Locum Doctors - an area for NHS savings?

[Nitefly]

I had a bit of a quibble with a friend (a doctor!) just now about Locum doctor pay. To me, it seems ridiculous that, all things considered, some locum GPs are earning over £1,000 a day. I'm personally aware of one doctor that quit his GP permenant role and got hired to do the same job as a locum at that rate. The NHS is being squeezed and my thoughts were that there should be some sort of cap lower than £1,000, which is objectively an enourmous amount of money. The counter argument was that such locum are specialists and have earned that level of payment - after training for 10 years why shouldn't they command that sort of salary? Locum doctors don't get the equivalent full time staff perks either, the argument went - but I think NHS pension contributions should be reduced anyway (with a increase in base pay but an overall net saving).

I concede they are specialists and that they should get paid well, but perhaps the NHS should run its own agency system rather than the current system which seems to be that surgeries get more money to pay locum doctors should no full time staff be available... a self fulfilling prophecy?

What say you, OCUK? I know I am probably quite ignorant on the subject

 

[Sliver]

I agree that there should be a cap which is lower than £1000 per day. Locum doctors are a necessity and should command a higher salary than a typical GP, but not £1000 per day, that's just ridiculous.

 

[Dis86]

surgeries get more money to pay locum doctors should no full time staff be available... a self fulfilling prophecy?

Bingo. Something I've said many times. Why would you want to be NHS staff when you can guarantee more money and constant work any ways as a locum?

 

[dowie]

The NHS is being squeezed and my thoughts were that there should be some sort of cap lower than £1,000, which is objectively an enourmous amount of money. The counter argument was that such locum are specialists and have earned that level of payment - after training for 10 years why shouldn't they command that sort of salary?

spoken like a true Tory - they've done this already with Agency nurses so I wouldn't be surprised if it did happen for GPs

Out of all the ways of saving money in the NHS I think skimping on pay is fairly low down the list, doctors and nurses are generally underpaid.

Frankly given some of the other 'professionals' and what they can earn at a daily rate I'd not begrudge GPs getting up to 1k a day - though I'd also point out that that figure is probably at the very high end

I'm curious so I had a quick google - if we look at some data (granted it is a few years old but then again inflation hasn't been too high in the past few years) most locums aren't (or at least weren't) earning 1k a day... then again maybe the shortage in GPs has pushed up daily rates recently - in which case the cost of hiring them is simply reflecting the market*

http://www.gponline.com/locum-rates-2012-13-locums-booked-directly-practices/article/1227547

The NHS is apparently is trying to get GP practices to report instances where they've paid more than £80 an hour for locums so I guess they are interested in this area


*they are, after all, self employed individuals. I wonder what top end pay the govt has paid in the past when say hiring barristers. IIRC there has also been outrage at a select few earning say 500k through legal aid.

 

[Arazi]

I worked at Aintree hospital, i setup accounts amongst other things for locum Drs, they got £1500 per shift, i knew one Dr was a GP in Liverpool but on weekends he did locum work also.

I was astonished when i heard about the wage.

 

[Minstadave]

Locum GP pay is high partly because there indemnity fees are ridiculous.

My wife is a GP and insurance alone for a full time locum is around 10k currently annually.

Locums aren't easy to find especially at short notice which bumps up the fees. The general shortage of GPs hasn't been addressed for decades.

If the Government actually invested in training and retaining staff they wouldn't be left having the NHS pay hand over fist for locums.

It's the same for hospitals, actually more for a consultant Locum. You can offer less but no one does them.

An out of hours plumber will charge you more per hour.

 

[Sliver]

I worked at Aintree hospital, i setup accounts amongst other things for locum Drs, they got £1500 per shift, i knew one Dr was a GP in Liverpool but on weekends he did locum work also.

That's just mental. When you consider a typical GP will earn anywhere between £60,000 to a little over £100,000 per year, while Locum Drs are earning more than two to three times as much. Silly money.

 

[Diddums]

Pretty sure Ican figure out how to fix broken people for that kind of money

 

[Minstadave]

That's just mental. When you consider a typical GP will earn anywhere between £60,000 to a little over £100,000 per year, while Locum Drs are earning more than two to three times as much. Silly money.

If you work 8 sessions a week you make roughy £200,000 a year. Minus indemnity, I don't think you get pension contributions and you have to travel all over the country to find shifts if they are available. Most are OoHs shifts so obnoxious hours.

