Fears over impact of National Insurance rise on general practices

Matt Kneale — Fri, 01 Nov 2024 16:54:39 +0000

DAUK’s GP committee has warned the employer National Insurance rise announced in the Budget could put huge financial pressure on already struggling general practices. DAUK welcomed the announcement of an extra £22.6 billion for the NHS in the Budget. However, we also expressed concern at the potential impact on general practice of an employer National Insurance rise. Now Dr Steve Taylor, DAUK GP spokesperson, says a rise could make many practices unviable. He said: “DAUK shares the concern across the GP community the Budget will potentially put huge extra costs onto GP practices.

National Insurance rise

“With employer National Insurance contributions rising together with the rise in staff costs, which have not been adequately funded, it could mean practices really struggle to keep their head above water. “There is no way that Labour will meet it’s manifesto commitment to ‘bring back the family doctor’ unless it funds GP practices properly to recruit, retain, and grow capacity, particularly GPs, many of whom are underemployed or unemployed. “General practice has been delivering five million more appointments a month which puts the extra 40,000 a week promised in context. “Patients want and need to see doctors.”

General practice

Now DAUK is supporting GPCE calls for GPs and patients to write to their MPs to express concern at the potential impact National Insurance rises will have on practices. GPCE has produced a letter template for people to copy and paste and send to their MP. The letter is reproduced below. You can support the work of DAUK by becoming a member or donating to our Go Fund Me. Find your MP’s email at: https://members.parliament.uk/members/Commons ———————-

GPCE letter template

Dear I am writing to flag a profound concern around NHS GP Practices and the Autumn Statement announcements on Employers’ NICs. We have lost over 1000 NHS GP practices in the past decade. If Darren Jones’ comments on BBC QT are correct, we shall see many more hand back their contracts overnight. NHS GP Practices are excluded from employer support for small businesses – and previous Conservative governments have offered full recovery for NICs rises. GPs are very clearly defined in the past 25 years of law as “public authorities”. The assertion by Darren Jones above flies in the face of various legislation, including: – Freedom of Information Act – The Equalities Act – GDPR – IR35 Presumably Treasury do not intend to amend hundreds of pieces of major legislation in order to claim an extra 1.2%? Such poorly thought through comments are sending us into a tailspin. This needs absolute clarity as soon as possible. Likewise, the methodology for recent uplifts is out of date and has failed to deliver. Any repeat of a Global Sum % uplift will not work with the NICs change proposed, because of the ‘fixed per employee’ element. The Association of Specialist Medical Accountants has flagged this concern too. Treasury and DHSC need to take immediate steps to correct Mr Jones’ comments and assure the profession that they have no intention of threatening the viability of thousands of NHS GP Practices, lest Labour kills the family doctor. Yours

Budget 2024: NHS funding boost welcomed but concerns over impact of national insurance rise on general practice

Matt Kneale — Wed, 30 Oct 2024 16:22:41 +0000

The Doctors’ Association UK (DAUK) has welcomed the announcement of extra funding for the NHS in today’s Budget. Rachel Reeves MP delivered her first Budget since becoming Chancellor and announced an extra £22.6 billion in the day-to-day health budget and a £3.1 billion increase in the capital budget. The funding was welcomed by DAUK chair Ms Helen Fernandes, who said it was desperately needed after more than a decade of austerity and underinvestment. Ms Fernandes said: “The news of extra funding is a welcome step in the right direction. “But it’s going to take sustained long-term investment to put right the years of austerity and cuts.

Budget 2024

“As a result of that underfunding there are issues regarding pay, working conditions, staff shortages, training, access to jobs, buildings and estates, the list goes on. “And the Government also needs to sort out social care. As Lord Darzi said in his review, the dire state of social care is one of the reasons the NHS is in a mess.” Ms Fernandes expressed concern that the rise in employer national insurance contributions, if extended to general practice, could have ‘dire consequences’ on practices. Ms Fernandes said: “GP surgeries are struggling to survive, with hundreds already closing their doors, and many general practitioners struggling to find work. “An increase in employer national insurance costs, if it was to include general practice, could have dire consequences and might well be the expense that makes many unviable. “A rise in employer costs is also likely to have an impact on recruitment and retention in social care, which in turn would have a detrimental effect on hospital admissions, discharges, and waiting lists. “The same with the rise in the national minimum wage. Of course we want to see people paid properly for the work they do, but it could have unintended consequences for general practice and social care.”

Primary care

DAUK’s GP lead Dr Lizzie Toberty said a large proportion of the new funding announced by the Chancellor should be directed towards primary care to help ease the pressure on hospitals and to move care to community settings. Dr Toberty said: “Following the Darzi Report and Wes Streeting’s stated desire to move care from hospitals to community, the money has to be spent in primary care. “Darzi said GPs had been the most fiscally responsible group within the NHS. Yet somehow we now have the utter catastrophe of qualified GPs without employment while patients are desperate to see a general practitioner. “Let’s get them back to work by investing funds in core general practice work.” Dr Toberty said the Additional Roles Reimbursement Scheme (ARRS) needed reforming. She said: “Millions of pounds of ARRS funding is sent back to the Treasury unspent every year. The Government needs to move ARRS into core funding. “We don’t need more GPs, we need employment for the ones we’ve got. “There also needs to be a shift from recruitment to retention. Reward NHS staff who stay firmly rooted in their communities and who provide the continuity which ultimately provides the most financially efficient and effective way to provide patient care.

Vital investment

“Investment is vital but money needs to be spent in the right places.” Dr Toberty added: “They also cannot focus on one size fits all solutions. “They need to trust local health systems to organise their own solutions without absurd rules set by Whitehall. “If they did this patients could see improvements in their access to a GP within weeks, presuming pre-employment checks could be carried out quickly.” And Dr Toberty said there needed to be a ‘huge shift’ in how the NHS values staff. She said: “Lord Darzi talked about loss of discretionary effort because staff “All the new scanners and surgical hubs require staff, not only to recruit but to retain. “The NHS has a poor reputation in this regard. “What is the government going to do to look after and value the staff they have?” Support the work of DAUK by donating to our Go Fund Me.

Budget – DAUK