The government has defended GPs pay after it was revealed some family doctors are taking home more than £350,000 a year.
An investigation by the Daily Mail using the Freedom of Information Act found one GP, in the Colchester area, earning £380,394 a year. The 2004 GP contract has also been criticised after it was revealed some GPs earned up to £204 an hour to work weekends and evenings.
The Department of Health said that most GPs had seen no increase in their pay over the last three years and defended the GP contract, saying it had improved recruitment and retention of doctors in the health service.
One GP working in Huddersfield and Dewsbury earned £321,794, while another practitioner in Norfolk was taking home £310,000 even after staff costs and other costs were subtracted.
A spokeswoman for the British Medical Association said: "There is huge variation in these figures and this is not reflected in previous statistics, which show very little difference between the highest and lowest earning areas of the country."
Copyright © Press Association 2009
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"Public funding is given to GPs to run the practice, therefore they can't be private contractors. All the fund details have to be given to audit departments to check as to how the money is utilised. GPs, as private contractors, get all NHS conditions (pension, sickness, holidays) and flexible working conditions as self employed but the staff who work hard, specially nurses who conduct 90% of the work, are not even given NHS conditions to work or pay. General practice should not be run by GPs and they should be made to be clinicians" – Esh, Middlesex
"The partners of the practice own the business. They are entitled to make as much profit as they see fit. Nurses get very good regular wages without risk and do not work a minute past their contracted hours without clawing it back at some point. I am an IT Manager, employed by four partners to deal with QOF, DES, LES stats reporting etc. I receive a good wage with monies raised from above. I am paid to do the job I agreed to. People with massive chips on their shoulders really should change jobs to a supermarket or production line" – Name and address withheld
"I once worked in a GP surgery. Not one of the GPs worked a full week. The only clinical staff to work a full working week were the nurses. We were sometimes lucky if the GPs worked three days out of five. I can't say I'm surprised about the amount of money they earn and they did not seem very interested in sharing the profits with practice staff. Out of six fellow practice managers or deputy practice managers locally, I was the only person not to receive a bonus at the end of the F/Y. It really opened my eyes to how petty and money-grabbing these people are. I would not say they are as bad as MPs but some of the GPs come close" – Christopher Hampson, Cambridgeshire
"The GPs in my practice would dearly love to work 20-24 hours and earn the sum that the media claims GPs are making (they make nothing like that). It is disheartening to see that so many people are so resentful of their employers and it does raise the question of why they remain with them. The grass is not always greener on the other side but if I felt the way some of the respondents do I would certainly take the chance rather than staying put and letting such negative feelings fester!" – Susan, Gateshead
"Why should the owners of this business (GP practice) be any different from the owners of any other? You work for the firm and the bosses reap the reward and take the risks. If Ann is a practice manager then she should argue for a better return for all the staff and the bottom line is if she doesn't like that attitude of her employer - leave!" – Name and address withheld
"I agree with Ann in Derbyshire. Our staff worked very hard for the QOF and never had a bonus or a pay rise or even a word of thanks, just criticism all the time. I wouldn't expect a bonus but a pay rise would be nice in line with the cost of living. I find it resentful when I saw our GP earning £200,000 and we got nothing. I don't expect a bonus as to me that is a luxury, but a cost of living pay rise is not much to ask for. Hence the reason I resigned in the end" – Jane, Lancashire
"In response to Ann, I think that is a gross generalisation. Our practice nurses are on AFC, get regular appraisals and pay awards as do the other staff. We are in a very deprived area and the drs do appreciate the nurses and work considerably more than 20 hours, seeing patients is only part of the work – though even if it wasn't, our GPs do a lot more than 20 hours. Don't tar all GPs with the same brush. We run a flat hierarchy and know that resentful staff do not work well, it can be done. There are enough challenges out there; internecine fighting will not assist in delivering patient care. I am not naive – there are drs in Leeds who treat their staff badly and I would not work for them!" – Name and address withheld
"Our GPs are earning nothing like these extraordinary sums. This level is not typical but makes good headlines. This is a newspaper summer story to fill the pages when Parliament is not sitting and should be taken with a large pinch of salt" – Name and address withheld
