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Partner plan must not restrict practices

Late last year, GPC chair Dr Laurence Buckman warned the profession had ‘failed’ the next generation of GPs over its reluctance to offer partnerships.

Late last year, GPC chair Dr Laurence Buckman warned the profession had ‘failed' the next generation of GPs over its reluctance to offer partnerships.

He claimed the shortage of jobs was a much greater threat to the profession than private providers or polyclinics, and launched a BMA campaign to persuade practices of the value of expanding their partnerships.
Predictably enough, and by Dr Buckman's own admission, the campaign has not been a great success. Against a backdrop of economic crisis and successive pay freezes, persuading practices to take on new partners as an altruistic act was always going to be a tough ask.

So the GPC has come back with a much more radical set of proposals. Dr Buckman wants the return of the Medical Practices Committee, with the power to decide whether an area needs more GPs and where they should go, and to recommend funding to ensure a new partner is recruited or an old one replaced. The proposals could even dramatically shake up the way GP funding is handed out, and restore a firm incentive for employing a partner ahead of a salaried GP.

On top of that, the BMA's model contract is likely to be back on the agenda, with regulators keen that GMS practices aren't disavantaged when competing with other providers that have more freedom in the contracts they offer.

Righting the imbalance

On the face of it, there doesn't seem a great chance of the GPC's plans becoming reality.

The Government has placed choice and competition at the core of its health policy, and the BMA's proposed measures could be viewed as anticompetitive. Providers – whether private companies or GP practices – could reasonably argue that whether they need a new doctor, and how much salaried employees should be paid, are matters for them alone.

But the GPC has a saleable catch-line. It claims the uneven distribution of GPs – and partners in particular – is a key driver of health inequalities. It will sell its proposals to ministers as a way of righting the imbalance.

But is that argument sufficient to justify the return of the MPC – even to a Government desperate to add some gloss to its record on inequality? GP partners may not thank the BMA if their freedoms over the employment of doctors are eroded, particularly where they are facing competition from new providers.

The MPC was in any case hardly a resounding success first time around, as our legacy of underdoctored areas demonstrates.

The key may be in designing a new-look MPC that has real powers to target funding towards underdoctored areas – but that won't stifle GP entrepreneurs purely on the basis they practise in areas deemed to have enough doctors.

A system that identified the need for new partners in areas of high deprivation, and provided funding for them, would be welcome. A system that attempted to bar practices in ‘overdoctored' areas from expanding would surely be a backward step.


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