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Gold, incentives and meh

GP leaders to vote on support for fully salaried GP profession

The GPC could negotiate a new contract with Government under which GPs give up their independent contractor status and all go salaried, LMCs have suggested.

A motion to be presented by Oxfordshire LMC at the emergency LMC Conference at the end of the month suggests 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’.

Although the Oxfordshire LMC motion is the only one scheduled for debate, several LMCs suggested similar motions to the agenda committee.

This included Mid Mersey LMC, which proposed a motion saying ‘that the days of independent contractors delivering safe and sustainable general practice are coming to an end and calls upon the GPC to actively support the development of a salaried GP service’.

LMCs have voted on the topic before but the motion to move to a fully salaried service has always been voted down.

A Pulse survey of over 600 GPs last autumn found that support for a fully salaried model of general practice is growing, with 26% now in favour. However just over half, 54%, remained opposed. 

The motion follows similar calls by former RCGP chair Professor Clare Gerada and NHS England in London, while NHS Hull CCG has also looked into plans for developing a fully salaried model - which it later discarded,

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.

Read the agenda in full here

Readers' comments (57)

  • I think most GPs are just in complete denial that the game has changed. Patients no longer care about 'the doctor patient relationship', they only care about what they want and only act how they do to get it. They are only out to get what they want and have no respect for us, even the ones that say or pretend they do- why else would they demand home visits when they are perfectly able to leave the house? Why else demand appointments immediately for trivial nonsense? And these are the ones that pretend to respect us.

    If they respected us they wouldn't do these things.

    as others have said, continuity of care is just another word for dependency. You get continuity of care by actually reviewing notes and not by simply knowing the patient for 30 years. Yes it's easier to say no to a drug seeker if you 'know them', but then it's not really that hard if you just say no and stick to it and they will leave.

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  • Too much tree hugging nonsense in general practice. Continuity of Care is over rated.

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  • The BMA Salaried GP scale is £55412 to £83617, model GP contract. However the consultant scale is £75249 to £101451 with a top up excellence award of between £2957 and £75,796. This to me means an actual pay scale of between £55412 and £177247. Please correct me if this is wrong. If you look at press releases consultant pay can be much higher than this.
    Why can’t a Salaried GP force have the same consultant pay scales?

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  • To the last few comments- Some of you have touched on the crucial issue which is the notes. "Continuity" best suits those doctors who keep such poor medical records that only they really (if they can remember) know what is going on.
    I have worked with these doctors. They are often well loved by their patients but keep inadequate notes, take weeks to deal with admin and seem to almost enjoy the chaos which they create by their selfish ways of working. Perhaps it boosts their ego and makes them feel important as they know people just have to work around them and make allowances.
    Anyway if we are (and we are!) going to have 8-8, 7 day working, continuity will go out of the window. We will see increasing cross-cover and hub working. Only by sharing the record can this be achieved and I am already watching the panic in my locality of many of these rubbish doctors who refuse to share the record and are desperately trying to use patient confidentiality as a reason to protect themselves from the scrutiny of colleagues. It will be interesting to see how federated colleagues deal with the situation where they find substandard care. Let’s see candour and transparency at work!

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  • Having read the above comments - I for one can't wait for the day the current massive need for locums comes to an end. And before anyone bleats- I know that will be along time coming with current mantra of it's all about "supply and demand, dictated by market forces" blah-dee-blah-dee-blah.

    It would seem that locum work is the 'dependency' that many GPs are being fed is the way to a utopian existence. In fact in our present predicament it is just the outcome of dysfunctional system. If we all decided to 'do it solely for the money' and forget about the silly bits like 'admin, meetings, pathology results' why not train to be a banker, and be a first aider at weekends. I would have said paramedic or A+E doc if 'whizz bang wallop, in and out' is what medicine should be for you, till I remembered that silly bits like 'admin, meetings, pathology results' is part of their responsibilities too!!

    To some continuity of care has a purpose, to others clearly not. Each to their own, but it seems that we are in danger of throwing the baby out with bath water if attitudes persist that this fundamental aspect of GP'ing is diminished in the quest to 'earn a few more bucks'.

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  • Anonymous | GP Partner17 Jan 2016 12:23pm

    I am one of those mercenary locums who you might think does not want to do the extra stuff. I do not consider these items of work to be silly at all. Quite the opposite in fact. I object the complete lack of recognition of the massive workload all these bits represent and the fact that partners are not properly remunerated for them. If someone wants to pay me to do their repeat script reviews or sort out their admin then I'm good to go. The trouble is that nobody in power or leadership seems to place appropriate value on this work which they trivialise.
    I am genuinely sorry if, as a partner you feel got at by people like me, it is not my intention. It is just that these extra tasks are almost exclusively associated with the drudgery that partnership entails.

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  • Society has no more good will. And why should it when resources are overstretched and the most trivial nonsense is medicalised?

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  • Its those cardigan wearing pseudo-martyrs that we need to get rid off.

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  • No we don't want to get rid of them at all. We need a few people who wish to fight to the death. Who else would be prepared to be the last man standing holding the obsolete 25 year lease and paying the staff redundancies?
    Just watch, the next 3-4 years will be a competition to see which partners can jump ship the quickest. Its like a game of pass the parcel with the prize being bankruptcy.
    Your turn...

    Ditch the contract comrades!

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