Rachel Reeves plan for a tax hike on partnerships will decimate the GP workforce – and her government’s plans to turn the NHS around, says Katie Collin
We’re now a month nearer to Reeves’ second Autumn Budget, and the speculation has come thick and fast. But of all the tax raids potentially on the horizon – and there are many – for me, there is one that would be particularly catastrophic. And all it’ll do is crush Starmer’s lofty plans for the NHS.
What I’m talking about here is the touted end to national insurance exemptions for partnerships – a move that will supposedly make a £2bn dent in our budget deficit. While Reeves is said to be looking at ways to protect GPs from such a policy shift, let me tell you, family doctors across the country still have no certainty over the future of their incomes. And as is characteristic pre-Budget, we’ll no doubt see conflicting announcements from Number 11 over the coming weeks.
At the end of the day, there is still a very real possibility Reeves will inadvertently decimate our workforce of GP partners across the country.
I interface with hundreds of GPs across London and the UK every day, and the number of times I’ve heard our doctors consider moves to the likes of Singapore or Australia in search of better pay, resources and government support is astounding. The fact is that many of our GPs are disillusioned with how our government is treating their sector, and any pinch on their own wallets could give them the push they need to exit the profession entirely.
GP exodus
Put simply, any partnership raid could light the touchpaper for a GP exodus never before seen.
I can imagine readers thinking that this is something of an overreaction. That GPs, by and large, live fairly easy work lives. That they tend to be bracketed amongst the higher-earning professions. Given the 8am appointment rush the public experiences every day, there’s even some sense that they should be doing more.
In reality, general practice is one of the most misjudged and mishandled sectors nationwide – and family doctors have borne the brunt of lousy fiscal policy perhaps more than most. Last year’s Budget was estimated to have cost our GPs £200m, with minimum wage and employer NIC hikes putting significant strain on the huge staff costs of practices across the country. And where practice finances didn’t allow, partners themselves were expected to make up the difference.
On the other hand, Streeting’s reforms dictate that getting an appointment should be as easy as booking a delivery, a taxi, or a takeaway. A pithy, idealistic statement, but as the number of patients per GP nudges 2,200 – 400 more than what the government deems clinically safe – I can’t help but feel it’s a tad too much.
Time and time again, GPs have been let down by our government – either in misjudging their financial capacity, workloads, or otherwise. So, as whispers of a direct hit on their personal income come to the fore – both via a partnership NIC crackdown and even possible cuts to the tax-free pension lump sum allowance – I can’t help but sound the alarm.
If Reeves proceeds, many of our GPs could retire early, emigrate, or even reduce their hours. And that wouldn’t just affect the availability of day-to-day patient care, but our government’s broader ambitions for the NHS.
Earlier this year, Starmer and Streeting banded together to announce their Labour government’s NHS 10-year plan. We would see the end of the primary care network, the reintroduction of community care, and the establishment of new neighbourhood health hubs. A plan built to modernise our health service and prioritise preventative care.
But without the GPs to staff said hubs, this plan will faili. Starmer’s and Streeting’s ambitions would be scuppered. The NHS would remain unchanged. And our public would not get access to the care and treatment they’ve been promised.
It’s vital that our Chancellor reconsiders any crackdown on our GPs and their finances. Partners are already on the precipice of leaving the sector – we cannot push them over the edge.
Katie Collin is a partner at Ramsay Brown LLP