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Jobs crisis requires deeds not words

As partnership posts dry up and four-fifths of vacancies advertised are salaried, what is to be done about the jobs crisis?

As partnership posts dry up and four-fifths of vacancies advertised are salaried, what is to be done about the jobs crisis?



The GPC warns it is the biggest threat to the future of general practice. Chair Dr Laurence Buckman claims an entire generation of GPs has been failed. He even suggests handing over control of GP job vacancies lock, stock and barrel to the Department of Health in a desperate attempt to fix the problem. But still the supply of partnerships dries to a trickle, and the profession shifts ever more dramatically in nature as the move towards a salaried workforce gathers pace.

If there were GP leaders who had not fully woken up to the issue, the latest Pulse figures will surely snap them into life. Four-fifths of advertised GP vacancies are now for salaried positions. That compares with just 37% back in 2003 – the last full year before the Government abolished the Medical Practices Committee and relinquished control over GP employment – and is significantly higher than even last year, when two-thirds of posts were salaried.

But that's not the only warning from Pulse's analysis of more than 250 job advertisements. There are real reasons to believe the supply of partnerships is getting not only weaker, but also more unevenly distributed. Back in 2003, 49% of partnerships advertised were in postcodes classified as relatively deprived. Over the past two years, the equivalent figure was just 30%. If the Government's equitable access scheme has had any success at all, it is one based on ramping up the supply of salaried doctors in deprived areas, whereas partnerships increasingly look like a luxury that few areas – or practices – feel they can afford.

Unlikely to help

The GPC's call for the Department of Health to step in always looked slightly outdated in the cut-throat new world of the NHS market, and seems destined to fall on deaf ministerial ears. The Government has, after all, always found GPs' independent contractor status something of a nuisance. A profession of compliant and ever-so-slightly fearful employees would suit ministers just fine, and they are unlikely to bend over backwards to sort out a problem largely of the profession's own making.

Negotiators have been brave in their words over the partnership problem, but now they need to be brave in their deeds.

Next time they sit down at the table with the DH for negotiations over the GP contract, they have to insist on restoring the link between payments and number of partners. If even the profession's leaders are not prepared to place a value on partnerships, it is naive to expect ministers, or individual practices, to do so.

Pulse editorial comment: Jobs crisis requires deeds not words

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