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GMC cuts its annual retention fee for doctors

By Mike Broad - 14th December 2011 7:45 pm

The GMC is cutting the annual fee paid by doctors by £30 - the first cut since its introduction in 1970.

The fee reduction is part of a package of measures agreed by the GMC’s council earlier today. Along with the Annual Retention Fee being reduced from £420 to £390 for doctors holding registration with a licence to practise, provisionally-registered doctors will pay £95 a year, down from £100 in 2011 and £145 in 2010.

Those doctors holding registration without a licence to practise will be charged £140 down from £145 per year. All these reductions are effective from 1 April 2012.

Furthermore, any doctor whose total gross annual world-wide income from all sources is less than £30,000 will qualify for a 50% reduction in their annual retention fees due after 1 April 2012. The current threshold is £26,000.

Niall Dickson, the chief executive of the GMC, said: “We have a responsibility to provide value for money and, as far as we can, to control our costs. Last year we were able to freeze the annual fee paid by all doctors and cut the fee paid by newly qualified doctors. As a result of further efficiencies achieved across the organisation, we are able this year to pass on savings to all doctors.”

The GMC attributed the fee reductions to improving operational efficiency, which has led to savings of over £8 million in 2011. Examples of savings include expansion of the in-house legal team, reducing our requirement for external lawyers; reducing the number of panellists sitting on panels from five to three; and greater use of e-communications rather than paper.

In addition to the annual fee reductions, the cost of a Certificate of Completion of Training (CCT) will now be £390, down from £500 in 2010. And the cost of a Certificate of Eligibility for Specialist Registration or GP Registration (CESR or CEGPR) will be £1500, down from £1600.

Dickson added: “We are making these reductions at the same time as facing increasing demand on our services and delivering major initiatives that will benefit doctors and patients, including the introduction of revalidation, the Medical Practitioners Tribunal Service, and the roll-out of employer and regional liaison teams.”

The 245,000 doctors on the register will save an estimated combined total of over £6.5 million, the GMC estimated.

Read a blog on the issue.

Tags: Fees, GMC
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Time for doctors’ representatives to trim their fees

By Mike Broad - 12:52 pm

I hear there’s been a bit of a spontaneous campaign on DNUK, the online doctors’ forum, calling on the medical institutions to freeze their annual fees to correspond with the stagnation in doctors’ wages.

For those of you who have been living in a cave, Chancellor George Osborne recently capped public sector pay rises at 1% for two years - this will follow the ending of a three year pay freeze for consultants in 2013/2014.

The call for fee freezes is not new. It happens most years. Every time I attend the BMA’s annual shin dig the argument is the same. The group, which includes the BMA and BMJ, announce big returns - on the basis of membership fees, the BMJ’s significant recruitment revenue, and their investments.

Some doctors then jump up and say they would like to see a freezing in membership fees. Normally the auditorium murmurs some initial agreement only for the Treasurer to stand up and guilt them all into voting through the membership rises because “if we don’t the BMA won’t be able to achieve so much”.

I’m sure variations of this argument are played out time and time again within our fee charging medical institutions - whether it’s royal colleges or medical indemnifiers.

I appreciate that ‘the people in charge’ are duty bound to run successful organisations, but surely enough is enough. This year there is a bigger picture - with industrial action over pensions starting to look more likely - and there is more to be gained for the branding of your institution if you have some empathy with your members.

Now one institution looks like it is going to actually cut it’s fees. Have a guess which one? No. Choose the one that was at the bottom of your list.

Yes, amazingly, the GMC is going to be the first.

Hospital Dr is not always very friendly to the GMC (with good reason), but credit where credit is due: in cutting its fees, it has taken an important step. And it follows a freeze the previous year.

I could start banging on about why doctors shouldn’t pay anything towards their regulation any more because they are no longer in a self-regulatory system, but I won’t.

The £30 reduction signifies more than just a saving for doctors. It suggests there is some understanding of its membership, and the pressures they are operating under. Not sure I’d go so far as to say ‘empathy’ but we shouldn’t disparage this move - it could be the start of a relationship with the profession rather than a minor dictatorship.

