A DOCTORS’ leader says GP earnings must be brought into line with those of hospital consultants in order to attract more young medics into the profession.

Dr Andrew Buist said wide variations in GP incomes also had to end, but insisted there was no plan to scrap the independent contractor model in favour of paying GPs a fixed salary.

Dr Buist, the chair of BMA Scotland’s GP committee, was speaking ahead of the profession’s annual Scottish conference in Glasgow tomorrow.

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It comes after a letter jointly signed by Dr Buist and Health Secretary Jeane Freeman was sent to GP practices across Scotland this week asking partners to return their income, expenses and workforce data for the first time.

The information will be used to inform the rollout of Phase 2 of Scotland’s new GP contract in 2021.

Dr Buist said: “We believe that this data collection will show that incomes vary too much between GPs. Some will earn a lot less than consultants, some may earn more.

“The intention with Phase 2 is to move to a GP pay that is comparable to hospital consultants because we need to attract the next generation of doctors into the profession, and they need to be reassured that there won’t be a significant income difference between becoming a hospital consultant or entering general practice.”

The starting salary for a hospital consultant in Scotland is £82,669, rising to around £92,000 after five years and nearly £110,000 with 20 or more years experience. This can be boosted through private practice, overtime or merit awards, however.

In contrast, GP practices are funded by government but run as small businesses by GP partners who pay themselves directly while deciding which patient services to offer, how many staff to employ and what to spend on maintaining or improving premises.

Currently, GP partners have a minimum income guarantee of £80,430, but research indicates that a minority are have been able to boost their take-home pay to between £200,000 and £300,000 under the current system, leading to claims of “profiteering”.

There has also never been a requirement for GP partners to disclose to Government how they spend public funds, or how much their claim as pay.

The Herald revealed in October that Dr Helene Irvine, a public health consultant who advised the Scottish Government on the current GP contract, had written to MSPs calling for an end to independent contractor status in favour of a salaried model.

She argued that the secrecy around GP earnings and the potential for profiteering had made Government reluctant to invest the amounts needed in general practice, with the share of the health budget devoted to GP practices falling from 9% in 2005/6 to a record low of 6.8% by 2017/18.

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The call for GPs to share their income and expenses data with Government for the first time is controversial for some who fear it indicates a shift towards a salaried model “by stealth”.

“That’s most certainly not our vision,” said Dr Buist, who works as a GP in Blairgowrie in Perthshire.

He added that BMA Scotland would also reject any attempt to impose a cap on GP earnings.

He said: “If we get the model right, we won’t need a cap. As I said, there will be a comparable income to consultants but it’s not a salary because GPs will be able to provide additional services - what we call ‘enhanced services’.

“So if you want to earn extra you can do that by working efficiently. You’ll also be able to boost your income as your experience increases, by a partner, and by doing extra things like extended hours. But we’re not in favour of a cap.”

Dr Buist said the data gathered on income and expenses will be used to devise a new pay structure for GPs which will be put to BMA members a year from now. The introduction of Phase 2 will depend on getting a majority of GPs to vote for it, however.

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General practice in Scotland has struggled as the ratio of junior doctors opting to train as a GP compared to a consultant has fallen from around 50:50 to 20:80. This has contributed to rising vacancy rates, exacerbated by the growing numbers of GPs retiring early, quitting or working part-time.

Dr Buist said: “Hospital medicine obviously has its attractions, but so does general practice, and we shouldn’t have a variance between the pay levels.

"This change will move us slightly along the line [towards a salaried model], but we will still crucially have the autonomy to run our practices as we see appropriate.”