GPs could be compensated for the Chancellor’s National Insurance raid, Downing Street has suggested.

       Family doctors are pleading for exemptions from the NI hike, saying the extra tax on employers could force some out of business.

       GPs have said that the move could mean surgeries are forced to make staff redundant, with estimates that the measures could cost some practices the equivalent of five nurses’ salaries.

       When the Budget was announced, the Government had said that the public sector would be exempted from the rise.

       However, on Thursday night, Darren Jones, the Treasury minister, said GP practices were “not part of the public sector” and would face extra costs.

       Under the changes, employers’ contributions will increase by 1.2 percentage points to 15 per cent from April. Companies will also have to start paying for staff who earn more than ￡5,000 a year, instead of ￡9,100.

       Amid mounting concern from GPs, who said patients would “bear the brunt” if surgeries close, Downing Street on Friday suggested that family doctors may see extra funds coming their way.

       A No 10 spokesman said contracted workers, including GPs, were not eligible for an exemption from the hike.

       However, they suggested the next GP contract could see extra funds allocated to compensate for the hike.

       Negotiations on the deal are due to start within weeks. Terms are negotiated annually.

       However, terms were imposed this year, with many GPs currently taking part in “work to rule” protests against their current contract, which boosted funding by 7.4 per cent.

       A No 10 spokesman said: “There is a general process whereby departments, the Department of Health, for example, confirm their funding for general practices.

       “I think that’s part of the annual GP contract process. I believe that will take place later in the year.”

       Average earnings for GP partners in England currently stand at ￡140,000, up from ￡103,000 in 2012.

       Dr David Wrigley, a GP and deputy chairman of the British Medical Association (BMA), said the impact of the tax hike would be “monumental”.

       He wrote on X: “Make no mistake. The impact of NI rise/lower salary threshold on NHS GP surgeries across the country will be monumental. Many are already on a financial tightrope due to years of neglect. We need a rapid announcement of full reimbursement.”

       The BMA on Thursday had said health ministers were “locked in discussions with Treasury” over the issue.

       Dr Katie Bramall-Stainer, chair of BMA’s GP committee, said she had held discussions with Stephen Kinnock, the health minister, while Phil Banfield, the BMA council chairman, did the same with Wes Streeting, the Health Secretary.

       Dr Bramall-Stainer argued that NHS GP practices did “count as public sector”, citing the Freedom of Information Act 2000 which defines them as “public sector authorities”.

       The Royal College of GPs (RCGP) said it had contacted Mr Streeting, seeking assurances that practices would be protected from the changes.

       Professor Kamila Hawthorne, chairman of the RCGP council, said: “We are writing to the Health Secretary today asking for urgent assurances that GP practices will be given the same protection as the rest of the NHS and public sector and receive the necessary funding to cover these additional costs.

       “We have very serious concerns about the impact of the increase in National Insurance employer contributions on GP practices right across the country, many of whom are already struggling to keep their doors open and make ends meet due to historic chronic underfunding.

       “They are working their hardest to provide quality care for their patients against a backdrop of significant budget constraints and staffing challenges – and this added level of insecurity will only compound these pressures.

       “For some, this extra financial burden will be the straw that breaks the camel’s back, forcing them to make tough decisions on redundancies or even closing their practice, and ultimately it is our patients who will bear the brunt.”

       Concerns about the impact on GPs and care homes were first raised when Mr Streeting acknowledged there were a number of healthcare providers that would be affected by the NI rise for employers.

       Asked whether social care providers would be protected, he told the BBC’s World at One programme: “I’m working through that now and I’ll have more to say on that in the coming weeks, in terms of what we can do more quickly to deliver the shift I’ve wanted to see for some time, in the focus of NHS investment spending out of hospitals into primary community.”

       ‘We’re going to struggle’

       Paul Stanley, of the Gas House Lane GP surgery in Northumberland, told BBC Radio 4’s Today Programme: “I’ve done some very quick sums earlier on this morning and it looks like for a practice of our size, with our number of staff, it’s going to cost us in the region of ￡40,000 a year.

       “I think what we’re looking at is an unfunded increase in our staffing costs which may ultimately impact on our resources and staffing levels. The increased costs mean we might have to think about the levels of staffing we have.”

       Dr Jess Harvey, a GP from Shropshire, told the BBC: “Unless we’re getting given suitable remuneration to cover this National Insurance inflation, we’re going to struggle. There are practices that are already considering redundancies because it’s so hard to manage financially.”

       Jeff Butcher, chief executive of family care business Blackadder Corp, added: “We will certainly not be taking on additional staff. We’ll have to cut back on improvements. This morning I was supposed to be going to a home to look at investing in a small extension and a passenger lift. That almost certainly will have to go.

       “I think it will exacerbate the speed of closure of homes.”

       Munira Wilson, the Liberal Democrat education, children and families spokesman, told the BBC’s Question Time: “The employers’ National Insurance rise is going to put a lot of our social care providers under a lot of pressure.

       “Because the vast majority of social care providers, whether they’re care homes, providing care in your own home, are private providers and they’re going to have to shoulder the burden of this National Insurance rise.

       “We consider it a Lib Dem win because there was a strong focus on health. There’s a lot of questions still yet to be answered.”

       St Christopher’s Hospice in London said the tax rise would result in an additional cost of ￡450,000 a year – the equivalent of nine specialist nurses.

       Hospice staff also face a real-term pay cut as salary increases face being cancelled to pay for the rise.

       Iain Cameron, the chief executive of Rowans Hospice in Hampshire, said: “We were planning a potential 2 per cent pay rise for staff but if 1.2 per cent of that will be a national insurance increase I don’t think we’ll be able to afford to pay our staff.”

       Mr Cameron said the increased cost would also widen the gap between what hospices could pay nursing staff and what they could earn doing the same job for the NHS – which has seen pay rises and is exempt from the additional tax.

       Hospices receive less than a third of their funding from the Government but must compete with the NHS for staff, putting them at a disadvantage if they cannot match salaries.

       Hospice UK, which represents 200 charity hospices, has warned that this would increase the pressure on a sector already having to significantly reduce its services.

       Charlie King, of Hospice UK, said: “There’s a critical principle that organisations who are providing healthcare services on behalf of the NHS, like hospices, should be treated the same as NHS bodies, like hospitals, when these sorts of decisions are made by the Treasury.