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GP leaders reject call to explore salaried only status

GP leaders have rejected a motion for the GPC to explore a move away from the independent contractor status.

In a heated debate at the Special LMC conference, GP leaders presented arguments for and against a future where all GPs would be salaried to the NHS.

The motion suggested that because ‘many younger GPs currently prefer to be salaried rather than partners’, the GPC should look at ‘future contractual models’ which ‘explore all options including movement away from independent contractor status’.

Presenting the motion, Buckinghamshire, Berkshire and Oxfordshire LMC chief executive Dr Paul Roblin said it merely suggested the GPC explore all options. Despite this, there was strong sentiment against the proposal.

Dr Roblin said the time had come to explore the fully salaried option because ’many GPs now prefer employed status’, quite unlike the sentiment following the introduction of the 2004 new GMS contract, since which GPs have been ‘portrayed as fatcats’ by politicians and the media.

He said: ’So we have seen a change, and the key issue for me is that partnership has become unpopular – being an employer is unpopular – for all the reasons that I think we all know too well: difficulty in recruitment, bureaucracy, annual changes to the contract and overregulation and the degree of risk that becoming a partner entails – particularly committing to building leases, committing yourself financially.

’For all these reasons, younger doctors are wary of seeking partnership and the older doctors are exiting the profession at a rate I have not seen before in my life.’

Also speaking for the motion, Dr Thomas Micklewright from the GPC education and training subcommittee said he had ’no intention of becoming a GP partner in my lifetime’.

He said: ’As it stands, as I see it, a salaried service could provide contractual limits on unsafe working conditions. It could allow for investment in post-CCT training with paid study leave equal to secondary care doctors, and would force politicians to finally take responsibility for the workload crisis that they have created.’

But speaking against the motion, Doncaster LMC medical secretary Dr Dean Eggitt suggested the mere suggestion was a ‘bomb’ that would explode and abolish general practice as the ‘bedrock’ of the NHS.

He said: ’We are not fighting for our livelihood but for the health of the nation, and this motion is a hidden bomb to that bedrock… To actively participate in a move towards a greater salaried model is not only the active giveaway of our goodwill and efficiency that is keeping the NHS afloat, but is the giveaway of our colleagues to private providers.

’Let’s call this motion for what it is, it is a move towards en masse, giving away of elf-employed status and becoming salaried to whomever is left, and loss of the efficiency and goodwill of the system.’

It is not the first time LMCs have voted on the possibility of all GPs going salaried, with the option of retaining the independent contractor status also being favoured at previous conferences.

However, a recent Pulse survey suggested that GP support for a move to a salaried service is increasing, with 26% now in favour and just over half (54%) opposed.

Ahead of the conference, the union Unite said in a statement that its GP members would be ’supporting the motion that asks the GPC of the BMA to investigate expanding the salaried GPs sector as the best way of stopping health secretary Jeremy Hunt imposing detrimental contractual changes on the GP profession’.

GPs in Scotland are already moving ‘as close as possible’ to a salaried service as part of the devolved health economy’s new contract model.

The motion in full

OXFORDSHIRE: That conference believes that many younger GPs currently prefer to be salaried rather than partners, and that in looking at future contractual models, the GPC Executive Team should explore all options including movement away from independent contractor status.


Readers' comments (9)

  • These dinosaurs need to ensure that they can offload their leases and staff redundancies onto poor unsuspecting younger doctors. Except that the younger generation isn’t as gullible as that. It really doesn’t matter what the LMC says on this one as young doctors are voting with their feet and simply not applying to become partners. Good for them!
    And for those unfortunate enough to be partners, now is the time to leave.
    Ditch the contract comrades!

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  • Vinci Ho

    I am not sure whether this motion carries any meaning?
    Do you think Agent Hunt really care about which way it goes?All he cares about is this government will gain the most in political capital from the eventual terns and conditions , one contract or the other. Junior doctors are salaried employees and they are up against these politicians who fundamentally show no respect in the whole medical profession.
    That is exactly the reason why the details of so called package is not to be announced until next month. Eh! That is entirely targeting these notions of this conference and they want us to look really stupid in voting for our future unilaterally.
    Clearly , Chaand,it is only a fine line between negotiation and extortion ........