"I am a practice manager for five hardworking doctors who earn a third of what is being quoted. They do an 11-hour day and still have lots of paperwork and non-NHS reports to do at the end of the day. They have given all staff pay rises even though their income has dropped and have also spent their own money on making the surgery a comfortable place to work. The staff are treated to nights out and still receive a Christmas bonus. Ann from Derbyshire needs to find a more caring practice than she is currently employed in!" – Pat, Lancashire
"I am a practice manager in South London. Only rarely will GPs earn this money. I don't think any investigation is necessary. Practice income varies hugely; these extreme salaries are just that: extreme, not typical" – Colin Paget, London
"This is absolutely true story: 80% and over share of work for QOF and other DES and LES goes to practice manager and receptionist shoulder but none of them get any penny for their unlimited extra work. Because of recession and hard job market nobody can say anything. Even 2.5% annual increase in pay is very hard to get. GPs are really doing business and others are giving service to the patients" – Name and address withheld
"This is typical of the Daily Mail lately coming up with sensational headlines. The papers did the same for the swine flu outbreak, which caused panic. This latest headline leads to the comment above where a nurse is filled with disgust – why? It is not true that all nurses do most of the contract work and do not get a pay rise or share of the QOF reward. Nurses are in great demand and all this nurse has to do is to move to a practice that rewards her adequately for her contribution. Whilst the new contract did reward doctors for the work they do in one fell swoop, I have no doubt that the new contract could have been negotiated so that the practice income increased in stages. As it happened, the DH is now deperately trying to claw back some of the money that it paid in the past which was led to no pay increases in the last three years. As a practice manager, I wish the papers would provide a breakdown of how this doctor earned over £300,000 as I would like achieve this sort of income for my doctors who have done a lot of training and work extremely hard for the just rewards that they receive" – Flavio Gracias, Middlesex
"I don't know any fulltime GP who earns more than £90k once the employers' superann is deducted. I also don't know any who only work 20-24 hours a week unless they are part time and they certainly wont get paid that much. I am a practice manager and Ann is kidding herself if she thinks nurses do all the QOF work. However, if a GP's share of profits is actually £380k, which I doubt, then it does need to be investigated. I just don't see how that can be" – Mary, Scotland
"I am sure we will see more reports like this as GP partners retire (on typical shares of £100,000 to £120,000) and are replaced by salaried doctors on £65-70,000, thus leaving a surplus to any remaining partners" – Andrew Clark, Derbyshire
"I work as a manager in primary care and it has been my experience that in most cases GPs work extremely hard and do very long hours (unlike the nursing staff I employ). It is about time people stopped criticising highly skilled professionals when they justifiably earn high wages – it is jealousy and nothing more. The demands on GPs are significant and their role critical. We need quality clinicians and need to pay for them" – Jeremy, Buckinghamshire
"I think Ann must work in an area where patient demand is very low, my GPs do around 30hrs patient care, plus QOF, plus PBC, scripts, paperwork, referrals and visits. I would suggest that their working week is around the same as mine: in excess of 48hrs most weeks. I am also part of a large PBC hub and certainly none of the GPs of the 100 in our hub earns anywhere near that mark from GP work. Nurses on the other hand work set hours, with on the whole long consultation times, no weekend or shift work and, whilst I have the greatest respect for what my PNs do, I have yet to see a PN who will opt to work in the hospital sector to gain the increased pay that on a whole is paid in that sector, whilst I see many hospital nurses applying for jobs in general practice. Some loyalty is amiss here, and if the practice she works in is so bad then another job is recommended" – Jim Bond, Cheshire
"Ann from Derbyshire may be describing the situation in her practice, though her statement is so vague as to be meaningless. I can assure you that this is not the case with regard to practices in this part of the country where GPs work very hard and do not earn anything remotely close to £380,000. To make sweeping statements such as she has made is totally wreckless and most unprofessional" – Name and address withheld
"I work as a practice nurse and am absolutely disgusted with the GP earnings. They are working on average 20-24 hrs a week and do no weekend or out-of-hours work. Most of the contract work is done by the practice nurse who mostly including myself do not get a pay rise or a share in the QOF money. The sooner this is investigated the better! I am sure just like the investigation revealing the MP's expenses you will find that the public are not getting value for money from their GP's. The nurses workload has increased hugely with no extra staff being employed or indeed no increase in pay" – Ann, Derbyshire