At G PC meeting today a paper from the Department of Health was produced
outlining the payment on offer for Primary Care Group board members. This is
still in final draft form and I am not free to give much detail from it. You
will not like the payment on offer. It is split into two parts; an element
of reimbursement for cover (compensatory allowance), for which receipts or
invoices will be required, and an honorarium which will be same amount for
all board members be they Dr ,nurse, social worker, or lay. Level 1 £5.7K
total of which £3K is deemed to cover locums (compensatory allowance). It is
envisaged that ordinary board members will work for four or five sessions
per month. Chairman of PC G's will be expected to work two to three sessions
per week at level 1, and three or four sessions at level 2. Payment
increases with the level ( An increase of £1,900 in the jump from level 1 to
2. There will be "corporate responsibility" for all board members i.e. it is
an advisory role with accountability rather than responsibility for
organising detail and implementation.The chairman will receive a slightly
larger honorarium if the population exceeds 75 thousand. In total, level
1,around £17.5K <75K population, £19.2K <75K population ( includes £6000
deemed to cover klocums). It is likely that the paper will be sent out
officially from the Department of Health tomorrow. There was a long and
heated debate at G P C. The conclusion was that G PC should not give a
directive, but that John Chisholm will write to all GPs outlining our
feelings about the deal, what the pension implications might be ( bad news),
and how we feel you might cope with it. The general feeling was that we
should not withdraw from PCGs ( It was not my feeling!), but that the time
committed to the PCG should only reflect the payment on offer.i.e. minimal.
By my reckoning the payment will only allow for about one session every two
weeks for ordinary board members at Level 1.
I was told that whilst I cannot refer to detailed paragraphs in the document
as yet, I am free to comment on the debate at G PC. Hence I will simply
reproduce verbatim what I said in the debate.
" The Guidance refers to five sessions a month for board members.
What the hell am I going to say to my constituents in Gloucestershire who
have been receiving £60 an hour, which I negotiated, for work to date
establishing PCG's? They will not accept a cut of 50%, and payment that will
not even cover locum rates. The total payment on offer works out at just £93
a session. The sessional rate for a locum in Gloucestershire is £105.
I know from my last LMC meeting that many of those who put their names
forward for PCG's have already written resignation letters which will be
submitted if the payment is not right. They had to take on trust when
putting their names forward last week, that the payment would be fair, given
the vagueness of the summer guidance. Their practices are not going to
release them for this payment.
No superannuation is simply unacceptable.
Since when has our pay level been set by the pay level of social workers and
nurses? This is nothing but an insult, and it bears very threatening
messages for G P pay as a whole, and for the prospect of a unified N H S
Review Body.
I can only reiterate what I said last month, that now is the time to review
the whole idea of whether we can support the principle of PCG's, let alone
whether we can continue at such break-neck speed, without proper negotiation
our terms, and time for reflection.
We need firm national leadership and we need to be recognising the strength
of our position if the government wants to see it's reforms succeed.
I would like you to recommend cessation of all co-operation with PCG's until
satisfactory payment, with appropriate superannuation, and full
reimbursement of expenses, is agreed. I expect from past record that this is
a forlorn hope.
If PCG's go ahead without us they will not have the necessary expertise. The
inevitable rationing will be blamed on the nurses and social workers. They
won't have the necessary statistics in order to function effectively.
Let's recognise our own strength. Put the brakes on."
There were others similarly angry, but many who wanted to sit on the fence,
stay in, and reduce time committment to match the pay on offer. There was
only one who thought the deal was reasonable, except for superannuation.
Regulations will be changed to allow chairmen who reduce their committment
to be guaranteed the right to return to their former level of contract ( it
doesnt say where, or what happens if manpower juggling has turned the area
into a restricted area while the chairman is in post). There appears to be
no allowance for all the additional reading time, and time to communicate
with grass roots GPs.
I know what I would tell the DoH to do with it's offer if I had put my name
forward for a PCG. I wonder what the rest of you will now do?
Let me know. Also let me know if you approve or disapprove of my stance.
Peter Fellows, GPC.
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