GP's

[pjm007]

Who actually pays a GP's wages ?

[rojash]

Well, assuming you're a taxpayer, you do

[pjm007]

So why does a surgery have the right to remove somebody from thier list i.e, a taxpayer ?

[dosset]

same reason as being barred from any premises.just because your a tax payer it doesn't give you the right to be attended to if you are obnoxious ,offensive etc

[pjm007]

i realise that dosset, but by being out of the practice range (might i add, 3 miles from door to door) What sort of excuse is that ? Surely they can't do that.

[AllYourBase]

GPs wages are paid in a variety of ways, but all by the taxpayer eventually.

Most Practices are businesses owned by the partner GPs involved. They contract services to the NHS and therefore the GPS are paid by the practiec business, not the NHS. The NHS picks up the tab further down the line.

The system has changed recently to a requirement by practices to provide a specified range of servces to a certain number of patients within a defined area (defined by the local care trust). the more extra services of the most quality, and the more patients, the more money they get.

Prior to this, GPs were paid in two ways, fundholding and redbook systems.

In the older redbook system, a GP practice would charge the NHS for every task/duty carried out, for example, �20 for a patient appointment, �30 for a home visit, �50 a clinic, �100 per practice nurse etc (those figures are made up, but the real ones were listed in the official "red book" of fees, btw). This has benefits to the accountants as it was easy to judge but did not promote quality or variety


The other, fundholding, was introduced by Ken Clarke I think, was when a GP practice agreed to undertake services for a defined population and was given a set budget which they could use as they pleased - which rewarded efficiency and prudence.

In some areas, the NHS care trust employs Doctors directly at specific, very high, salaries. This is because a need for GP services is identified but no Doctors want to set up their own practices there. Often this happens in run down areas or densely populated areas.

[AllYourBase]

The reason a a surgery has the right to remove a patient is that there is a far more fundamental right fo every NHS employee (or contractor) to provide treatment without fear of verbal or physical assault. This applies to NHS dentists, your local chemist, as well as GPs and hospitals. A line has to be drawn and the NHS has an lmost zero tolerance atitude to this sort of behaviour. Patients are also removed of they regularly hawk or pester Doctors for drugs they don't need, fail to attend apppointments, atempt to forge illness/sickness, abuse staff etc. There is also a rule about the distabec a patient can live from his/her practice. If there are nearer practices, A dr may ask they reloace to a nearer practice, as should that patient ever require a housecall, it may be a considerable distance the Dr may have to travel.

Finally, there is also the issue of cross care trust treatment. Every care trust has it's own budget, based on the local population, so a patient living in one shouldn't really be claiming treatment from another. Often this is done by postcode (which is where the term postcode prescribing comes from, as one street may be able to get treatment as their care trust pays for it, but a neighbouring care trust has decided not to) Perhaps this applies to you?

[ummhayaat]

Actually it really has to be quite alot to take a patient off of a gp list. Modern gps are trained to give a more patient centred service. It is no longer the time when a GP says and the patient listens. However, since the vast majority of gps in practice today are from the "old school" this is not being practiced.

As opposed to nurses, a complaint letter about a gp is regarded as an extremely serious case.. and is more than a hassle for the gp to set right.