So, who is going to be next?

I hope they all put their hands up and offer reductions - not just freezes. When it comes to reward the profession is being battered.

There was an underrated piece of research recently (and slightly ironically) by the BMA’s junior doctors committee which revealed the mean cost of training to juniors across nine hospital specialties. The total? £18,257. And this at a time when they’re carrying record debt into their careers, with the advent of tuition fees, and their earning capacity has been compromised through reduced work hours.

For the record, it showed that general practice is the least expensive specialty to train in (from FY1 to CCT) at £6,825. While anaesthetics was the most expensive specialty at £24,912, closely followed by gastroenterology and acute medicine.

What more evidence do our representative bodies need to show a bit of Christmas spirit?

In this vein, Hospital Dr is offering FREE training to consultants in acute and advanced general medicine in 2012 in London. Register to attend early HERE not to miss out. Juniors are welcome too!

Tags: Fees
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GMC fees frozen and halved for new doctors

Pulse - 10th December 2010 5:02 pm

The GMC has frozen their fees for next year and slashed them for newly qualified doctors, saying they recognise it is a “difficult time” for the profession.

The main yearly annual retention fee is being frozen at £420 for 2011/12 and for new doctors, the cost of the first year of full registration will be halved to £210.

Provisionally-registered doctors will pay even less - £100 a year - and any doctor whose total annual income is less than £26,000, will be entitled to a 50% discount.

The changes - due to begin from April 2011 - will help 14,000 newly-qualified doctors, saving them a combined total of around £1.8m.

Fees continue to go up while pay goes nowhere

By Mike Broad - 28th June 2010 2:18 pm

I couldn’t help but see some hypocrisy in the BMA’s representatives voting for a 2.5% increase in membership fees next year, when its very own junior doctors committee were last week banging on about how unfair increases in training charges were by the colleges.

A small but vocal minority wanted BMA membership fees to be tied to doctors’ pay increases from now on. “How can we sanction 2.5% when our pay will not increase for two years?” one said.

The JDC want to be involved in setting colleges’ training charges. Maybe the wider membership of the BMA should be involved in setting its fees?

Tags: Fees
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Juniors enraged by escalating college fees

By Francesca Robinson - 25th June 2010 8:18 am

Trainees are calling for a say in royal college fee setting procedures following a spate of escalating charges which are being enforced on them without consultation.

The JRCPTB (Joint Royal College of Physicians Training Board) recently put up its enrolment fees by 22%; the Royal College of Obstetricians and Gynaecologists has raised its annual subscription to the trainees’ register from £75 to £120 and the Royal College of Surgeons recently raised its exam fees.

Junior doctors, who will have no pay rise for the next two years following the Emergency Budget, say this unfair as college fees are compulsory.

Dr Shree Datta, chair of the BMA’s junior doctors’ committee, said: “We have heard of increases in three different colleges it’s not just the college fees but also the exam fees that are going up so much. I’ve no doubt that in the next few months we will see a couple more following suit.

“You can’t just squeeze more and more money out of people.”

The JDC and the Academy of Royal Colleges Trainee Doctors Group are both calling for college trainee committees to be consulted on fee setting procedures.

Dr Ollie White, SpR in child and adolescent forensic psychiatry, Oxford, co-chair of the Academy Trainee Doctors Group, said: “The issue has increased in profile recently due to a sharp increase in the JRCPTB trainee fees and the fact that trainee fees are now compulsory due to the mandatory requirement for all trainees to be registered with their college under Modernising Medical Careers.”

He said the Academy Trainee Doctors Group were keen to ensure there was trainee involvement within each colleges’ fee setting procedures, for there to be transparency of fees to ensure that they were cost neutral, and for there to be no more sharp increases in fees in the future.

JDC joint deputy chair Johann Malawana said: “With the introduction of these compulsory fees, we see the introduction of a tax on juniors by royal colleges without any democratic accountability.”

