Skip to main content
NCBI home page
The BMJ logoLink to The BMJ
. 1998 Apr 25;316(7140):1322.

Doctors should beware of asking for too high a salary

Scottish GPs earn less than intended average net remuneration

Christopher Tiarks 1
PMCID: PMC1113049  PMID: 9554918

Editor—In the last paragraph of his letter about doctors’ salaries, Baker asked if the profession really wishes to be seen by society in the same light as accountants and lawyers.1 I would answer that the profession naturally wishes to retain its individual identity of integrity and responsibility but would nevertheless wish to have at least the same value placed on it as is placed on the legal and accountancy professions.

Though our remuneration improved dramatically after the doldrums of the 1960s, since 1980 in general practice it has dropped to less than half that of our comparators defined by Pilkington in the report that preceded the introduction of the Doctors’ and Dentists’ Review Body.2

Baker’s friend, who may well augment his practice profits from earnings outside the NHS, is both fortunate and exceptional. The average Scottish general practitioner, despite length of service, earns £43 245, which is 93.1% of intended average net remuneration (£46 450 pa)—below the lowest consultant scale of £43 750; consultants will inevitably rise to a minimum of £56 470 after five years. (These figures are calculated from the latest figures for average net income according to government statistical region as the percentage of the British average, the figures used by the Doctors’ and Dentists’ Review Body for 1997-8 being used.)

One quarter of general practitioners in Highland area who are “induced” (receive “inducement payments” for general practitioners to remain in practices that are not otherwise financially viable) are restricted to practice profits of only 82.4% of intended average net remuneration. Successive governments have failed to recognise the importance of the old adage “The labourer is worthy of his hire.” We are right to seek a fair improvement in our remuneration to secure the high standards already attained and to reverse the worrying decline in morale and recruitment.

References

  • 1.Baker R. Doctors should beware of asking too high a salary. BMJ. 1997;315:954. . (11 October.) [Google Scholar]
  • 2.Royal Commission on Doctors’ and Dentists’ Remuneration. 1957-1960 report. London: HMSO; 1960. (Pilkington report.) [PMC free article] [PubMed] [Google Scholar]
BMJ. 1998 Apr 25;316(7140):1322.

What is too high a salary?

P G Houghton 1

Editor—In a letter Baker queried the validity of doctors seeking increased remuneration; he told an anecdote about the salary of a recently appointed general practitioner who was being paid £90 000-£100 00 a year, albeit in an admittedly “not typical” and “well run” practice.1-1 We are not told whether these are gross or net earnings and, on the assumption that they are net earnings, whether this sum reflects income purely for general medical services or includes external and private fees. Even if it includes only external fees, there are circumstantial variables to be taken into account, including high list size, deprivation payments, dispensing income, and fundholding management fees, which are not necessarily universally available.

There will be many disappointed potential general practitioners if they expect such a salary. I doubt whether Baker would have been so charitable if I had written some 25 years ago to suggest that all surgeons were overpaid. One consultant surgeon, whose houseman I then was, had just earned double my annual salary in one day: he had performed a prostate operating list in the morning (the list had included two laryngectomies at £500 each) and a private/NHS list in the afternoon with several private consultations in the evening before going out to dinner. Simple arithmetic suggested that he earned over £3000 for that day, with the potential for reaching Baker’s excessive figure for today of £100 000 in a month.

I am no different from lawyers and accountants, some of whom earn less and some more than I do, but we all wish to receive adequate and appropriate remuneration for our skills and efforts. The partnership in which I work—of four general practitioners—paid our accountants some £4000 last year, or £1000 a head; the population of Birmingham (one million) received full general medical services at the same time at a cost of about £60m or £60 a head (or just over £1 or 10 cigarettes a week). Society values what it pays for: I see no reason to be considered a special case just because I happen to enjoy being a doctor.

References

  • 1-1.Baker R. Doctors should beware of asking for too high a salary. BMJ. 1997;315:954. . (11 October.) [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES