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Doctors' leaders defend GPs' productivity after NAO report

28/02/2008

Doctors' leaders have spoken in defence of GPs' productivity after a report questioned whether their new contract has resulted in increased efficiency.

The National Audit Office (NAO) said the new contract for general practice has cost the Department of Health £1.76 billion more than it originally budgeted for.

In the first two years of the contract, productivity has dropped by an average of 2.5 per cent per year.

While the number of consultations with patients has increased, the NAO says these are not in proportion with the increase in costs.

GPs are now working seven hours less per week and the annual average pay of a GP partner is £113,614, an increase of 58 per cent since 2002-03.

But the NAO found that GPs' pay has stayed the same or decreased.

GP partners have also taken more profit from the practice as pay.

Positive findings from the report include nurses spending more time on practice work, leaving GPs to spend more time with more complex cases.

GPs also now spend more time with each patient, an average of around 12 minutes compared to eight minutes in 2002-03.

"There is no doubt that a new GP contract was needed and there are now 4,000 more GPs than five years ago," said NAO head Tim Burr.

"But in return for higher pay, we have yet to see real increases in productivity. The extra money flowing into practices has largely benefited GP partners rather than rewarding other important members of the practice team.

"Primary care trusts now need to deliver to patients the benefits that were expected in return for GPs increase in pay."

Dr Laurence Buckman, chairman of the British Medical Association's (BMA) GP committee, highlighted the fact that the new contract was brought in partly to reduce the excessive hours GPs were working and to redress the pay imbalance.

He claimed that before 2004 the UK's GPs were among the worst paid in the world.

"General practice has changed and primary care is now provided by a whole team working in the surgery," Dr Buckman added.

"The number of consultations has gone up, the time spent with the patient has increased and the work GPs do is more complex.

"In fact the entire way GPs work has changed so it's meaningless to talk about productivity in the way the NAO has done. GP productivity should be measured in improvements in health, not the frequency of consultations - and the early evidence is that the contract is leading to improvements in clinical care."