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BMA pushes national plan to pay for partners

By Lilian Anekwe, Gareth Iacobucci

The BMA has unveiled proposals for a nationwide incentive scheme to encourage practices to take on partners, using money diverted from the Darzi centre rollout.

Doctors' leaders launched their manifesto for the next general election with calls for the Government to offer payments for practices that recruit partners, to address acute shortages in partnership positions.

Pulse revealed in September that the BMA was discussing options for partnership incentives, which were a central demand of Pulse's One Voice campaign. The proposals would be along similar lines to plans unveiled in NHS South-West

Essex to pay practices up to £225,000 each over four years to take on a partner.

The BMA is suggesting an incentive scheme be rolled out across the country – but targeted particularly at deprived areas, where there is often a shortage of partners and difficulties offering continuity of care.

It wants resources freed up from projects such as the national rollout of GP-led health centres, citing Pulse's investigation revealing many are struggling to attract the number of registered patients expected.

The BMA's manifesto vows to press for urgent talks with whoever wins the election, but its proposals will be seen as aimed more at the Conservatives than the current Government, which this week repeated its opposition to partnership incentives. Its pledge follows our One Voice campaign, focusing on opening up partnership opportunities to ease tensions between principals and salaried GPs.

The BMA manifesto calls for practices to be ‘encouraged to offer more GP partnerships, especially in underdoctored areas' and urges ministers to consider how funding could be allocated to help GPs expand their practices. BMA chair Dr Hamish Meldrum said: ‘We recognise many of our young colleagues do want partnerships. There must be incentives.

‘We are realistic about the money available in the short term, but will discuss with the Government any incentives we can put into the contract. We'd far rather see the money to put a Darzi centre in every PCT, often unnecessarily, used to help practices take on partners.'

Pulse revealed in August that many sessional GPs were considering defecting to the Medical Practitioners' Union, after becoming disillusioned with an alleged BMA bias towards partners. The GPC said last week it would be carrying out a survey of LMCs, salaried GPs and locums, as it aims to improve sessional GP representation.

Dr Richa Singh, a salaried GP in Somerset, said it was vital young GPs were given the opportunity to become partners. ‘There certainly should be incentives. People have to address the fact partnership is dying.'

Others were sceptical about whether the BMA would be able to negotiate incentives. Dr Richard van Mellaerts, a sal-aried GP in Bethnal Green, east London, said: ‘This is a positive step, but we need to consider if any Government will actually do it – it would undermine involvement of private providers.'

The DH, in its supplementary evidence to the Doctors' and Dentists' Review Body, said: ‘We do not believe [partner incentives] are the right approach.'

The Conservatives have not committed either way.

Meanwhile, University of Manchester research suggested partners risked ‘undermining the ethos of general practice' by treating salaried GPs as poorly as private providers.

The manifesto also calls for increased investment in public health, arguing that well-resourced smoking cessation services and setting a minimum price level for alcohol would reduce demand on the NHS in future.

BMA chair Dr Hamish Meldrum One voice BMA's manifesto: key pledges

Safeguard patient-centred general practice

1/ Preserve continuity of care, and limit the use of private sector
2/ Support the current list-based system of general practice

Engage with GPs in the design and implementation of policy

1/ Involve GPs more in developing policy initiatives
2/ GPs must be fully engaged in commissioning services, including out-of-hours
3/ Elimination of ‘crude targets' and ‘blunt national surveys'

Support and develop general practice to deliver quality care

1/ Practices should be encouraged to take on partners
2/ Extend consultation time to 15 to 20 minutes
3/ Extend GP training to five years

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