Greedy whingeing doctors

by Chris Bertram on October 25, 2005

Today’s Guardian has “this”:http://education.guardian.co.uk/students/tuitionfees/story/0,12757,1600221,00.html?gusrc=ticker-103704 :

bq. Doctors today called for a change in the law so that graduate medical students do not have to pay fees of up to £3,000 a year upfront.

Which to my mind sits somewhat ill with “this”:http://news.bbc.co.uk/1/hi/health/4373519.stm :

bq. Accountants believe average GP pay will burst through the £100,000 barrier this financial year for the first time.

Just to emphasise, that’s _average_ GP pay.

{ 25 comments }

1

Barry 10.25.05 at 6:33 am

That’s amazing. Doctors in the US have incomes above $100,000 US, but can also graduate with debts well over that amount.

2

Factory 10.25.05 at 6:44 am

Australia fixes this issue by having all the uni fees incurred as a debt is which is garnished off the students after they get jobs that pay over a certain amount, this taxes only the rich, and effectively removes any disencentive not to go to uni because of high fees.

3

fightingdem 10.25.05 at 7:05 am

So what’s the median and what’s the range?

4

fightingdem 10.25.05 at 7:11 am

I should have also asked what are the retirement benefits? How many hours are they expected to work in an average week? How many days off each year?

5

Tom 10.25.05 at 7:15 am

What about a poor student who can’t stump up £3000 before qualification but who can obviously very well pay it afterwards?

6

steve 10.25.05 at 7:15 am

So much for the NHS’s monopsony power. It is interesting that the state sector is good enough for GP’s to work in, but not good enough for most of their kids to be educated in.

7

Matthew 10.25.05 at 7:22 am

I suppose Chris the emphasis is meant to be on the ‘upfront’ bit, no? I’d give them the option of deferring at commercial interest rates.

8

rea 10.25.05 at 7:23 am

Well, but you might consider it poor social engineering to admit only those who have 3000 up front to the ranks of GPs who will eventually be making 100,000

9

Matt McGrattan 10.25.05 at 7:43 am

The situation is that all students in England now have to pay fees upto £3000 annually. The precise amount varies depending on the course and the university.

It’s possible for all to defer this as part of a student loan agreement which is only repayable after graduating and once income rises above £15,000 per annum. On top of the fees most students will need to take out further loans to cover living expenses.

The reason the medical doctors want special treatment is because those who are studying for a medical degree after having completed a previous undergraduate degree don’t have the option to defer payment until after they graduate.

I don’t necessarily see this as greedy whingeing: people on low incomes who want to become doctors in this way will have a serious problem meeting the fees upfront. In this respect the Doctor’s are asking for 4 year graduate medical degrees to be treated like undergraduate degrees.

Doctor’s taking this route i.e. graduate entry to medical school only make up about 10% of medical students.

Of course they bloody well ought to be able to pay them back later given that they will be earning a salary that averages 4 times more than the UK median male income.

10

Peter Clay 10.25.05 at 8:15 am

Presumably dentists earn something similar. And there aren’t enough of them.

11

nik 10.25.05 at 8:39 am

Yes, it’s the “upfront” bit they’re complaining about, people who already have an undergraduate degree don’t have the option to defer payment until after they graduate.

Frankly, they’re still taking the piss though. If you want to do a Masters or a Doctorate – or any other second degree – you don’t have the option to defer paying fees.

12

Michael Kremer 10.25.05 at 9:02 am

“Compensation

The U.S. Bureau of Labor Statistics estimates that family and general practitioners earned an average yearly income of $139,860 in 2003.”

http://www.collegeboard.com/csearch/majors_careers/profiles/careers/106718.html

Using online inflation and currency exchange calculators this comes out to about 82,500 British pounds.

13

Chris Bertram 10.25.05 at 9:12 am

Or to put it the other way round, £100,000 sterling amounts to US$177,420 (according to Google), and the annual upfront fee would come to US$5322.60.

14

Anthony 10.25.05 at 9:21 am

Can people stop repeating the fallacy that GPs are part of the state sector?

