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Gerada: We need to move on from GP partnerships

GPs need to forget about the partnership model and look at new models of organising their practices, such as federations, says RCGP chair Dr Clare Gerada.

In a sometimes heated discussion over the lack of partnership opportunities for salaried GPs, Dr Gerada urged GPs to stop talking about the partner/salaried divide, saying that model belonged to the last century.

Delegates attending a ‘Partnership Debate' at the RCGP annual conference backed a motion that the profession was doing new GPs ‘a disservice with a lack of partnership opportunities', but RCGP leaders urged the profession to think more laterally about how the profession is organised.

Dr Gerada, a GP in Kennington whose group of practices employs around 100 salaried GPs, admitted the partnership debate was 'complex' but argued that a ‘new model' of general practice was needed in the 21st Century.  

She said: ‘I think we should stop talking about the salaried/partnership divide. I think we should start talking about federating – joining and collaborating across practices, sharing expertise and resources.'

‘While the partnership model may be the model for the 20th Century I think we need to move on and find a new model.'

Dr Richard Fieldhouse, a GP in Chichester and chief executive of the National Association of Sessional GPs, said GP trainees needed to be educated in other models of working. He said the ‘chambers' models of locums working together was an example of how the concept of ‘partnership' could be provided in different models.

However, other GPs disagreed. Dr Colin Hunter, a GP in Aberdeen, warned that ‘GPs are doing the NHS and patients a disservice' by offering less partnerships. He acknowledged that changes to the GP contract in 2004 and current cost pressures have seen growing numbers of practices, including his own, replace retiring partners with salaried GPs.

Dr Hunter said: ‘We are doing the NHS and patients a disservice by diminishing partnerships. It is not just the importance of independent contractor status, it is the culture and model of partnership that glues the NHS together. The reason primary care works in the UK is to do with the partnership model.'

Dr Peter Deveson, a GP partner in Epsom, Surrey, said the RCGP had been ‘found wanting' in its responsibilities to new GPs. He said his experience as a salaried GP had seen him feeling ‘disempowered and disenfranchised' and warned that the growing split between salaried GPs and partners put the profession at risk of attack.

He said:  ‘The RCGP has been found wanting in its responsibilities to doctors languishing in the bottom tier of a two-tier system,' Dr Deveson said. ‘I personally didn't feel exploited working as a salaried GP but I did feel disempowered and disenfranchised.'

‘We're missing a trick by not providing those GPs who want to be partners, the opportunities to do so.  The split between salaried and partners is dividing the profession at a time when we're increasingly under attack.'

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Readers' comments (1)

  • It is always fashionable to go for new ideas and christen it as system for the new century. Kensington is not the typical world for GPs and its one model is not valid for very rural practices. Federation and Chambers are not a good substitute for the proven system of partnership, unfortunately tinkered with and affected by the New Contract.

    Before the New Contract, basic practice allowance, in the scale of 25% to 100%, over 4 years, were paid to the surgery when a new GP joined. The incentive was to make partners. New Contract and tinkering by PCT and relinquishing its control mean that Surgeries did not feel the need to take partners. Salaried GPs also felt they had flexibility and avoided taking partnership. Both sets of GPs have created the present situation.

    The current problem is solvable but PCT needs to take some stringent measures. Deduct payments from those surgeries who do not take a new GP as a partner. Money talks and this would force the change. Try to eliminate the Salaried GP sector. If a person has qualified to be a GP to practice in UK, then the person has to aim to be a partner from day one.

    Try to fix the problem, no point running away to new system

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