Wednesday, January 25, 2012

Have Pay Rates Peaked for Locums?

Despite what we might read about in the daily mail (other equally contrite newspapers are available for GP bashing) the average pay of GPs has gone down in real terms in the last few years. It probably peaked with the onset of the new contract around about 2005.

However several factors have eroded the pay of partners – increasing costs such as rises in running costs eg heating and lighting (although I have yet to see a practice with solar panels), increasing staff costs and the recent pension rules changes that mean the practice has to pay the employer pension contributions of not only their staff, but their own pension contributions – and of course this is to increase soon. Locum costs of course factor and these have gone up by about an average of 20% since 2005 in my area.

The BMA lists the average net pay of GPs as going down from £102k in 2005 to £96k in 2009

Now of course as a locum of course I am keen for locum costs to go up, but is there not a danger that we are pricing ourselves out of work? As practices look towards ways of cutting costs they will look at how they can rearrange workload, perhaps using nurse practitioners, or salaried GPs even more than they do. Add this to the increasing number of GPs that seem to be coming out of training and the increasing number of training practices with an extra pair of hands. There may even be a shift back in locus towards having more partners - although this is a double edged sword for locums

But I have seen, perhaps for the first time in many years, a few fallow days and I am aware that this year has seen in my locality, a big swell in locums looking for work. This at the same time as the local trust is looking to save money, and one of the (arguably short sighted) ways they are likely to cut costs is to reduce the monies they pay GPs to come out of practice for various reasons temporarily.

Of course there will always be a need for locums, but I predict that the average fee a locum can expect to negotiate will perhaps either stagnate or even go down over the next few years. It's simple supply and demand; Hungry locums are going to be willing to undercut their competitors. There has always been an interesting relationship between fellow locums – we seek each other out for some peer support and mutual moaning about practices – but at the end of the day we are competitors and are not going to starve ourselves so that others may binge. It's symbiotic at times of plenty, but competitive at times of need.

It's not clear if as many GPs as have threatened to will take retirement as the pension rules change, but this of course may change the locum landscape again favourably. For as long I can remember I have been reading about the impending shortage of GPs, as the medical politicians parade their doom-mongering on sandwich boards around the medical media. It has never happened and I see no reason why it will happen this time.

That doesn't mean i am about to dust of my CV and browse the jobs section of the BMJ. I do locum work as a lifestyle and professional career choice, not just to make a living. I love the variety of systems, people and socio-economic areas that I encounter. But in the back of my mind there is a little anxiety about the future – although this is a familiar feeling for locum GPs.

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