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Independents' Day

GPs vote to remain independent contractors

LMC leaders have voted against a motion suggesting all GPs become salaried, although a number of delegates voted in favour of the proposal.

The motion had suggested that the ‘model of the self-employed independent practitioner has been so eroded by the current contract and regulatory regime, that the GPC should be exploring the establishment of a fully costed and salaried GP service’.

Presenting the motion, Liverpool LMC vice chair Dr James Graham argued that although the model had served the profession well for a long time, the GP contract had now become so full of targets and practices riddled with so much regulation that the partnership prospect was no longer attractive to young doctors.

In addition, he argued, work was being transferred from secondary care, funding streams kept shifting and workforce planning has become difficult.

He said: ‘The work and time involved in running a small business and maintaining staff and premises detracts from the time we have to devote to our patients.

‘In many parts of the country there’s already a GP workforce crisis, with young doctors not opting to enter general practice and older doctors retiring early as this is becoming a job that we can no longer do long term or full time.’

He added that some areas ‘are already considering a salaried service through a local GP provider organisation or through the CCG’.

He said: ‘If a salaried service has the potential to alleviate some of the problems in primary care recruitment and retention then it is time for the GPC to at least explore the option.’

Speaking against the motion, Dr Rob Bailey, representing Cambridgeshire LMC, said: ‘Is that what you really what? I am a self-employed independent contractor. Yes it has been tough, and yes recruitment is harder than it has ever been.

But do I want to throw it all away and abandon the partnership model of general practice altogether? Do I want to work in a management-led rather than a GP-led organisation? The answer is no. Let us be clear. This is not something that we would ever have considered without the severe pressure we are being put under by Government.’

However responding to the debate, which saw a number of GPs speaking against the motion, GPC chair Dr Chaand Nagpaul said: ‘I would like to see this motion not as an either or but as a motion that unifies the profession, so that we actually can provide two contractual options including partnerships, but also give real value to those who want to work differently, because this is a time when we must pull together as a profession.’

Motion in full

LIVERPOOL: That conference believes that the model of the self-employed independent practitioner has been so eroded by the current contract and regulatory regime, that the GPC should be exploring the establishment of a fully costed and salaried GP service.


Readers' comments (6)

  • No to an All- Salaried model.
    No to an All- Partnership model.

    We want the system to continue rotting.

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  • I would not choose to be in the position of our hospital consultant colleagues with that castrated look in their eyes, whose professonalism and leadership have been undermined, undervalued and eroded by the modern management model in hospitals caught up in the web of the market economy of the NHS.

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  • We need a model that combines the control and influence of a partnership with the improved working conditions of being salaried. It is not an either or argument but we need something new or risk General Practice falling over and the government imposing a solution. Superpractices and federated practices are already happening despite the paucity of ideas and guidance from the GPC.

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  • The LMC has not come up with any useful solutions to address the current problems faced by General Practice with regards to recruitment, access, etc.

    Now the Government will spring into action and dictate the the profession what solutions they have to address the problems.

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  • I'm afraid the current contractual model has been shown not to be very good for the development of general practice nursing. The recent RCGP Survey showed variation in training and a massively aging workforce. It isn't just about GPs you know!

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  • This GP cabal of succubii feeding on the taxpayers' NHS has to be cauterized NOW.
    * Non-NHS employee GP controlled and run CCGs distribute £65 000 000 000 of NHS E funding, are pushing Hospitals into financial crisis by favouring the cut-price Private sector, using NHS ICUs as back-up.
    * CCGs being investigated over too close connections between NEDs and Private Providers
    * Evidence of bloated 'new' practice centres having been constructed, now lying only partly used.
    * Retention of the ''8 day notice to quit'' a practice on an ipse dixit basis.
    * Overzealous use of ''Three DNAs and you're OUT.'', without effective appeal.

    Outsourcing to the private sector of such an obviously integral part of our NHS is: outmoded; anachronistic; not 'evidence-based'; and indicative of the top-down attitudes of far too many operating in and around the increasingly lidless honeypot of our NHS.

    If GPs won't accept salaried status, NHS E should set up and run its own integrated GP Practices - starting with 24 hour, 365 day facilities attached to A & E Departments.

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