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Government 'needs to take control of GP recruitment', GPs warn

By Steve Nowottny, Andrew Bracey

GP leaders want the Government to take central control over which practices are allowed to recruit new doctors, to tackle health inequalities and the desperate shortage of partnerships.

A central committee would have powers to recommend funding for new partnerships in underdoctored areas and to veto practices' attempts to advertise vacancies in areas judged to be ‘overdoctored'.

Senior figures at the GPC are calling on ministers to re-establish a national body to oversee distribution of GPs, along the lines of the Medical Practices Committee, which was abolished in 2004.

GPC chair Dr Laurence Buckman told an RCGP conference last week that it was essential to address the shortage of partnership opportunities and ensure GPs were spread more evenly.

‘The number of GPs in any area must meet the population needs. This was controlled by the MPC, which forced doctors into areas of most need.

‘Workforce planning by the Government is the answer to this. We need another MPC.'

The controversial call comes after a series of talks between the GPC and RCGP over how to tackle plummeting numbers of partnerships and increasingly limited opportunities for newly qualified GPs.

Dr Clare Gerada, vice chair of the college, said workforce planning and a change in funding arrangements was essential to attract new GP partners to areas that needed them.

She said: ‘We hear of 120 applicants for one job in London and then one job in Cumbria that could not be filled.

‘We now have a single budget for staff – there is a disincentive [for taking on partners] – so we need a review of how staffing budgets are allocated.'

Under the previous MPC arrangements, practice funding was linked to the number of GPs at a practice rather than the number of patients.

GPC negotiator Dr Peter Holden said a wholesale shake-up of funding was unlikely but that changes to workforce planning were needed.

‘Many of us wondered why the MPC was demolished in its day. It was a very 1940s paternalistic system, but it worked.'

Salaried GPs would also have to adjust their expectations in order to secure a partnership, he warned. ‘Among some colleagues we see an unwillingness to settle down outside where they want to be. Some people think they can't live anywhere other than London.'

Dr Andrew Mimnagh, chair of Sefton LMC, backed the idea: ‘It would be better having some idea of national input rather than being subject to the vagaries of NHS administration.'

But Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs, said he opposed attempts to ‘artificially manipulate the market'.

‘The BMA is behaving like a spoiled parent who won't let go. It has a 30-year-old child that it is still dressing in nappies.'

A Department of Health spokesperson said the recently established body NHS Medical Education England would ‘provide an opportunity for the DH, doctors, dentists, pharmacists and scientists to work together to tackle professional training and medical workforce needs'.

RCGP vice chair Dr Clare Gerada RCGP vice chair Dr Clare Gerada What was the Medical Practices Committee?

• Established in 1946 to ensure a fair, even distribution of GPs across England and Wales, the MPC identified ‘underdoctored' areas and had powers to prevent vacancies being advertised in ‘overdoctored' areas

• Under the MPC, funding was linked to the number of GPs at a practice rather than the total number of patients – providing an incentive to replace a departing partner

• The committee was abolished in 2004, partly because ministers felt it was failing to make a difference in some persistently underdoctored areas – and partly because of the acute shortage of GPs across the country

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