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At the heart of general practice since 1960

'I don't want fly-by-night salaried GP'

Job adverts for salaried GPs are far outstripping those for principals, research by Pulse has revealed ­ Ian Cameron

talks to four GPs who have advertised in our jobs pages

about their practice's recruitment reasoning

Uncertainty on finances would put partners

off new role

Dr Phil Koczan says financial uncertainty is the prime reason his practice wants to take on a salaried GP rather than another partner.

His practice in Chingford, Essex, is taking over a neighbouring practice on a franchise basis and the new recruit will cover sessions there.

Dr Koczan says he and his partners cannot tell at this stage how the finances of the new practice are going to stack up and an incoming partner, they felt, would be unwilling to take on the potential risk.

'Taking over a separate practice, our finances are not certain initially,' he says.

'I think that uncertainty would put people off.

'Getting a new partner who may not be right for the practice, and where you are asking for a big financial commitment in an area they may not know, can also be destabilising for both the new doctor and the practice,' he adds.

Advertising for a salaried GP means they can guarantee an income for the new recruit and any loss, if there is one, can be swallowed by the existing partners.

Dr Koczan also believes a salaried post enables the practice to create a career structure, with varying degrees of responsibility and financial risk, that would not exist if every GP was a partner.

He says: 'Rather than coming in on day one as a partner a better option is to have a

career progression.'

A salaried position will also allow both the new doctor and the practice to decide if they fit in before a commitment is made to an equity stake.

Young GPs are not interested in becoming principals

Dr Gopal Agrawal believes bringing in salaried GPs is 'the only way', given the current climate of insecurity over the future of the NHS and the lack of interest among younger doctors in becoming a principal.

For his two-partner practice in West Bromwich, money is also an issue.

Dr Agrawal says his practice needs an additional GP to cope with meeting rising patient expectations and demands for faster access, but it cannot afford to take on another partner. 'With all these changes you don't know what you are doing,' he says.

'There are so many hidden Government agendas, and too many rules and regulations that keep changing. There's no stability.

'I've not got a clue what the future will be so I cannot commit the practice to another partner ­ I don't know

myself whether I will be working as a GP,' he adds.

'The younger generation don't want to commit any investment because the Government doesn't guarantee any future for them. A salaried GP is the only way.'

Practising risk reduction and offering female GPs flexibility

Recruiting a salaried GP enables you to 'play it by ear', Dr Jane Mann says.

Her practice in Highnam, Gloucestershire, is expanding but wants to take it slowly

and see how things work out before committing to a new partner.

'Because we are expanding rather than replacing a partner it's easier to play it by ear and see what we really need with a salaried doctor,' Dr Mann says.

'It's an element of not really knowing what the financial scene is and it also gives us a chance to get the right person.'

She adds that the policy also recognises the changing nature of general practice, with an increasingly female workforce preferring to work flexibly without the financial commitment of a partnership.

'We are uncertain about the future ourselves,' she says.

'We don't know what the Government will spring on us next or whether they will pull the rug out from under our feet.

'There's no certainty like there used to be, but it would be different if someone was retiring ­ then we would recruit a partner.'

In a village you want a partner, not 'fly by night' salaried GPs

Dr Stuart Findlay says he does not want any 'fly by night' salaried doctors at his rural practice in Haddenham, near Ely in Cambridgeshire.

He wants a partner who is committed to the practice,

to the village and to its

patients.

'We want someone to buy into the practice, willing to commit to the practice both professionally and financially, who is not just in it for the bucks. It might seem old-

fashioned and trite but, living in the village, I can't escape the fact I actually live with my patients,' he says.

'A lot of salaried doctors move from practice to practice ­ that's no damn good.'

Dealing with patients, Dr Findlay says, is the easy bit, so bringing in a salaried GP would do little to ease the

administrative and staffing issues that take up a lot of his time.

With one of three existing partners leaving, neither do Dr Findlay and his remaining colleague want to shoulder the extra financial burden of buying them out.

Dr Findlay admits his chosen course of action makes things tougher so he is advertising with a start date of April 2006.

The practice, which describes itself in the straight-talking ad as 'free from

artificial flavours and preservatives', is even prepared to pay for locum cover to enable the potential recruit to work in the practice for a couple of weeks and be sure they are the right person for the job.

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