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We analyse the determinants of annual net income and wages (net income/hours) of general practitioners (GPs) using data for 2,271 GPs in England recorded during Autumn 2008. The average GP had an annual net income of £97,500 and worked 43 hours per week. The mean wage was £51 per hour. Net income and wages depended on gender, experience, list size, partnership size, whether or not the GP worked in a dispensing practice, whether they were salaried or self-employed, whether they worked in a practice with a nationally or locally negotiated contract, and the characteristics of the local population (proportion from ethnic minorities, rurality, and income deprivation). The findings have implications for discrimination by GP gender and ethnicity, GP preferences for partnership size, incentives for competition for patients, compensating differentials for local population characteristics. They also shed light on the attractiveness to GPs in England of locally-negotiated (Personal Medical Services) versus nationally-negotiated (General Medical Services) contracts.

OBJECTIVES: To find out which groups of people would use a National Health Service walk-in centre that would offer mainly health care advice, staffed by nurses. To understand the circumstances in which people would use a walk-in centre and to ascertain to what extent it would meet patients' expressed health-care needs. DESIGN: A postal survey of 2400 people plus 27 semi-structured interviews and one focus group. SETTING AND PARTICIPANTS: The study was conducted in Wakefield, Yorkshire UK, and included both white and ethnic minority groups. RESULTS: Most people reported that they would use a walk-in centre. It would be more attractive to young as compared with older people, ethnic minority as compared with white people, people who are dissatisfied with access to NHS services and people with urgent health-care problems. People want a wide range of services, including diagnosis, treatment, prevention, and general information. People also want access to both doctors and nurses, to male as well as female practitioners, to counsellors and interpreters. The type of service planned for this walk-in centre will meet some of the expressed needs. However, patients' expectations of the walk-in centre exceed planned provision in a number of key respects. CONCLUSION: Walk-in centres without GPs and with limited services will disappoint the public. It is important that walk-in centres are evaluated and attention paid to 'local voices' before additional money is allocated for such centres elsewhere.

General practitioners (GPs) have been found to have a higher level of anxiety and depression then hospital managers and consultants. In 1995 and 1998, we surveyed GPs in Buckinghamshire. We found that the development of out-of-hours co-operatives was an important factor in the improvement in GPs' health status.

Objective: To compare the clinical effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients. Design: Prospective, controlled trial with randomised and patient preference allocation arms. Setting: General practices in London and greater Manchester. Participants: 464 of 627 patients presenting with depression or mixed anxiety and depression were suitable for inclusion. Interventions: Usual general practitioner care or up to 12 sessions of non-directive counselling or cognitive-behaviour therapy provided by therapists. Main outcome measures: Beck depression inventory scores, other psychiatric symptoms, social functioning, and satisfaction with treatment measured at baseline and at 4 and 12 months. Results: 197 patients were randomly assigned to treatment, 137 chose their treatment, and 130 were randomised only between the two psychological therapies. All groups improved significantly over time. At four months, patients randomised to non-directive counselling or cognitive-behaviour therapy improved more in terms of the Beck depression inventory (mean (SD) scores 12.9 (9.3) and 14.3 (10.8) respectively) than those randomised to usual general practitioner care (18.3 (12.4)). However, there was no significant difference between the two therapies. There were no significant differences between the three treatment groups at 12 months (Beck depression scores 11.8 (9.6), 11.4 (10.8), and 12.1 (10.3) for non-directive counselling, cognitive-behaviour therapy, and general practitioner care). Conclusions: Psychological therapy was a more effective treatment for depression than usual general practitioner care in the short term, but after one year there was no difference in outcome.