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A faulty production line

Three-quarters of GPs would reject switch to salaried profession

Exclusive The vast majority of GPs do not believe the profession should give up its independent contractor status, in a comprehensive rejection of the RCGP chair’s call for a salaried profession.

A Pulse survey of 523 GPs found 76% do not believe GPs should give up their independent contractor status and become salaried to the NHS, only 14% said they did support such a move, and 10% did not know.

It comes after incoming RCGP chair Dr Maureen Baker rejected the proposal alongside GPC negotiator Dr Peter Holden.

But the idea - floated by RCGP chair Professor Clare Gerada earlier this month - was backed by prominent GP academic Professor Azeem Majeed.

The survey was carried out over the past week on the Pulse website, and involved 523 GPs, including 74% partners, 13% salaried GPs, 9% locums, 2% GP registrars and 2% private or other GPs.

One GP partner, who rejected proposals, expressed the concern that GPs would ‘then just become a service industry with a service mentality’. Another salaried GP, also against proposals, added: ‘We are our patients’ last ally. We need our independence.’

But one GP partner said: ‘General practice has changed and is changing beyond recognition. I strongly support Clare Gerada in her proposal to abandon independent contractor status, especially if we are increasingly a pawn in a political game.’

Professor Gerada said that she was glad that ideas over the alternatives to the independent contractor status of GPs were being explored.

She said: ‘I think what this survey tells us, and what my view would be, is that there could be no single, top-down solution. What I think it shows is that we need to continue exploring options, and that what really matters now is all of us getting together, whether salaried or independent contractor, and sort it out.

‘Because my worry is that the solutions that we are hearing about are not going to be favourable - wholesale [foundation trusts] employing GPs. Whilst I think foundation trusts could employ GPs in certain circumstances I certainly don’t think the solution is selling out the jewel and the crown of the NHS, which is GPs.’

Professor Gerada added that the model she was talking about was GPs becoming salaried to a GP-led organisation rather than a foundation trust.

She said: ‘I think every five years it is important to test [ideas] out. Where I think it all got a bit muddled is that I am not talking about GPs being salaried to foundation trusts, I am talking about being salaried to a GP-led organisation which means having a mixed model.’


piechart salaried GP survey Q

Source: Pulse survey of 523 GPs

GPC deputy chair Dr Richard Vautrey said that he was not surprised that some GPs supported the profession giving up their independent status, but that most understood the value of it.

He said: ‘I think you will find that there are doctors who, whatever their current status, have become completely fed up with the micromanagement of the current arrangements and the pressures from [NHS England] area teams, CCGs and others. What they went into medicine to do was to treat patients. I think that they would welcome getting rid of some of that bureaucracy and I think that is reflected in some of those comments.’

‘I think GPs really do understand the value of being their own boss to a degree and having the flexibility to run their practice the way that is appropriate, as independent advocates for patients.’

Readers' comments (28)

  • Vinci Ho

    So GP led organisation i.e. Federation (GPF) is the way forward , at least in London huh??
    All comments are welcome , especially single handed GPs in London .....

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  • Bob Hodges

    The sound of UK trained GPs giving a flying **** all the way over in Australia isn't exactly deafening.

    Rome is burning, lets put down the violins and start addressing the fact that in 2 years time we'll be tens of thousands of GPs short.

    That's what will kill General Practice and NHS with it soon after.

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  • Azeem Majeed

    I have listed arguments in favour of the current independent contractor model of general practice and in favour of a salaried service on my blog.

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  • Each GP should be able to decide for themselves. Once the NHS get them under their belt, there will be no end of expectations that only superman can provide.

    GP's are the NHS but somebody isn't listening!

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  • If GPs stopped being partners then there would not be the same commitment to doing the endless paperchasing as a partner would have whos trying to make the business successful and that means they would only need to do what was nessecary and would need to go that extra mile like they do now. I feel some doctors in my practice would like the burden taken off them if the salary was right.

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  • Ivan Benett

    A survey of Pulse readers isn't one on which to place any sensible policy

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  • That's you told Pulse!

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  • Why should that be so, Dr Bennett?

    I suspect such indifference to grass roots GP opinion will do little to improve the recruitment and retention crisis.

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  • To be honest, I wouldn't care. Moving to a salaried service would mean that I would leave on time, have sick leave and holiday pay and employment protection according to the EWTD. If this happens I'll happy down tools as soon as the clock ticks over. This will be another expensive mistake for HMG- they have no idea that the service is held together by good will and by GP Partners working huge numbers of hours.

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  • Ivan, you come across as a truly positive and idealistic person which is wonderfully refreshing but two questions
    1. How old are you?
    2. Where are the representative body of GPs who agree with you and why do they not comment on Pulse?

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