The JDC has written to the Academy of Royal Colleges, NHS Education Scotland and Bill Burr, medical director of the JRCTB but have not yet received any replies.

The JRCPTB and the RCOG both blame a withdrawal of Department of Health support for college training and increased costs involved with developing new aspects of the curricula, particularly workplace based assessments and e-portfolios provided by NHS Education Scotland.

A spokeswoman for NHS Education for Scotland (NES) rejected the accusation that their e-portfolio service was expensive. “We currently charge the colleges who use the NES e-portfolio system £18/trainee/year. Until this year NES have not made a charge for specialist trainees. This charge has been initiated to cover the costs of hosting the portfolio, security checks and ongoing technical support. Deaneries meet the costs of the Foundation e-portfolio.”

She added that the e-portfolios had made a “very significant” improvement in the way in which trainees can record and demonstrate achievement of competences and progression against a curriculum.

Tags: Fees, Training
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Medics face trainee registration fee rise

By Mike Broad - 30th April 2010 9:01 am

A significant increase in trainee registration fees has been announced by the Federation of the Royal Colleges of Physicians of the UK.

The new fee for juniors in medicine wishing to pay a single payment for their core medical training will be £306, or £765 for specialist training. Both represent a 22% increase on the previous charge.

The new fees will come into force on 1 June 2010, and represent the first rise since 2007.

The federation blames the increased pressure on training budgets, which includes a reduction in Department of Health support for the JRCPTB. Also, there’s been the introduction of fees for using the ePortfolio, which the provider, NHS Education Scotland, formerly provided free of charge.

Trainees wishing to stagger payment of their fees, allied to collegiate membership of one of the royal colleges of physicians, will pay £153 annually. This was formerly £125.

For 2010/2011, trainees received a 1% pay rise.

Tags: Fees, Training
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Private practitioners at odds with health insurer

By Francesca Robinson - 17th March 2010 3:25 pm

A war of words has broken out between the private practice representatives and a medical insurer over accusations that the latter is trying to force down consultant fees.

The Federation of Independent Practitioner Organisations (FIPO), which represents independent sector interests, is protesting about a new low fee schedule introduced by AXA PPP Healthcare.

A fixed ‘fee schedule’ has been applied by AXA PPP to all new consultants since 2008. Failure to accept the schedule means that some consultants are not recognised by the insurer.

But now, FIPO claims that AXA PPP is trying to force the new schedule on to established, experienced consultants.

It says patients referred by their GP to a preferred specialist may be told by AXA PPP that their consultant of choice could overcharge and they should see another, cheaper, ‘recommended’ consultant.

FIPO claims to have heard reports that patients who opted to see their first choice consultant have had their reimbursements reduced by anything up to 50%.

“We believe that this system could cause problems for some of the patients who may be moved by the insurer to a new consultant who has no knowledge of their case,” said FIPO chairman Mr Geoffrey Glazer.

“PPP is also targeting some anaesthetists, and again interfering with clinical matters, as the team work and understanding between surgeon and anaesthetist can be critical; no PPP clerk should be allowed to take this responsibility and thus interfere in these critical decisions. How can a clerk understand the specialist nature of the anaesthetic, the working relationship of the consultants or of the exact clinical reasons why a GP has suggested a referral to a specific consultant?”

But Dr Simon Peck, AXA PPP healthcare’s head of provider audit and information, retorted that FIPO had misunderstood the situation. Like all insurers they had a system in place to stop payment of excessive charges in order to keep health insurance premiums affordable.

“The vast majority of specialists - well over 90% - charge fees at a level we are happy to pay in full and it follows that the vast majority of our customers have their bills fully reimbursed. That will continue.

“We have always declined to pay bills from the small number of very high charging specialists in full, however, and the only thing that has changed is that we have now clarified, through publication of our schedule of procedures and fees, the amount that we will reimburse.”

FIPO has launched a survey of consultants to assess the extent of their concerns about their relationship with medical insurers.

