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At the heart of general practice since 1960

Government must be laughing at our disarray

To say that these are difficult times for general practice is a masterly understatement. The importance of us sticking together, therefore, cannot be greater, and all that can be done to reconcile the differences between our two groups should be done.

I see no conflict in the role of the BMA in representing both salaried GPs and their employing GP contractors. Representing both sides can only lead to a more independent stance in mediating in any discussion between the parties. Conflict can only be worsened if rival organisations become involved, each battling for their side with little regard for the other.

I do feel, however, that the BMA has taken its eye off the ball in this matter for some years now. If practices are to employ ever-increasing numbers of salaried GPs, then a robust and properly thought-through model contract is required.

The current model BMA contract is a joke, and I have argued in the past that it must be completely rewritten with the interests of both parties in mind. Some clauses might cause pain for practices, such as extensive sickness absence pay, study-leave entitlements and so on. The GPC should negotiate with NHS Employers to pass some of these obligations over to primary care organisations in the form of allowances, which could be claimed in cases of prolonged illness of a salaried GP, for example.

Instead of seeing this matter as a threat to general practice, we should use it as a springboard to strengthening the profession. The Government must be laughing its socks off at the disarray we find ourselves in. It engineered this move to more salaried doctors to weaken our position and that's exactly the effect it's had.

From Dr Andrew Hamilton, GP principal, Unst, Shetland

I don't think the shortage of partnerships is simply a question of supply and demand. The situation is not that simple. A two-tier market exists for partners and non-partners, with the partners holding a monopoly as primary care providers.

It is virtually impossible for younger GPs to tender and compete for practices because of increased competition from large practices and private companies.

The current situation is untenable and it will either result in an end to partnerships or an abrupt about-turn in Government policy, which I think is unlikely. I don't perceive partnership to be the goose that lays the golden egg, but the lack of partnerships is hampering the professional development of young GPs, which can only be bad for us all in the longer term.

From Dr Gary Dyson, salaried GP, Bradford

It's time someone took the initiative to bring change.

The BMA seems to think it is indispensable and its position is secure. It publishes a glossy magazine to show the world how great it is. But when it comes to supporting doctors, it seems to shy away.

From Dr Kadiyali Srivatsa, salaried GP, Woking, Surrey

BMA house

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