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Cheapening of GPs finally takes its toll

The Government's repeated pay freezes are a key factor in the sudden dearth of applicants for salaried GP posts – it's time it faced economic reality

The Government's repeated pay freezes are a key factor in the sudden dearth of applicants for salaried GP posts – it's time it faced economic reality

The economic crisis wasn't the only reason the Government demanded a pay freeze for GPs next year. Ministers also felt there was simply no need to put pay up. ‘The healthy recruitment and retention position' across the NHS and ‘the expectation the position will strengthen further in 2010/11' meant the supply of GPs would keep flowing, whether the money got better or not. ‘Long-term vacancy rates among GPs remain unaltered at 0.3%,' added the DH's evidence to the pay review body, making an apparently convincing case for pay restraint.

Except, that is, for one minor problem. The Government's information was out of date, offered up in the complacent belief that if GPs were desperately scrambling to find work last year, chances were they would be this year too. But, as Pulse reveals this week, some very odd things have been going on in the GP job market over the past year. Suddenly large numbers of GPs seem to have vanished from it, and GP leaders and recruitment consultants alike are recounting tales of job ads going unanswered and vacancies left unfilled.

In fairness to the DH, it wasn't long ago GPs were talking of a jobs desert. As recently as last December, the BMA warned of black spots across the UK, where an oversupply of recruits and a shortage of vacancies left young GPs struggling for work, forced into short-term contracts or, apocryphally, resorting to shifts as taxi drivers. The turnaround was sudden – unprecedently so, according to one recruitment consultant – but that's not to say it couldn't have been forseen. The sudden boom in Darzi centres and APMS providers, and the extending of hours at three-quarters of practices, have sent demand for GPs soaring. At the same time, there are claims that fewer young GPs are on the jobs market, perhaps as a result of the feminisation of the workforce. That heady mix has sent the balance of jobs to recruits abruptly out of kilter and applicants for salaried posts have fallen from about 60 to just a handful per post at some practices.

At first glance, it might seem hard to square this sudden shortage of recruits with the frequent complaint from salaried GPs that partnerships are so scarce. But there is a common thread, with recruitment experts warning partnerships are still not available, and that sessional GPs are increasingly unwilling to move for another salaried post. Indeed, a growing number have apparently become so disillusioned with the lack of career opportunities that they have turned their back on NHS general practice and opted to join the private sector instead.

In the short term, this all sounds like bad news for partners, who may have little choice but to recalibrate their recruitment strategies to make vacancies more attractive. But the Government too will need to respond to the situation. Its entire policy over the past five years has been based on the assumption that an abundance of trainees, and use of skill mix to restrain demand, would make GPs an increasingly cheap commodity. Now that policy has reached its logical conclusion, with a demoralised profession and another recruitment crisis. Pay freezes may go down well at the Daily Mail, but at some point ministers will have to bow to economic reality and start paying the going rate.

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