Mr Richard Packard, FIPO deputy chairman, added: “Reducing patient choice through last minute financial pressures, when the patient is most anxious and in need of help, is interference in proper clinical practice.”

Tags: Fees, Private practice
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Poor pay rise + inflation = demovitated docs

By Mike Broad - 4th March 2010 6:56 pm

We’re into March already and it won’t be long until we find out what your pay rise is going to be for 2010-2011. Did I say pay rise? Sorry, I meant pay cut.

OK, they can’t actually take money away from you, but when inflation is taken into consideration doctors will be looking at a pay cut.

Back in November the Chancellor said that for the two years from 2011 he would seek to ensure all public sector pay rises were capped at 1%. You can bet doctors won’t do better this year.

Even doctors’ representatives are saying a 1% pay rise for doctors would be “a result”. They’re anticipating less.

Such is the state of the nation’s economy most doctors appear resigned to a poor deal. They weren’t, however, expecting foundation trusts to plot an assault on their SPAs, clinical excellence awards and progressional pay increments as well.

The irony of it all is that a government that was obsessed with eliminating private practice has, in the end, created an environment that is conducive for it.

Fears over inflation are very real, with rates increasing this year on all measures. The Retail Price Index rose to 3.7% in January, from 2.4% in December.

The OECD found that Britain’s CPI inflation rate of 3.5% in January was two or three times higher than other European nations. It blamed rises in supermarket goods and energy provider charges. Petrol prices and the increase in VAT have also played their part apparently.

Here’s some Stephanomics on the subject - she’s better qualified than me to comment and suggests inflation could be more of a problem than the Treasury is letting on.

But it’s not only the rising costs of general items that doctors should be concerned about. How will medical organisations, which charge professional membership fees, respond?

Full registration with the GMC currently costs you £410 a year. This is going up to £420 from April - a 2.4% rise.

If you’re a fellow of the Royal College of Physicians, you paid £485 in 2009. In 2010, you’re paying £495 - a 2.1% rise.

Consultant membership of the Royal College of Surgeons rose from £375 in 2009/2010 to £380 for 2010/2011 - a 1.3% increase.

A standard membership with the BMA for 2008/2009 was £399. This rose by 2% to £407 for 2009/2010.

None of these rises are atypical or offensive, and I’m sure they’re justifiable. But - and it is a significant ‘but’ - they are all likely to outstrip this year’s consultant pay deal.

And this is without even considering indemnity fees and other association, society and journal membership and subscription charges. As the expectations surrounding continuous professional development rise, so will the cost to the individual consultant.

Most of these fees are tax deductible, but it doesn’t stop them representing a significant outlay.

It therefore comes as no surprise that other organisations are trying to offer cheaper ways for doctors to access some of these services.

Just as doctors, and the organisations they work for, are coming under pressure to deliver even better value for money, then so must the medical institutions that serve them - particularly the ones doctors are obliged to pay fees to.

One can get blinded by pay particularly when other private sector professions, like bankers, are still doing well. As this commentator points out there is a total reward package within the public sector that others don’t benefit from.

That does of course assume that employers and the government don’t start messing around with your pensions, clinical excellence awards and other terms and conditions, which all contribute to the ‘total reward package’. If that is successfully avoided, a few flat pay rises might end up looking like ‘a win’.

Tags: Fees, Pay
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BMA loses millions in economic downturn

Pulse - 19th June 2009 4:38 pm

Almost a quarter of the BMA’s investments have been wiped out in the downturn, contributing to a total decrease in the association’s net assets of almost £52m.

The union’s annual accounts show unprecedented losses, which the association blamed on ‘extreme financial turmoil’.

The value of the association’s investment portfolio fell £28m and the net pension deficit increased by £28.3m, while the value of all other net assets increased by nearly £5m over the year. The treasurer reported a consolidated net deficit of £9.7m - and a decrease in the value of the association’s net assets of nearly £52m.

The figures come as the association revealed it would be recommending an across-the-board subscription rate rise of 2%, although a BMA spokesperson said this was unrelated to the investment losses.