NEW GP contracts will hand partners an average windfall of more than £10,000 per year - prompting warnings that doctors will pocket the cash as a personal salary hike.

The cash boost was branded "scandalous" by the trade union representing paramedics at a time when NHS staff earning less than £30,000 a year have been promised only a three per cent rise once the long-running public sector pay cap is lifted.

John Marr, GMB branch secretary for the Scottish Ambulance Service, said: "We have been calling for an increase in resources across Scotland and this just makes a mockery of it. How much would it cost the Government to put more ambulances on the road, to put more nurses in A&E to bring the waiting times down? But they're giving this to GPs as a backhander - here's a pay rise for doing what you do. I just think that's scandalous."

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Matt McLaughlin, Unison's regional organiser for NHS Greater Glasgow and Clyde, said: "Hard-pressed NHS workers such as cleaners, porters and nurses will be surprised that the Scottish Government appear to be rewarding a significant pay increase to general practitioners without the same strings that are attached to their measly pay offers."

An estimated 68 per cent of GP partners in Scotland will share in a £23.2 million windfall paid for by the taxpayer under a controversial new funding allocation formula based on workload.

The uplift, which equates to an average 10.2 per cent hike per partner – or £10,239 based on an average full-time partner salary of £100,000 - will be delivered no-strings-attached if the proposed new Scottish GP contract - negotiated between the Scottish Government and BMA - is approved next week.

Due to their status as independent contractors, GPs can choose how to spend the cash and could invest it into patient services or hiring extra practice staff.

However, Dr Erik Jespersen MBE, a senior partner at Lorn Medical Centre in Oban and former medical director for Argyll and Bute who provided the figures to the Herald, said that most would not.

He said: "It is very likely that a majority of GP partners will take the additional income as profit, and in many cases it will not directly benefit patient care."

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The BMA dispute Dr Jespersen's calculations, insisting that it is impossible pull out a precise percentage of full-time partners who will benefit because the £23m will be shared between 63 per cent of practices which vary in size and by the number of sessions worked by individual GPs.

But Dr Jespersen said it was the most accurate estimate possible based on the most recent workforce data for Scotland. His view has been corroborated by several healthcare statisticians.

He stressed that the sum was "not unfair" in itself after years of squeezed salaries and a widening gulf in earnings between GPs and consultants, but said the problem was "the way it's distributed according to the flawed workload formula".

Read more: Highland GP calls for full regional breakdown of contract vote

The Herald:

(Image: Practices with red dots are losing up to 87.6 per cent of their funding allocation under the proposed new formula, and will require protection payments to keep their income the same as it is now. Green dots identify practices who gain financially under the new SWAF formula) 

While 63 per cent of practices will share in the £23m, the rest - in rural Scotland and some of Scotland's poorest communities - will get nothing.

This is at the core of a bitter rift emerging in the profession between the new contract's so-called "winners and losers". But leading academics warn it will also backfire on patients and taxpayers by exacerbating the recruitment crisis in rural Scotland - where GP shortages are worst - and disproportionately benefit GPs in more affluent postcodes with high volumes of elderly patients, while failing to address the health inequalities blighting the most deprived areas.

The new Scottish Workload Allocation Formula (SWAF) will replace the Scottish Allocation Formula (SAF), in place since 2004, to determine each practice's funding entitlement. However, critics argue that since it rewards practices offering a lot of appointments - that is, those which appear to have the highest workloads - it automatically benefits those which already have the most doctors.

As a result, the cash is flowing to the Central Belt and cities such as Dundee and Aberdeen, while a practice in Shetland will see its allocation cut by 85 per cent. The Scottish Government has pledged to make up the difference through income protection payments to ensure no practice is worse off than it is now, the point for many is that it will increase urban practices' financial advantage.

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Professor Philip Wilson, professor of primary care and rural health at Aberdeen University, said: "The differential between Shetland and a comfortable suburb of Glasgow has now increased. It's going to make it easier for practices in Glasgow to recruit doctors and easier for them to pay locums, but practices in Caithness for example - which are already having to pay £1000 a day to attract locums - are not going to be able to carry on."

Similarly, of the ten most deprived practices in Scotland, five will gain nothing under the formula while the other five will receive an average uplift in their total financial allocation of 1.9 per cent. In comparison, a practice in affluent Broughty Ferry will gain 12.3 per cent, while one in the Marchmont area of Edinburgh gains 7.4 per cent and another in Bothwell, Lanarkshire receives an uplift of 6.8 per cent.

Professor Graham Watt, founder of Scotland's 'Deep End' project for practices in the poorest areas, said: "Despite what the First Minister and Cabinet Secretary said in the Scottish Parliament in December 2015 the new contract funding does not address the unmet needs of patients in deprived areas. Is this a priority or isn't it?"

Dr Alan McDevitt, chair BMA Scotland’s GP Committee, said: “If implemented, the changes to the workload formula will address the situation that currently sees many GP practices underfunded for the amount of work that they carry out, particularly in relation to elderly patients and those in deprived areas.

"This underfunding impacts on the level of service that practices are able to provide to their patients and in a number of cases has contributed to practices handing back their contract to the health board.

“The proposed contract will ensure that every practice in Scotland has their finances protected, while providing more financial support to those practices with under-resourced higher workloads."

A spokesman for the Scottish Government said: “From April there will be additional investment of £23 million to support the introduction of the new workload formula, and the practice income guarantee. As the BMA themselves have set out, this means that no practice will see a reduction in funding under the new contract.

"Following the outcome of discussions on pay and expenses for 2018-19, we are likely to see funding for every practice in Scotland increase."