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At the heart of general practice since 1960

Older GPs more likely to vote No in contract ballot

A substantial minority of male GPs in their late 40s and 50s are the group most likely to vote No to the new GP contract because it is skewed in favour of young doctors, it has been claimed.

The prediction from primary care analysts and GPC members suggests a generous deal on pensions will be essential to satisfy GPs with more than 20 years' service.

One in three GPs are in their late 40s and this group could prove decisive in accepting or rejecting the contract.

Dr Steve Gillam, senior adviser on primary care to the King's Fund, said dissatisfaction was highest among older GPs.

'They might be less convinced, or more put off, by the contract. I know they have scaled down the quality framework but this might still be offputting for those who are set in their ways,' said Dr Gillam.

Dr Ron Singer, Medical Practitioners Union representative on the GPC, said: 'Older GPs are dissatisfied because they have seen the work get harder. They might look at the pension deal and say there's nothing in this to keep me on past 60.'

Dr Trevor Underwood, a GP in Reading, said a No vote was most likely to come from 'male, middle-class, premises-owning, employer GPs' because the new contract was skewed in favour of GPs wanting a flexible career.

He added: 'I feel the negotiators have given insufficient weight to the position of the established GP principal, who currently feels disenfranchised by the GPC.'

GPC member Dr Kailash Chand said the pensions deal was 'very, very vital' to stem the tide of older GPs leaving the profession.

The GPC has repeatedly promised there will be no new contract without a satisfactory pensions deal, but it has still not agreed on the issue of pensions dynamisation.

Dr Brian Balmer, chief executive of Essex LMCs, said it was equally important to secure the support of non-

principals who were mainly young GPs making up almost 15 per cent of the electorate.

Dr Peter Harvey, former chair of the GPC's non-principals sub-committee, said non-principals might vote No because removing the basic practice allowance would discourage practices from offering partnerships to locums and assistants.

Length of service %

Under 5 years 12.1

5-10 years 18.0

10-15 years 22.8

15-20 years 18.3

20-25 years 14.8

25-30 years 8.9

Over 30 years 5.1

Type of practice %

Inner city 13.2

Urban 30.6

Suburban 32.4

Rural 22.6

Isolated rural 1.2

GP categories %

Principals 86.3

Non-principals 13.7

PMS GPs 30.0

GMS GPs 70.0

Singlehanders 10.0

(England)

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