I was amused to note the absurd suggestions the Taxpayers' Alliance made to balance the government's books in an advance copy of a policy document they are, apparently, publishing today.
They want to cut £50 billion out of government spending programmes by, amongst other things:
abolishing the Department for Business, Innovation and Skills, the Department of Energy and Climate Change and the Department for Culture, Media and Sport, and £4.4 billion by bringing Scotland's central grant in line with Wales.
So there's some real world politics for you. Which is also reflected in their plan to close the Department for International Development.
But I was most struck by this:
The TPA said cuts of this scale could be attained by measures including renegotiating GP contracts to trim more than £1 billion from "excessive" pay
There are about 35,600 GPs in the UK. And there is a massive recruitment crisis which will get much worse as many are in their fifties and looking to retire early, all of which contributes to the problem of getting an appointment. And the TPA wants to solve this by cutting GP pay by an average of a little over £28,000 a year. That's obviously going to help, isn't it? Young doctors are going to be queuing up to be GPs in that case, aren't they?
Or, is this just a plan to drive people into the private sector?
Either way, the TPA are simply proving they live in cloud cuckoo land and have not the slightest idea how markets work, or what much of
government does, but I guess we knew that anyway.
Disclosure: my wife is a GP but has been unable to work for almost two years because of ill health.
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The message from this post seems to be that incentives – in his case pay – matter.
Of course they do
To some degree they matter, of course
Why ever not?
I think David was rather expressing surprise at your view that, when it comes to your wife’s pay, markets are to be respected and looked up to. In markets which don’t affect your wife’s pay, your attachment to the market is somewhat less enthusiastic.
I am wholly committed to the mixed economy
Always have and always will be
What I argue against is the corruption of markets
An interesting idea, Richard, not least because under this government – and to a fair degree, under the previous one too – both BISS and DECC have become pretty much nothing more than mechanisms for promoting the interests of the private sector, and big business (such as the energy companies) rather than government departments. And as for the Department for International Development, under this government that been similarly transformed into the DfPBBA (“Department for Promoting Big Business Abroad”). Consequently if they were abolished the private sector would have to take on all that work itself, and more importantly I suspect, pay for it itself, rather than receive it free as yet another state funded (hidden) subsidy.
Beyond that, I’d just add that over more than a decade I’ve never spoken to any researcher of social or economic issues who doesn’t think the work of that Tax Payer’s Alliance to be anything other than a joke. And one which starts with the name, of course.
Agreed, from beginning to end
Oh, this is mostly bonkers right-wing nonsense (“Taxpayers Alliance”, indeed) that can safely be ignored or ridiculed.
But are GPs overpaid? Paid about the right amount? Underpaid? Should they be “nationalised” and made NHS employees?
I am quite sure they should be employees of the NHS
But as for pay rate – I reckon it’s about right in most cases
A few exploit the situation and make far too much, but they are a few, not most
The problem with GPs is not their pay. It is the systemic farce imposed on them by the Tories doing the NHS reorganisation they promised they wouldn’t.
That and borderline criminal capacity planning management by government.
There is a streak within government and sections of the public sector that truly believes that private sector outsourcers have some sort of magic wand that makes money and resources appear out of nowhere.
Just as there is a belief within the labour party that taxing people causes real resources to pop out of nowhere.
This GP crisis has been a long time coming and both main political parties should hang their heads in shame for failing to head it off.
It’s a national disgrace that’s going to take some serious work to resolve.
If pay is about right,Richard why is the recruitment not happening? Factors to do with change fatigue (I left teaching partly because of this), too much patient demand to doctor ratio, demoralisation, money being diverted from patient care to cover privitisation costs?
This is worrying -I come accross more and more doctors who are choosing to work part time so it can’t be all about money -the stresses are becoming intolerable.
Stress is the issue
Depty of Health ignores it
“I am quite sure they should be employees of the NHS”
I agree with you there – but the BMA would never allow that (unless their pay was increased substantially).
Richard,
Speaking to my GP, he says that most of his patients over age 40, and working in some sort of public service, want to go part-time or leave. I am in that age group and have had to give up my teaching career due to c.f.s/m.e. I am certain that most GPs well and truly earn all they get! However, I am beginning to think that the option of reducing work intensity with a small drop in salary might be the most sustainable and attraction for many. Danny Dorling has got some interesting things to say about this and how the absurdly high rewards in the financial sector have distorted our attitudes to remuneration.
From my experience any wise GP works part time
That provides the only chance of surviving the job
And does not guarantee it then
“Any wise GP works part-time”
I make a habit of being better-mannered than you but I have known a large number of GPs (friends, neighbours, schoolfriends – my school actually had a “Medical Sixth” to put boys on the road to practising medicine for the good of mankind rather than the good of their bank balance as many could have earned more elsewhere, a few friends of my parents,/parents of friends, and a very few as a patient), nearly all of whom worked full-time and many of whom were wise.
I therefore say that you are just plain wrong. Many, probably most, wise GPs work full-time because they care about their patients and they can provide better care by working full-time than two part-timers each of whom only knows part of the story (even if provided by case notes which are a precis).
Your wise GPs tend to die young
I don’t call that wise
But let us agree to differ
Because this is the same effect that we see with Premiership footballers and the same effect banks claim is at play when they pay their employees large bonuses.
Those are rent seeking behaviours
If you do not know the reference start reading, I suggest
If footballers would play football for less, then yes, there is economic rent. But then their sporting talent is scarce and temporary, and valued. There is usually some sort of profit in a bilateral commercial transaction entered into voluntarily, with both sides thinking it will benefit them. Are there barriers to entry that artificially increase scarcity and stop talented footballers achieving similar salaries?
So, how much should Premiership footballers be paid? Or to put it another way, who should benefit from the millions of pounds, euros, etc, that broadcasters are willing to pay (and to charge to their customers) for the rights to broadcast football matches? FIFA? The FA? The clubs? Their members or shareholders? A charity? Some sort of public trust charged with developing football?
Footballers are not paid these sums because of talent
They are paid these sums because football is used as the lure to induce people into broadband contracts
That is where the rentr arises
My advice regarding the TPA is to ignore them.
To include them in a high quality blog like this is to give them too much credibility.
Its appear that the Taxpayers Alliance’s suggestions might be considered where as the suggestions made for many years now by Tax Justice Network even now are taken up and properly implemented? A local campaigner for our Tory candidate was sure in his mind that this government was completely “on the case” to wipe out tax dodging and had closed all necessary loop holes. When I asked him about staff cuts at HMRC and the inability to collect the billions that are owed, he excused himself!
That’s selective cherry picking of our policies by parties
With respect Richard, yu’ve actually made the point about markets and footballers. These men in their early twenties, very often Fr Africa or South America make for unusual rent – seekers to say the least. These businesses want to lure TV and broadband customers to buy their products. To do that they need to buy he most talented performers. To do that they need to pay them more than their international competitors. It is analogous to GPS.
And respectfully, GPs do not have high powered agencies with a massive interest in increasing pay or in transferring where they work
And equally respectfully, that doesn’t diesn’t alter the fact that footballers are earning what the market fixes as their (market) worth. The point I made in my earlier comment stands every bit as much as it did earlier today.
The let us disagree
“Or, is this just a plan to drive people into the private sector?
I suggest not. The plan is move the entire NHS lock, stock and 2 smoking barrels into the private sector with perhaps the exception of those with chronic conditions. No money to be made from them.