They are not.

They are small businesses with contracts to provide services to the NHS. They are not salaried NHS employees – with some exceptions.

However, they do manage to obtain some of the benefits of NHS employment – like the excellent pension provision.

15

jayann 10.25.05 at 9:37 am

I should have also asked what are the retirement benefits? How many hours are they expected to work in an average week? How many days off each year?

Mine work a maximum 4.5 day week in the weeks when they do work. They don’t have to see a specific number of patients and they take as much holiday/leave as they like. GPs here are now paid more for doing significantly less (they had to give up just £6000 per year to get rid of the out-of-hours home visits they’d whinged so much about).

Dentists are paid by unit of work done.

16

Mike Otsuka 10.25.05 at 9:57 am

If you scroll down to the bottom of the Guardian piece, you’ll see that only one year of upfront fees is at issue, since the NHS covers fees after the first year.

The British Medical Association say that it’s concerned about less advantaged students being deterred by this. But this affects only those who already have one university degree, which is an overwhelmingly middle class pool.

Perhaps the BMA could put its money where its mouth is and set up a scholarship to cover the first year of fees of disadvantaged students who have a university degree. If each of their members donated a very small fraction of their income, that would easily cover this expense.

17

SamChevre 10.25.05 at 10:25 am

Doesn’t Great Britain have a lending/borrowing market? Here in the US, it is easy to borrow tuition and living costs for medical school–which are around $50,000 a year. Lenders know that doctor’s incomes are consistently high, and so are very willing to lend to future doctors.

18

chris y 10.25.05 at 11:16 am

Trainee doctors in Britain I have known have been able to borrow up to about the level of the national debt with no questions asked. But lenders tend to want evidence that they will actually qualify first, so they are less forthcoming to first year students than they become later, because there is a substantial drop out rate at this stage.

Presumably this serves to justify their demand, but whether it does so successfully, I take leave to doubt.

19

jet 10.25.05 at 2:11 pm

If the US moves to a socialiased (or nationalised, as you will) health care system, does this imply US doctors will see ~$40,000 increase in average salary? Are labor costs of GP’s large enough to effect the debate?

20

Daniel 10.25.05 at 2:29 pm

GPs are a subset of “doctors” and as noted above, they are more like small businessmen than government employees (btw, I’m not sure if all that £100K is gravy, or whether it has to cover practice costs???). But I must say I’m surprised that they are on this much; there’s many many more of them than there are university professors, or even Directors of Diversity.

21

Rob 10.26.05 at 4:48 am

To be honest, you have to expect this kind of thing from the BMA. After all, they had to have their mouths stuffed with gold in order to get them to condescend to treat poor people (I’m amazed no-one had mentioned it yet, really).

22

abb1 10.26.05 at 5:11 am

An alternative to high up-front costs could be some kind of arrangement for doctors to serve as low-paid residents at public hospitals for a few years after their graduation. And by doing this they earn a right to become ‘small businessmen’ when this mandatory residence period ends. Just a thought.

23

SamChevre 10.26.05 at 10:38 am

An alternative to high up-front costs could be some kind of arrangement for doctors to serve as low-paid residents at public hospitals for a few years after their graduation. And by doing this they earn a right to become ‘small businessmen’ when this mandatory residence period ends.

In the US, residency is already required–is it not required in the UK?

24

abb1 10.26.05 at 11:53 am

Yes, but in the US private hospitals benefit from quasi-slave-labour of residency (or am I missing something?). In Europe it should be the public that pays for their education.

25

Matt McGrattan 10.26.05 at 12:00 pm

Standard medical training is 2 years of academic study, then 3 combined years where they do academic study and work under supervision (as students) in a hospital. At this point they become a ‘Dr.’.

Then there are a further 2 required years in a hospital (similar to the US residency system).

At this stage, I gather, there can then be several more years of on-the-job training in their chosen speciality before they are fully qualified.

http://www.bma.org.uk/ap.nsf/Content/doctorsqual

has the details.

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