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At the heart of general practice since 1960

Scottish contract on a knife edge as GPs split 50:50 on new direction

GPs in Scotland are undecided about which way they will vote on the new contract, a Pulse survey has revealed.

The survey of more than 200 respondents over the past two weeks has found a split in the vote, with 33% of GPs intending to vote for the contract, compared with 32% against, with the remaining undecided. 

However, there has been an increase in GPs saying they will vote in favour of the new contract over the past few days after the BMA has been conducting roadshows on the implications.

Local GP leaders are meeting tomorrow (Friday 1 December) in Glasgow to discuss the contract, and if – as expected – they support the deal, it will be put out to vote for all GPs in Scotland afterwards.

But the Rural GP Association yesterday warned that the contract will lead to rural general practice in Scotland ‘facing extinction’, as their guaranteed funding will decrease.

The contract, announced this month, will see GP partners guaranteed a minimum annual salary of £80,000, a change in their role so they will lead multidisciplinary teams and a move towards the NHS taking over all GP premises.

Pulse’s survey revealed that attitudes seem to be shifting in favour of the contract ahead of the vote. In the first week, 26% said they were in favour of the contract, compared with 36% against; in the second week, 37% were in favour, compared with 24% against.

The chair of the BMA’s Scottish GP Committee, Dr Alan McDevitt, has said that this contract ‘is our best chance to save general practice’.

He said: ‘We talk about having GPs being GPs. You don’t have to be an entrepreneur to work in general practice. We want GPs to be clinicians most of the time.’

He added: ’I truly believe that this contract will deliver a better future for GPs in Scotland and their patients. It will allow GPs to continue to provide innovative local services tailored to the needs of their communities, whilst reducing business risk and workload pressures.’

Dr Chris Black, joint secretary of Ayrshire and Arran LMC, also gave his support to the contract, telling Pulse: ‘It’s going to be vital [to attract GPs]. When you speak to younger GP colleagues, they are apprehensive about partnerships and they like the idea of this model, which offers them more protection.’

However, there has been dissent, most notably from the immediate former chair of RCGP Scotland, Dr Miles Mack, who warned: ‘The autonomy GPs have to employ and manage their team appears will be lost in the new GP contract.

‘We will be giving this up with no assurance on workload control and T&Cs far short of those enjoyed by Consultants. Seems odd…’

And just yesterday, the Rural GP association warned that the contract will ‘give a significant boost to urban primary care at the expense of rural services’.

Its statement added: ‘The new funding formula will see cuts to rural NHS primary care services and around 90% of practices in the North of Scotland will see their allocated funding reduced by up to two-thirds. Although there is a promise of short-term funding protection in the contract, the detail of this has not been provided, and this uncertainty looks set to destabilize rural healthcare across Scotland.’

The Pulse survey also revealed that respondents were more positive about the effect of the contract on workload, rather than pay. Around 43% said it would have a positive effect on workload, with 22% saying it will have a negative effect. But only 19% said it would have a positive effect on pay, compared with 33% who said it would have a negative effect.

Survey results in full

Will you be voting for or against the contract when it goes out for ballot?

For: 33%

Against: 32%

Undecided: 35%

Has the BMA done a good job in negotiating this contract?

Yes: 33%

No: 39%

Don’t know: 28%

Click here to read the full results

Readers' comments (8)

  • Cobblers

    I suspect HMRC may take a view that Scottish GPs under this contract are employed.

    If I, as a locum, agreed to such terms I suspect IR35 would come into play.

    Bear that in mind those who wish to vote for this deal.

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  • They are only guaranteeing that we won't lose out on the global sum but other income streams are being cut and expenses (eg staff superann) continue to rise year on year. Pay stability is a misnomer.As senior partner I am now taking home significantly less than our registrar. Unless there is a dramatic turnaround, retiral seems to be the sensible option. I feel desperately sorry for my younger colleagues who took on partnerships in good faith. If you think the government here supports Primary Care then think again. Sadly I fully expect the profession to vote for the new contract as we don't do confrontation.

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  • Vinci Ho

    Without examining the circumstances carefully, being either liberal or restrictive will run into mistakes.
    As I wrote before , one size clearly does not fit all in here. The significant differences between city and rural practices must be respected.
    Clearly ,many Scottish colleagues are in favour of the changes targeted at workload and premises. But the terms and conditions pledged remain at the stage of ideology setting. Hence, a ‘yes’ vote will very much base on the assumption that one believes the GP forward view can materialise. Any doubts on GPFV simply breeds the conspiracy theory ,’the devil will be in small details.’
    It is phenomenal while UK ,as a country , is at historic crossroad where its fate in the rest of 21st century is at stake , the fate of our profession is subjected to a similar dice tossing.
    Twenty odd years ago , my senior partner told me (when I first started general practice in last century) that we would all ultimately turn ‘salaried’ as the state would fail to fund any more GP partner. Perhaps , the ‘prophecy’ is to be fulfilled one day in this century.
    One thing I keep telling myself is to fully respect the ‘votes’ of our younger colleagues because they are the ones who will look after me consistently in 10,15 years time . The waves in the front are always pushed upon by those behind. People like me will become history and our younger ones turn into the pillars to support this profession. Yes , some argue that could easily be an extinction of general practitioners once and for all . But one can only believe it is not over until it is over .
    Vote with your heart or your brain , your choice ........

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  • So the guaranteed funding for my practice amounts to £106 per patient per year, for unlimited access. I could not insure my dog for this, nor buy half an hour of my solicitors time.
    It’s hard to find a word that is not “unsuitable or offensive”.

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  • I would only consider this if the £80,000/year was for 40 hours/week with paid holidays and sickness benefit.

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  • There are good things here. MPIG is being incorporated into the global sum so no practices will have to worry about that disappearing.
    Leasing of premises hase been a big issue for some practices so removing this burden will be good.
    The £80K is THE MINIMUM a FT partner will earn- it is unconscionable that so many have been below this level till now.
    Other than that we will still be indeopendent businesses managing our own budgets and taking on staff so not likely that HMRC are going to change views.
    Doubts? Yes.
    Its going to take quite a while to grow all the phramacists/paramedics/physios/nurses to help out- if they can be grown at all.

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  • Please stop talking about £80000 "minumum" salary. It is nearer £70k amount with no maximum number of hours or holidays

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  • Is there not something wrong with offering 65% of practices an instant significant pay rise under the new formula, just 2 weeks before voting on it? Quite a challenge for the remaining 35% to make their voice heard with no union fighting their cause.

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