25% pay rise.
My Lords, I thank my noble friend Lord Reid for once again setting the record straight on this issue. Moreover, in Labour’s last year in office, 98% of patients were being seen by their GPs within four hours. Does the Minister agree that the key problems that need to be addressed were set out in the Nuffield Trust’s recent report—an emerging crisis in the GP workforce, not enough GPs being trained, more trainees now working part-time, more existing GPs planning to retire early, and the numbers just not keeping up with those of hospital doctors?
There is a whole mix of issues. Morale is clearly one, but it is our view that the 48-hour target did not work. From 2007 to 2010 the percentage of patients who were able to get an appointment within 48 hours when they wanted one declined from 86% to 80%. This Government take a different approach. We are trying to focus on local solutions rather than top-down targets. According to the latest data from the GP patient survey published in January this year, 84% of patients were able to book an appointment at their GP surgery when they needed one and 91.8% of patients got an appointment at a time that was convenient to them.
My Lords, going back to the answer my noble friend gave to the noble Lord, Lord Laming, who made a fundamentally important point, she said that the work of GPs was being looked at by NHS England. As I understand it, NHS England is answerable, in some form or other, to this Government. Does my noble friend accept that if there is to be the sort of fundamental and comprehensive change that not only the noble Lord, Lord Laming, but a lot of other people believe to be necessary, that change will have to be agreed on a cross-party basis rather than on a narrow, government basis, whoever happens to be in Government?
Yes, consensus is already a good idea. I am sure that the next few months will see all of us airing our differences. But in some areas—the one that comes to mind immediately is the area of joined-up services between health and social care—there is already quite a lot of agreement.