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Publication of GP earnings

Peculiar Practice

John Cormack

Tuesday, 23 February 2016

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calculator_shutterstock_373491838.jpgWe GPs have been asked to publish details of the income this year and in a way this seems a reasonable request - after all it is taxpayers' money and there should be some accountability. Moreover we love it when other people are made to publish details of their incomes and perks - so when for example Sir Neil McKay, the former chief executive of Midlands and the East SHA, retired with a vast pension pot having looked after himself very well indeed, he was rightly exposed. Why should the medical profession be made an exception? The fact that this innovation will encourage a few hundred more ‘mature’ GPs to think seriously about early retirement and will stop young doctors from applying for jobs in underfunded areas is unlikely to strike fear into the hearts of those running the NHS as they have yet to wake up to the extent of the crisis in General Practice.

Might there be a legal challenge to this requirement, however? Does it breach the Data Protection Act (DPA)? Might the Information Commissioner get involved?

In the case of big practices there doesn't appear to be much of a confidentiality problem at present. The Londonwide LMCs give on their website the following advice, based on the official guidance for the GMS contract 2015/16 (p10-16): “The individual earnings of each GP are added together to make the total practice earnings and then this amount is divided by the total number of GPs. In the BMA example [from the official guidance], a full-time GP partner (eight sessions) is earning £110,000, but the only figure that is published is the £56,250 which is so much lower as it has been divided by all the GPs in the practice, even the part-time salaried GP earning only £25,000 per annum.” In other words, because there are so many docs lumped together, this is a meaningless exercise and there is little chance of breaching the DPA.

But what of the small practices? There’s nowhere to hide if you’re a single handed practitioner. So what’s the situation there? There is a precedent. In the past I have tried to discover details of GP earnings for my own purposes ... because of the long-term underfunding of my practice. (We made a loss of £4,760 in the last financial year .... much more if you factor in the payment for the premises as we are asked to do for the declaration due by 31st March.) It would have been very useful to me if the local GPs had been asked to share the details of their profits/earnings with their colleagues over recent years - and bear in mind that it's a very big step from this to publishing the figures online which is what's on the horizon at present.

When I made my request, the NHS (in the form of the Mid Essex PCT) took advice and was told that it could not publish the names of GPs as to do so would contravene the Data Protection Act. This is a quote from a letter to me (and copied the Chief Exec, Mid Essex PCT) dated 18th March 2009 from the assistant director of finance at the PCT.

When the Information Commissioners Office considered your request for disclosure of GP pensionable profits, the letter we received from the ICO acknowledged the PCT’s concerns about the confidentiality of that information and the fact that the PCT received this information from individual GP's solely for pension purposes. The letter concentrated on the question of whether the data could be made anonymous such that our concerns about confidentiality and data protection could be set aside. The ICO specified a format in which the information could be presented anonymously that would mean it would not be considered ‘personal data’. In my email dated the 5th of January I attached a spreadsheet in the format specified by the information commissioner in his letter. We have subsequently received a letter from the ICO confirming that we have met the requirements for your original FOI request and that the case is closed.”

All the ICO would seemingly allow the PCT to release was a list of figures. The assistant director of finance said she was not allowed to provide any names or details of the GPs … some of which were part time, others full time. As for which of them were single-handed GPs, I was told with a straight face that the Mid Essex PCTs did not know how many single handed practitioners/practices there were on its patch.

So, does this bring salvation to small practices? I doubt it. It seems that the Mid Essex PCT wanted to conceal what was going on. Contrast this with the present situation - the NHS top brass will be very keen to ensure these figures are published – so they will do whatever is necessary to ensure this comes about.

So … despite this precedent, I’m sure as regs is regs that small practices and single handers will be told disclosure is mandatory.

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John Cormack

Long time small-town single-handed GP known to older GPs for his campaign to preserve confidentiality in the NHS and his high court battle against Ken Clarke when the Tories launched their new contract in 1990. He has been an elected member of the GMC and was for a time ‘Joint Chair’ of the 'dysfunctional' Maldon and South Chelmsford PCT’s Professional Executive Committee. He's best known now for the unique underfunding of his practice which prompted his change of name by deed poll: John Cormack-the-Family-Doctor-who-works-for-the-NHS-for-free (although the GMC still won't let him use his new moniker on prescriptions).

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