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  • What planet are the supporters of continuing self employed status on? Being a partner means that you must personally invest in a small business with rising workload (outside of your control), rising costs (outside of your control) and falling income (outside of your control). You take responsibility for managing the entirety and therefore personally must do whatever it takes to ensure the work is done so hence the situation we are in now of 14 hour days with no breaks for less pay than we had 10 years ago. What type of union do we belong to, would any other union fight for the right to have its members exploited in this way?
    They seem to be clinging on to some rose tinted vision of what GP's do for the NHS as a result but neglecting the welfare of GP's. If we were all salaried, the NHS would have to find a way of managing the work that we do and to find a way of paying the right number of people for the necessary hours to do it. Individuals would not be responsible for the service, organisations would be and as a result it would be more secure and sustainable. Individual GPs could work in an environment that was structured and supported, be allowed to concentrate on being a clinician, just as our consultant colleagues do. I envy their predictable workload and even more their predictable income as I have neither. Being a partner was the worst decision I ever made, I have been salaried and have never done anything other than work hard, as a breed we are conscientious and will do what we have to do.
    I would rather the government ditched negotiating with the GPC, a group of folk of a certain age with a very outdated outlook, and started to talk to large organisations and younger GPs with a positive vision for how out of hospital care could be delivered in a way that is better for both patients and it's workforce.
    This is the General Practice Kodak moment..... let's keep making films guys, digital will never catch on....

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  • To Anonymous | GP Partner30 Jan 2016 3:34pm
    You couldn't have put it better. Don't wait for that lot to sort it out. I resigned from my partnership and it is the best thing I could have done. It was one of the most, nay, it was THE most liberating thing I have ever done.
    Individuals need to do what is right for them and leave all the old cardigans holding their staff liabilities and leases.

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  • Being a GP partner is the worst of all worlds, self employed but without any of the benefits, a ceiling on earnings and working whithin a highly prescriptive framework.
    Unfortunately, being salaried is unlikely to be any better.

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  • The big problem with a totally salaried service [as I see it] is that employed people do not kill themselves over their service.
    That sounds like a stupid comment but why would any employee put his/her health at risk over something they don't own? Quite rightly they would not.
    I am not suggesting that killing oneself over ones business is desirable but I use the term to describe the absolute sense of ownership a partner feels and this leads to benefits for all [ Doctors Patients and government].
    What the government [and then further down the road the private companies] is missing is that if you dilute the commitment of the principals in practice you will set the scene for a bronze standard delivery when it could have been gold. The best part of the worst of this is will that it will be more expensive to provide this bronze standard service.

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  • Unfortunately GPs complain of the current dire work life situation, but then reject even considering possible solutions. We are our own worst enemies!

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  • I applaud GPs for considering and debating this, and as it happens i agree with the result.
    For the sake of patients, the health of the population, and cost-effectiveness, GP partners are much better. Salaried GPs move from job to job (when you are young you want to be in the city; young children - move to the country etc) and patients don't have time to build up a relationship of trust. Less trust = less likely to unload little worries = develop medical illnesses with corresponding costs.
    GPs and primary care provide the vast majority of care and patient contacts. What we really need is better funding in primary care and services aligned around GP practices. More money means that GPs can afford to employ that extended primary care team that frees up GPs to do the things that noone else can do.
    So there's an easy solution. Pity it is one that #unt won't countenance.

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  • Having been an employee in 3 different GP led partnerships over the past 12 years i agree that GP's should become salaried and be clinicians, not managers which most are not trained or skilled to be.
    Many PM's have merely stepped up from being on the front desk and lack management or HR skills so GP's are trying to juggle admin management, HR, finances and payroll, staff recruitment etc etc with everything else they are expected to do and the result is huge stress, poor management and staff retention issues.
    We should use the skills we have been trained and are qualified to use and stop trying to do roles for which we are not equipped.
    One practice i worked in had a PM with an MSc in management. She was a force to be reckoned with but the practice is very successful, is always well staffed, have no recruitment issues, always meet targets with high levels, always seem to have up to date equipment and even hand out £50 M&S vouchers to all staff at Christmas! A PM well worth her money.
    Sadly, most GP partnerships won't pay out for decent staff so try and 'get by' and are failing.

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