They're welcome to it personally.

 

[shadow_boxer]

If you work 8 sessions a week you make roughy £200,000 a year. Minus indemnity, I don't think you get pension contributions and you have to travel all over the country to find shifts if they are available. Most are OoHs shifts so obnoxious hours.

They're welcome to it personally.

Yes, doesn't include employee pension contributions. The hourly figures banded about also are pre tax deductions. Also, Don't forget the inherently higher risk for the GP also.

 

[dowie]

That's just mental. When you consider a typical GP will earn anywhere between £60,000 to a little over £100,000 per year, while Locum Drs are earning more than two to three times as much. Silly money.

So basically not too different to most other contractors in say IT, Finance etc.. relative to their perm counterparts?

 

[Dynix]

My partners department manager just had to pay £200 for the same printer which they could've bought off Amazon for £40 and they've been told there's no money left in the pot for basic things like assessment forms until the end of the tax year. I'm sure someone will come back about enterprise support but they have issues right down to feeding bottles for new borns - £1 bottle vs £20 through an 'approved supplier'. It's being squeezed because someone thought this was a great idea.

 

[dowie]

Some of that might be thanks to the nu labour PFI initiative. My mum worked in an NHS hospital that been privately funded, she wanted a book shelf for her office, she was told that they can't just call someone from maintenance to put in a simple shelf but that it has to be requested via some supplier - cost £300!

 

[Nitefly]

Interesting comments re the job comparisons. I would say there is a fundamental difference between 'filling in for a standard job role' and 'ultra specialist', and also a difference between contractor role which are short term and long term.

Many IT contractors that get paid the big bucks are working on projects such as, off the top of my head, installing oracle or sap for a blue chip company. Those roles will ultimately come to end and it would be unsuitable to recruit full timers to carry out those roles. This is why those roles exist and it makes sense to pay their high wages compared to a long term employee.

Ultra specialist medical consultants, or even say queens counsel, are effectively THE BEST in their field which they dominate. The level of specialism ultimately requires that level of pay.

Comparatively speaking, GP roles are not 'short term roles' nor are they 'ultra specialist roles' - they are posts that could be adequately filled with full time staff of national standard training. I can draw a distinction between the examples for that reason.

Off the top of my head, and without too much thought, I don't think any public sector contractor role that could be filled by a full time employee under a national standard level of training should be paid an equivilent annual rate of more than £150k-£200k a year max. That is an enourmous amount of money.

If you work 8 sessions a week you make roughy £200,000 a year. Minus indemnity, I don't think you get pension contributions and you have to travel all over the country to find shifts if they are available. Most are OoHs shifts so obnoxious hours.

They're welcome to it personally.

Is travelling over the country actually a thing for locum doctors? More like travelling between a couple of counties a year, from my limited understanding.

 

[Minstadave]

Is travelling over the country actually a thing for locum doctors? More like travelling between a couple of counties a year, from my limited understanding.

There's a wide variety of locum GPs and hospital doctors.

You have people on medium term contracts at one place, covering maternity, they get a standard salary.

There's a group of UK GPs that work locum shifts at multiple GPs, they're paid by the hour. They travel a lot and have the risk of not having familiarity with he practice or systems. A lot of these guys are part time with kids.

Then you've got GPs that fly in from Europe for short term (a week or so) to cover OoH shifts.

 

[dowie]

I'm sure there are plenty of Barristers who aren't QCs who still earn fat rates of pay. There are certainly plenty of IT contractors working on extended projects and locum work is generally temporary.

One of my friends is a locum, she works part time, has changed practices a few times and has had months off at a time to go travelling, I know a couple of others and they don't seem to just stick at the same practice for years but are working where they're needed. Not all locums are GPs either.

 

[Minstadave]

Checked with the wife - indemnity for a locum GP working one session a week (a single half day) is over £5.5k a year. So 8 sessions is going to be well north of 10k a year.

 

[dowie]

you do realise GP surgeries are privately owned businesses (formed as partnerships between GPs), also allowing physicians and surgeons to do private work is part of how the NHS was able to be formed in the first place

 

[Greebo]

I agree that there should be a cap which is lower than £1000 per day. Locum doctors are a necessity and should command a higher salary than a typical GP, but not £1000 per day, that's just ridiculous.

Why not? I know loads of consultants for H&S, Quality, IT who earn that per day. Doctors should come higher.