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At the heart of general practice since 1960

A divided profession will fall

As the GP negotiators hunker down and get ready for battle with the Department of Health over its contract proposals, they may want to devote some thought to the number one rule of all engagements.

As the GP negotiators hunker down and get ready for battle with the Department of Health over its contract proposals, they may want to devote some thought to the number one rule of all engagements.

Whether on the battlefield or football pitch, or around the negotiating table, the central maxim is to remain united at all times.

So it's worrying that Dr Laurence Buckman, GPC chair, admits to having taken his eye off the ball over the growing divide between partners and salaried GPs.

It is understandable, and only human, to have been distracted by the contract negotiations, but it has never been more important that GPs are able to speak back to the Government with one voice. At present, the voice of general practice is in danger of being refracted by the faultlines appearing at the centre of the profession.

A tricky problem

Not that this is an easy problem to solve. According to Pulse's survey this week, more than half of salaried GPs believe themselves the victims of exploitation over pay and working hours - but a similar proportion of partners robustly reject the accusations.

Yet almost half of partners do acknowledge concerns over the current state of the GP workforce, mostly focused on the lack of partnerships available. Almost three quarters of GP job ads are now for salaried vacancies.

Dr Terry John, the GPC's workforce lead, believes the contract itself may be to blame, by failing to incentivise practices for employing partners.

Others argue that the absence of partnerships is simply a symptom of the turbulent times in which GPs now live, and the precarious financial position of many practices. Identifying the true cause will be essential to devising a solution, and here it really is time for the GPC to take a lead.

There needs to be a national debate within general practice, perhaps in the form of a special congress between partner and salaried GP leaders. Open and honest debate between fellow professionals is healthy and constructive.

The alternative is division and resentment – which is a recipe for defeat.

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