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Independents' Day

GPs' independent status may change under Labour, says Burnham

GPs’ independent contractor status could be reviewed if the Labour Party wins at the next election, shadow health secretary Andy Burnham has suggested.

Speaking at the NHS Confederation conference in Liverpool today, Mr Burnham said that the traditional ’boundaries’ between primary and secondary care must be broken down and GPs would have to be ‘open’ to modifying their independent contractor status.

Mr Burnham said that the time had come to shift health professionals’ loyalties from ‘organisations, buildings, or professions’ and instead focus on the local population.

He told the conference: ‘There are of course implications here for professional practice and medical training.’

‘After decades of focus on specialisation, the time has come for a new emphasis on generalist care, on generalism. And I see the need for a new generation of generalist doctors and physicians, working in our communities. Not pigeonholed as a primary care generalist, or a hospital generalist.’

‘But working across the boundaries, and yes that might mean being open about changes to independent contractor status for GPs.’

Former chair of the RCGP Professor Clare Gerada caused controversy last year with her suggestion that GPs should relinquish their independent contractor status.

But GPs reacted overwhelmingly against the suggestion, including her successor at the college, Dr Maureen Baker, who said that independent contractor status was ‘very helpful’ for GPs, while the GPC said moving to such a model could ‘emasculate’ the profession.

A survey of GPs after Professor Gerada’s suggestion revealed that three-quarters were against such a move.

GP leaders have said the debate over independent contractor status was a ‘red herring’ and that the secretary of state should focus on bringing hospital consultants into the community.

GPC deputy chair Dr Richard Vautrey told Pulse: ‘The reality is that you don’t want to get bogged down into changes to the GP contract, to improve the way GPs and specialists collaborate with one another. ‘

‘I think we run the risk of losing the impetus around engaging and collaborating if we start to focus with GPs on organisational structure.’

He added: ‘The thing preventing [consultants from working more closely in the community] are the barriers. Often the ones management puts in place because they’re fearful that by developing community based services, they’re in some way undermining their own core business.’

‘It’s about competition between providers, and it needs to be overcome. The independent contractor status is a red herring as far as that’s concerned.’

The Labour Party proposed re-introducing a 48-hour target for GP appointments last month, which Mr Burnham told Pulse could be made a contractual requirement.

Readers' comments (62)

  • There is a fantasy about "resistant wealthy GPs". The truth is the opposite. Let's all go salaried, be subject to the working time directive and have paid sick pay, employers pension contributions and much less responsibility!! Bring it on.
    Where do I sign??

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  • So on one side he says "shift health professionals’ loyalties from ‘organisations, buildings, or professions’ and instead focus on the local population"

    But at the same time he wishes to concentrate on changing the contract status of GPs? How is that a focus on local population?

    All this tells me is primary care is screwed regardless of who wins the next election if we rely on politicians to make the right change. Time for grassroots to act I think.

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  • Have just been going through the salaried GPs contracts I think we could do very niceley, 37.5hours/ week, 4 hours a week private study/ professional training, 30 day holiday, plus 10 bank holidays,
    Why am I a partner? - bring it on!!
    48 hour access will be the provider's problem not the GPs

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  • Or we can all become locums - as they will not be able to recruit - and earn more than principals do now?!

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  • I as a partner have seen/ will see about 150 patients in person at the surgery this week.
    I will spend close to 5 hours doing home visits.
    This works out to be 30 hours. Add in my 30 minutes each day for lunch and 4 hours study leave and my 37.5 hours is done.

    Not quite sure who will look after my blood results, phone calls, scan results, letters, write my referral letters, do my QOF work and write all my comments onto pulse.

    At least that will be someone else's problem. This will shift demand management away from the GPs and onto the government. It will also reduce any incentive to stick to prescribing budgets, referral targets, admission targets and so forth.

    GPs will all get their buildings back to redevelop as they see fit. They will liquidise their other capital investment. I will probably make 20k/ year out of mine.

    For the sake of the people I hope they trial it in a small area first. See the balls up it creates then cower away in a dark hole and pretend they never suggested it.

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  • PG,

    Only problem is, BMA will just cave in at the point of partnership disappearing and dissolve it's "model contract". Even if BMA doesn't cave in, the government will erase the GMS contractual obligation to provide BMA model contract.

    So you'll be working 37.5 hours (which includes unsociable hurs on a shift), no private study, 30 days holiday including bank holiday and probably for 50k/year (I'm not kidding, if an APMS is run a cost effective GP unit, bearing in mind they'll have to ffot the bill for indemnity, employer contribution of pension and sickness cover etc and still make profit, I recon it'll have to be around 50k/year. Which is £25/hour, about same as employing a specialist nurse!).

    Or even worse - we'll have to sub-sub contract from subcontractor as self employed. Even less autonomy and drawings!

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  • If people honestly believe they will get an ideal BMA contract they are deluding themselves . 70 k tops for a 50 hr week because that's what they're getting with the current arrangements . To the average person this sounds fantastically generous because it's well known that all we do is treat a few coughs and colds and refer everything else to A+E.

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  • Thanks, Mr Burnham. I look forward to the cheque for buying my building, equipment and furnishings, and working a EWTD week. with Childcare and a company car. oh and paid study leave. and overtime. and no management responsibility unless I get a managers wage on top. and considering my experiance I expect a wage of equivelent of the top band NHS employees. And can I also now treat patients privately as I will have a lot more time due to the EWTD, so I can earn as much as some Consultant colleagues do?
    Oh and employees rights, so that I get sick pay and the right to take my employer to a tribunal if I get covered in blood from a patient at 3 am as you did not provide the appropriate safety gear. And I also look foward to my employers going through all our rigourous inspections. Oh and I need even more time off now to prepare and then have my appraisal. And while I remember will no longer have to fork out 5k a year for My defence subs, as I would expect you to pay that now.Thanks again . Oh wahts that, youv`e costed it now ? and you can`t afford all that? In that case Australia here I come.

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  • Vinci Ho

    Predictable. Nothing new.
    You wonder how much 'homework' has he actually done before this speech .Rhetotical ? Realistic ?
    Probably he just picked up from where CG let behind....

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  • Nothing will happen before the election and afterwards it will be like trying to resuscitate a corpse

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